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Working With Small Employers vs. Large Employers as a DPC
Whether you know it or not, a lot of DPC clinics already work with employers. Many DPC clinics have agreements with small employers, less than 50 employees, to provide primary care services for their employees. Employers with less than 50 employees are not required by law to provide insurance plans and due to the high costs, many do not offer health insurance as a benefit. More often than not, when these small employers do offer insurance plans they are often expensive to the employees in both premiums and deductibles leading most employees to reject the insurance plan. In the current law, small employers with less than 50 employees are not required to offer insurance, and individual employees are not required to accept the insurance plan if their employer offers one (no more individual mandated coverage).
However, some small employers do want to offer some health care benefits and find DPC as an incredible option for their employees. These small employers can contract directly with DPC clinics like yours and cover the monthly fees. The employer can pay for the entire monthly fee or they can split the costs with employees. For instance, the employer pays half of the monthly fee (half the fee from the employer and half comes out of the employee's paycheck). Either way, the employer collects all the fees owed to the DPC clinic and sends one payment a month for all the employees participating in the DPC services. Usually, in this arrangement, the employee would be responsible for any other charges incurred at the DPC clinic like dispensed generic meds or lab fees.
Large employers, those employers with 50 or more employees, are required to offer health insurance in our current health system and these plans must meet certain standards. (Employees of these larger employers are still not required to accept the insurance plans.) These larger employer health insurance plans may or may not work well with DPC as it depends on how the plan is set up. As the number of employees a company has increases, the type of insurance plans options do as well. Employers with more than 100 employees will get the most benefit of lower costs from using a self-funded (see insurance basics link) form of health insurance which allows them to be more creative in designing the health plans. These plans allow employers to really put DPC into the health plan as a full benefit and get the most bang for the buck. More large employers, with hundreds of employees, are using these self-funded type plans wrapping them with DPC as cost-saving options for their employees. The trick here is getting all the players--DPC docs, benefits advisors, and employers--at the table and talking on the same level.
So in review, smaller employees not offering insurance plans are low-hanging fruit for most DPC clinics allowing clinics to add 10 to 30 employees to DPC clinic services with little interference of brokers/advisors or regulators. Larger employers that are required to offer health insurance can be much trickery as there will be brokers or advisors involved and more regulations for the employer to follow. These extra players certainly require more work for the DPC clinics to be involved.
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Working With Small Employers vs. Large Employers as a DPC
Whether you know it or not, a lot of DPC clinics already work with employers. Many DPC clinics have agreements with small employers, less than 50 employees, to provide primary care services for their employees. Employers with less than 50 employees are not required by law to provide insurance plans and due to the high costs, many do not offer health insurance as a benefit. More often than not, when these small employers do offer insurance plans they are often expensive to the employees in both premiums and deductibles leading most employees to reject the insurance plan. In the current law, small employers with less than 50 employees are not required to offer insurance, and individual employees are not required to accept the insurance plan if their employer offers one (no more individual mandated coverage).
However, some small employers do want to offer some health care benefits and find DPC as an incredible option for their employees. These small employers can contract directly with DPC clinics like yours and cover the monthly fees. The employer can pay for the entire monthly fee or they can split the costs with employees. For instance, the employer pays half of the monthly fee (half the fee from the employer and half comes out of the employee's paycheck). Either way, the employer collects all the fees owed to the DPC clinic and sends one payment a month for all the employees participating in the DPC services. Usually, in this arrangement, the employee would be responsible for any other charges incurred at the DPC clinic like dispensed generic meds or lab fees.
Large employers, those employers with 50 or more employees, are required to offer health insurance in our current health system and these plans must meet certain standards. (Employees of these larger employers are still not required to accept the insurance plans.) These larger employer health insurance plans may or may not work well with DPC as it depends on how the plan is set up. As the number of employees a company has increases, the type of insurance plans options do as well. Employers with more than 100 employees will get the most benefit of lower costs from using a self-funded (see insurance basics link) form of health insurance which allows them to be more creative in designing the health plans. These plans allow employers to really put DPC into the health plan as a full benefit and get the most bang for the buck. More large employers, with hundreds of employees, are using these self-funded type plans wrapping them with DPC as cost-saving options for their employees. The trick here is getting all the players--DPC docs, benefits advisors, and employers--at the table and talking on the same level.
So in review, smaller employees not offering insurance plans are low-hanging fruit for most DPC clinics allowing clinics to add 10 to 30 employees to DPC clinic services with little interference of brokers/advisors or regulators. Larger employers that are required to offer health insurance can be much trickery as there will be brokers or advisors involved and more regulations for the employer to follow. These extra players certainly require more work for the DPC clinics to be involved.