Elevating
Care.
Reducing
Cost.
A comprehensive proposal for Eagle Fuel Cells
Executive Summary
Eagle Fuel Cells is currently enrolled in a level-funded plan that limits cost transparency and only returns 48.5% of unused claim dollars. Health365+ delivers a fundamentally better alternative by offering lower premium options with richer benefits, full access to critical regional hospitals, and a GAP option that transforms a high-deductible plan into copay-style simplicity. With up to 26% savings and 100% of the unused claim fund returned to you, Health365+ is the clear upgrade over the incumbent plan.
A Journey Reimagined
Health365+ is built on a different idea: real support should feel personal, accessible, and proactive. We achieve this through three core pillars that transform the healthcare experience.
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
This is how we deliver better care and lower costs. 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.
1. AI-Powered Pre-Certification
Our pre-auth service, powered by an AI engine and reviewed by clinicians, dramatically accelerates approvals to meet the CMS 72-hour guideline. This eliminates frustrating delays and creates critical data for our care team.
2. Proactive Clinical Outreach
The moment a procedure is approved, the data alerts the member's dedicated health coach. They don't wait for a call; they reach out immediately to begin care coordination.
3. High-Value Care Guidance
The coach guides the member to the best in-network providers, schedules appointments, and arranges follow-up care. This ensures a better experience, improved outcomes, and lower costs for the plan.
This isn't just about speed; it's about intelligence. Every administrative step is transformed into a proactive care opportunity, ensuring better care, a better experience, and lower costs.
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 condition 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 health coach and no-cost remote monitoring devices. This program is proven to save over $2,040 per engaged member annually.
A Conflict-Free Pharmacy Model
We fundamentally redesign pharmacy benefits to eliminate conflicts of interest, netting 30-40% savings on total drug costs. We deliver your drugs at COST and guarantee 100% of all rebates are returned to the plan.
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.
Transforming Benefits Communication
We lift the burden of benefits education from your HR team. We provide continuous, on-demand education and dedicated support for new hires, helping employees understand and utilize their full benefits package.
Year-Round & New Hire Support
We go far beyond a once-a-year open enrollment meeting. Our team provides dedicated, ongoing education for all employees, including a full onboarding for new hires, ensuring everyone understands their benefits from day one.
BenefitBites: Micro-Learning
We make complex topics simple with short, interactive "BenefitBites" courses. This modern approach makes it easy for employees to get the information they need, when they need it.
Voices of Our Partners
Don't just take our word for it. Here’s what employers, members, and brokers are saying about their experience with the Health365+ model.
"For the first time, I don't feel like I'm navigating my health alone. My coach, Sarah, reached out after my surgery was scheduled and helped me find the best physical therapist. It felt less like an insurance plan and more like a support system."
"The transparency is a game-changer. We finally have access to the data we need to make strategic decisions. The proactive education has taken a huge burden off our HR team, and our employees have never been more engaged with their benefits."
"Health365+ allows me to bring a truly different solution to my clients. Instead of just managing renewals, we're having strategic conversations about controlling costs and improving care. It makes me a more valuable advisor."
How Health365+ Delivers Financial Impact
Our integrated model isn't just better for members; it's better for your bottom line. We reduce costs by addressing their root cause, and 100% of the resulting surplus is returned to you.
Projected Savings by Category
| Savings Category | How It's Calculated | Value |
|---|---|---|
| Direct Premium Reduction | Current Annual Premium – Health365+ Total Cost | $80,543 |
| ACI-Based Rx Pricing | 25% of Total Funding × 35% Savings Factor | $16,761 |
| Pharmacy Rebate Return | 19 Members × $519.03 Per Member | $9,862 |
| Chronic Condition Savings | 15% Engagement × 19 × $2,040 | $5,817 |
| Total Projected Advantage | $112,983 | |
Recommended Plan Options
With Health365+, you gain unprecedented rights and control over your plan. The options below are built on this philosophy.
