Elevating
Care.
Reducing
Cost.
A comprehensive proposal for Asbury Senior Living
A Journey Reimagined
Health365+ is built on a different idea: real support should feel personal, accessible, and proactive. We're on a mission to transform health coverage from a frustrating maze into an experience that is guided, transparent, and genuinely helpful for everyone.
Our Philosophy: A Fundamentally Better Approach
A True Concierge Experience
We provide a dedicated, human-first point of contact for every member, moving beyond call centers to build real relationships and provide expert guidance.
Improving Health to Reduce Costs
Our model is designed to address the root cause of claims. By proactively engaging members to manage and improve their health, we deliver better outcomes and generate sustainable, long-term savings for your plan.
Human-Centric Technology
We leverage powerful, integrated digital tools not to replace human interaction, but to enhance it. Our apps and platforms free our care teams to focus on what matters most: your people.
Our Integrated Care Model
Our model isn't a set of disconnected services; it's one intelligent system that connects technology, data, and human expertise to proactively guide members at every turn. This is how we deliver better care and lower costs:
Care Coordination System
1. Intelligent Pre-Certification
Our pre-authorization service, powered by an advanced AI engine and reviewed by clinicians, dramatically accelerates approvals. This eliminates frustrating delays and creates critical early data for our care team.
2. Proactive Clinical Outreach
The moment a procedure is approved, that data triggers an immediate outreach from the member's dedicated health coach. They don't wait for a call; they reach out proactively to begin coordinating care and support.
3. High-Value Care Guidance
Our health coaches use our proprietary care guidance platform to direct members to the best in-network providers, schedule appointments, and arrange follow-up care. This ensures a better experience, improved outcomes, and lower costs for the plan.
Every administrative step becomes a proactive care opportunity. It's not just about speed; it's about intelligence.
The Coordinated Care Difference
In traditional healthcare, members are often left alone to navigate a web of disconnected providers, labs, and pharmacies. There's no central "quarterback" to manage their care. We solve this problem by acting as the single, reliable hub for all of a member's health needs.
Typical Member Journey
Fragmented, confusing, and stressful.
Member feels unwell and is unsure where to go.
Calls multiple doctor's offices to find an in-network provider and schedule.
Is responsible for coordinating between PCP, specialist, lab, and pharmacy.
Spends hours on hold with the insurance carrier to understand bills and coverage.
Health365+ Coordinated Journey
Unified, proactive, and simple.
Member contacts their dedicated Health365+ Care Team (one call, 24/7 support).
The Care Team promptly finds the right in-network provider and schedules the appointment.
Care Team handles pre-authorizations, specialist referrals, and prescription coordination behind the scenes.
Member has one point of contact for all questions. The process is simple and stress-free.
Core Plan Services
The integrated flow is powered by these foundational services, designed to provide comprehensive support across all aspects of care.
Virtual Direct Primary Care (DPC)
The digital front door to our system. For a $0 copay, members get unlimited, on-demand access to a dedicated care team for acute issues, chronic disease management, wellness visits, and prescription renewals.
Proactive Chronic & Whole-Health Management
Using data from across the ecosystem, we identify at-risk members and engage them with a personal health coach, and a free remote monitoring device (as needed).
A Conflict-Free Pharmacy Model
We fundamentally redesign pharmacy benefits to eliminate conflicts of interest. For high-cost specialty medications, our TPA, Marpai Health, will work with members to utilize Manufacturer/Patient Assistance Programs. Any remaining claim funds at the end of the year are returned to you.
The Health365+ Digital Hub
We empower members and administrators with a unified, intuitive technology platform that simplifies benefits and enhances the human-powered support our care teams provide.
Your Central Hub for Digital Support
Our platform provides a single point of access for all plan-related information and tools, eliminating the confusion of multiple logins and disconnected systems. It's the central hub for a member's entire health journey.
