The Future of Healthcare Coverage

Worksite’s Innovative Health Plan

There’s no denying the challenges employers face when it comes to finding affordable, quality healthcare for employees. With our Innovative Health Plan, the days of large renewal increases and the annual scramble to find affordable coverage are finally over.

Bringing new options to employers with a unique approach to health coverage

Affordable Pricing

The low fixed rates are made available by Worksite for all employees and there are three different choices in coverage. Our large participant pool helps minimize annual rate increases.

No Underwriting

No census or health questionnaires. Approval is guaranteed.

PHCS/MultiPlan Network

Extremely deep network of providers under the PHCS/Multiplan network, a nationwide PPO network.

Low Participation Requirements

To qualify you only need two employees to enroll.

Under 50 Employees?

Employers are not required to contribute.

Over 50 Employees?

Employers are required to contribute.

All plans are ACA compliant.

A Closer Look

The days of accepting the traditional healthcare monopoly, enduring large renewal increases, and scrambling to find affordable coverage are over. Worksite’s innovative approach is the first step in taking control of your company’s healthcare future.

Frequently Asked Questions

Worksite’s Innovative Health Plan is a level-funded health plan, so technically there is no carrier. The plan uses the PHCS/Multiplan Network, a national network of doctors and hospitals that are under contract to provide services.

The PHCS/Multiplan Network is a network of thousands of doctors and hospitals under contract to provide services to anyone in the network. Established in 1980, the PHCS/Multiplan Network has providers in all 50 states.

To locate providers participating in the PHCS/Multiplan Network, call 888.263.7543 or visit www.multiplan.us and follow these steps:

  1. Click “Find a Provider” located on the top right-hand corner.
  2. After acknowledging the disclaimer, click on the green “Select Network” button.
  3. When selecting your network, choose “PHCS” then “Practitioner & Ancillary”.
  4. Enter one of the search criteria suggested in the search box to begin your search.
  5. If your browser settings don’t allow location to be detected, enter your zip code.

The provider’s billing department should call 866.862.6935 to confirm eligibility. This is often more efficient than working with the office’s front desk. The phone number can also be found on the back of each PHCS card issued to your employees.

No, this is a group plan offered by Worksite. Upon enrolling, each group (client) becomes their own plan sponsor. Claims management and eligibility questions are handled by S&S Health:

https://secure.healthx.com/ssh.aspx
866.862.6935

For office visits, copays are paid at the time of service. A bill will be sent to the employee to collect copays for additional services, like imaging.

There is a one-time $25 processing fee to set up your group. Worksite will pay that to the PHCS/Multiplan Network and pass the cost through on your PEO invoice.

There is no underwriting required. All groups are automatically approved.

A minimum of two participants are required per enrolled group.

If your company has less than 50 full-time equivalents, you are not required to contribute to the plan.

If you are an Applicable Large Employer with more than 50 full-time equivalents, you must make the plan affordable according to IRS guidelines by contributing a minimum of 50%. 

Regardless of which month your company begins coverage, the renewal will be January 1.

Yes. Worksite and its partners administer the plan. We will pay and reconcile invoices and handle all terminations, additions, and changes.

Yes, premium deductions begin the month prior to the effective date.

The amount not collected can be charged to the employer and collected from the employee when they have sufficient wages. Worksite can work with the employee to spread out the payments to avoid a significant impact on their paycheck.

If they get an Explanation of Benefits, it will come from S&S Health. If it is a bill, it will come from the provider (doctor or hospital) directly.

Many medications, including maintenance drugs, are available by mail order. Others, like antibiotics, can be picked up at a local pharmacy.

Staying in-network is highly recommended. Reimbursement for out-of-network services is not guaranteed. Employees can request reimbursement by sending a copy of the receipt from their provider and a picture of the front of their PHCS card to: S&S Health, PO Box 18233, Cincinnati, OH 45218. The address can also be found on the back of their PHCS card. Employees should refer to the Summary of Benefits for more information. 

Let's get started!

Plan participants, call S&S Health at 866.862.6935
to confirm if a service is included.

Call 941.677.0110 for more information
or email IHP@WorksiteEmployee.com