From Passive Payer to Empowered Owner
| Aspect of Your Plan | Typical Fully Insured Plan | The Health365+ Model |
|---|---|---|
| Access to Claims Data | A "black box" where data is owned and hidden by the insurer. | Full Transparency. Access your plan's data to see exactly where your dollars are going. |
| Plan Design & Flexibility | "One-size-fits-all" menu of off-the-shelf designs. | Designed by you, for you, with the flexibility to meet your workforce's specific needs. |
| Role in Claims Decisions | Powerless outsider. The insurer has sole authority over claims. | Informed Oversight. You are the final authority, supported by a system designed to prevent surprise denials. |
| Financial Control & ROI | Unpredictable annual increases with no real control over costs. | Strategic Cost Management. Finally manage the root cause of costs: member health. |
Tiered Premium Comparison
| Plan | EE Rate | EE Annual | ES Rate | ES Annual | Total Annual | % Savings |
|---|---|---|---|---|---|---|
| Current Renewal | $1,022.21 | $12,266.52 | $2,453.29 | $29,439.48 | $272,315.40 | — |
| Silver H302 | $851.73 | $10,220.76 | $1,634.43 | $19,613.16 | $187,567.56 | 31.1% |
| Gold H202 | $905.36 | $10,864.32 | $1,792.25 | $21,507.00 | $204,648.96 | 24.8% |
| Bronze H405 + GAP | $750.21 | $9,002.52 | $1,335.57 | $16,026.84 | $173,428.80 | 36.3% |
Plan Benefit Comparison
| Plan | Deductible | OOP Max | Coinsurance | Key Notes |
|---|---|---|---|---|
| Current Plan | $2k / $4k | $7.9k / $15.8k | 70% / 50% | High cost, only 48.5% of unused claim fund returned. |
| Silver H302 | $3k / $6k | $6k / $12k | 20% After Ded. | Lower OOP max, stronger Rx, full claim fund return. |
| Gold H202 | $3.25k / $6.5k | $3.25k / $6.5k | 0% After Ded. | Premium design with $0 coinsurance. |
| Bronze H405 + GAP | $8k / $16k | $8.7k / $17.4k | 30% After Ded. | Deductible fully offset via GAP. Member experience mimics copay plan. |
A Stronger, Smarter Network
Health365+ offers a superior network strategy that closes critical gaps in your current coverage, ensuring broader access and better cost control.
Close Critical Gaps
Gain full, in-network access to essential local providers like SwedishAmerican and OSF Medical Group.
Maintain Existing Access
Keep 100% of your current in-network facilities. Your team loses nothing, they only gain.
Enhance National Coverage
Our PHCS wrap provides a true nationwide safety net for employees and their families wherever they are.
Top Utilized Facilities: Before & After
SwedishAmerican Health
Eagle River
Current Plan
❌ OON
Health365+
✓ In-Network
OSF Medical Group
Antigo
Current Plan
❌ OON
Health365+
✓ In-Network
Marshfield Clinic
Minocqua, Merrill, etc.
Current Plan
Limited
Health365+
Full Access
Howard Young Medical Center
Critical access
Current Plan
✓ In-Network
Health365+
✓ In-Network
Aspirus Tomahawk Hospital
Regional emergency
Current Plan
✓ In-Network
Health365+
✓ In-Network
MCHS Hospitals
Rhinelander & Minocqua
Current Plan
✓ In-Network
Health365+
✓ In-Network
GAP Strategy: Financial Protection for Employees
The Bronze H405 plan becomes especially powerful when paired with a GAP solution. This supplemental benefit is designed to bridge the deductible, transforming a high-deductible plan into one with predictable, low out-of-pocket costs for your members.
What GAP Covers
- 100% of the deductible and coinsurance for covered inpatient hospital stays, including room, board, ICU, and surgery.
- 100% of the deductible and coinsurance for covered outpatient procedures, like surgery, ER visits, imaging, and labs.
What GAP Doesn't Cover
- ×Routine office visit copays and prescription drug copays.
- ×Services not covered by the primary medical plan, such as cosmetic or experimental treatments.
Illustrative Claims: The GAP Advantage
Inpatient Stay
A member's 3-day hospital admission totals $12,000. Without GAP, they would pay their full $8,000 deductible. With GAP, they pay $0.
Outpatient Surgery
A member's knee surgery costs $5,500. Without GAP, this falls entirely under their deductible. With GAP, they pay $0.
Emergency Room Visit
An ER visit with a CT scan costs $3,200. Without GAP, this is an unexpected out-of-pocket cost. With GAP, they pay $0.
Our Partnership Pledge
Choosing Health365+ is the first step in transforming your healthcare into a strategic benefit. We are not a vendor; we are an extension of your team, and our success is measured by your success. You will have direct access to our Chief People Officer to ensure our program is meeting the evolving needs of your organization.
Our Pledge to You, the Employer
- We pledge absolute transparency. You will have the access to the data you need to make informed decisions.
- We pledge a proactive partnership. We will bring you data-driven insights and strategic recommendations to continually improve the health of your population and the value of your investment.
- We pledge to deliver a measurable return. We are committed to improving health outcomes that result in lower costs and a more productive workforce.
Our Pledge to Your Employees
- We pledge to always be a compassionate, human-first point of contact. You will be treated with dignity and respect by a care team that knows your name.
- We pledge to be your trusted health advocate. We will help you navigate the complexities of the healthcare system, coordinating care between your providers.
- We pledge to empower you. We will provide the tools, information, and on-demand coaching support you need to achieve your personal health goals.
Jeremy Spreitzer
Chief Executive Officer
Joshua Parise
Chief Innovation Officer
Select Your Plan
Please select your preferred plan option below to move forward. Clicking "Submit Plan Selection" will generate a pre-filled email to notify us of your choice.