"We believe technology should simplify the healthcare journey, not complicate it. Our platform provides the clarity for transparent decisions while always keeping the member at the heart of a human-centric experience."— Joshua Parise, Chief Innovation Officer
A Better Benefits Experience
We believe that a health plan is only as good as an employee's ability to understand and use it. We lift the burden of benefits education from your HR team by providing direct, expert support to your employees.
Guided Enrollment with Licensed Coaches
During open enrollment, Health365+ provides your employees with direct access to salaried, licensed benefit coaches to walk them through their options and complete enrollment.
BenefitBites: On-Demand Education
We make complex benefits simple with our library of short, interactive micro-learning courses sent directly to employees to teach them how to use their health plan effectively.
Voices of Our Members
Here’s what employees have to say about their experience with the Health365+ model.
"With my old plan, I felt like just a number... The first time I called Health365+, I spoke to a real person who knew my name and solved my issue in minutes. The difference is night and day."
"Managing my diabetes used to be a constant struggle. With Health365+, they sent me a free glucometer that syncs with their app, and my health coach checks in regularly. I feel more in control of my health than ever before."
"I was so stressed when my daughter got sick, but our Health Coach was incredible. She helped us find a top-rated pediatrician in our network and even scheduled the appointment for us. It was a huge weight off my shoulders."
Chicagoland Network Access
The HPN National network provides broad access to major hospital systems throughout the Chicagoland area, enhanced by the PHCS PPO wrap for comprehensive coverage.
| Hospital System / Major Facilities | Combined Access | Notes |
|---|---|---|
| Northwestern Medicine (Northwestern Memorial, Central DuPage, etc.) | ✓ | Covered under both |
| University of Chicago Medicine (Hyde Park, Comer Children's) | ✓ | Covered under both |
| Rush University System for Health (Rush Univ. Med. Center, etc.) | ✓ | Covered under both |
| Loyola Medicine / Trinity Health (Loyola Univ. Med. Center, etc.) | ✓ | Covered under both |
| Advocate Aurora Health (Christ, Lutheran General, etc.) | ✓ | Covered under both |
| Cook County Health (Stroger Hospital, Provident Hospital) | ✓ | Only covered with PHCS wrap |
| North Shore / Endeavor Health (Evanston, Glenbrook, etc.) | ✓ | Covered under both |
| OSF HealthCare (Little Company of Mary) | ✓ | Covered under both |
| Sinai Health System (Holy Cross, Sinai, Schwab) | ✓ | Covered under both |
| University of Illinois Health (UI Health Taylor St.) | ✓ | Covered under both |
| Presence / AMITA legacy (St. Joseph, St. Francis, etc.) | ✓ | Covered under both |
| Silver Cross Hospital (New Lenox) | ✓ | Covered under both |
| Major Children's Hospitals (Lurie, Comer, Advocate, Shriners) | ✓ | Covered under both |
Disclaimer: This hospital system coverage summary is based on independent research. Members are responsible for confirming provider participation directly with HealthSmart, PHCS, or the respective hospital system prior to receiving care.
Available Plan Designs & Rates
With Health365+, you gain unprecedented rights and control over your plan. The options below are built on this philosophy, offering a variety of benefit structures to meet the diverse needs of your employees.
Our Partnership Pledge
Our Pledge to You, the Employer
- Absolute Transparency: You will have full access to all data and insights needed to make informed decisions.
- A Proactive Partnership: We will continuously analyze your population health data and bring you data-driven recommendations.
- A Measurable Return: By improving health and optimizing care, we are committed to lowering costs.
Our Pledge to Your Employees
- A Compassionate, Human-First Point of Contact.
- Your Trusted Health Advocate.
- Empowerment with the tools and information they need.
Jeremy Spreitzer
Chief Executive Officer
Joshua Parise
Chief Innovation Officer
Accept the Proposal
To move forward with a selected plan, please make your choice below. Clicking the "Accept & Proceed" button will generate a pre-filled email to notify us of your decision.
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