Redirect Everyday Claims
Telemedicine visits, common prescriptions, labs and coaching are handled through the Preventive Care Plan, so routine care stops adding up as claims on the major medical plan.
Preventive Care Program
A Smart Way to Help Your Employer Clients Lower Their Annual Healthcare Costs
The Cennairus Preventive Care Program works in tandem with an employer’s existing health plan, whether it is fully insured, self-funded or level-funded. Employees get access to preventive care, virtual care, health coaching and mental health support. For self-funded and level-funded groups, pairing it with the major medical plan also helps reduce utilization by redirecting everyday claims, like telemedicine and prescriptions, to the Preventive Care Plan. Every part of the program is designed to follow federal benefit, tax and privacy rules.
Cennairus is a licensed wholesale broker. You stay agent of record and earn a monthly recurring PEPM (Per Employee Per Month) commission for every enrolled employee. We bring the program, the plan review and the implementation team.
This program
Works with the plan your client already has.
Built on IRS, ACA, ERISA and HIPAA rules. How we stay compliant →
Request a Program Review
Tell us about the group. We’ll look at eligibility and the current plan and walk you through how the program would work. No obligation.
Photos: Vitaly Gariev / Pexels
Adds to fully insured, self-funded and level-funded plans. No plan redesign and no re-underwriting.
Screenings, virtual care, coaching and mental health support that help employees stay healthy.
Written plan documents, voluntary participation and privacy protections are part of every implementation.
Our team and a third-party administrator handle setup, enrollment and ongoing administration.
Recurring Income for Your Agency
Earn a monthly PEPM (Per Employee Per Month) commission on every enrolled employee. We register you with the program under the Cennairus umbrella and handle implementation and ongoing support.
Live Broker Webinar Series
Get an insider’s look at the Cennairus Preventive Care Plan before your competitors do.
Here’s a healthcare savings strategy you can bring to the table this year. Join us live to see how the Cennairus Preventive Care Plan layers with an existing self-funded or level-funded plan to help reduce routine expenses and claims, with no plan redesign or disruption to coverage.
What You’ll Learn
Pick Your Session
4:00 PM ET · Live on Zoom
6:30 PM ET · Live on Zoom
Seats are limited. Save your spot today. Questions before then? E-mail Frank.
For licensed insurance professionals only. Any savings discussed are potential, not guaranteed, and vary by plan design, participation and claims experience.
For Self-Funded and Level-Funded Plans
Self-funded and level-funded groups see additional benefits by pairing the Preventive Care Program with their major medical plan. It is a practical way to reduce plan utilization, because everyday care that would normally run through the health plan as a claim is redirected to the Preventive Care Plan instead.
Telemedicine visits, common prescriptions, labs and coaching are handled through the Preventive Care Plan, so routine care stops adding up as claims on the major medical plan.
After the first plan year, lower utilization starts to show in the group’s claims history. That experience gives the broker more leverage when negotiating the stop-loss renewal.
Fully insured plans: the program pairs with fully insured plans too, and employees get the same preventive care and wellness benefits. Claims redirection savings and stop-loss leverage do not apply, because the insurance carrier holds the claims risk.
Results depend on participation, plan design and each group’s claims experience. Stop-loss renewal terms are set by the carrier and are not guaranteed.
Program Overview
The program has two parts that work together. The Preventive Care Plan is a self-insured medical plan that covers eligible preventive health services and medical care, as defined under IRS Sections 105 and 213(d).
The Cafeteria Plan, under IRS Section 125, lets employees pay for the Preventive Care Plan with pre-tax dollars. It does not provide benefits on its own. It is the payment vehicle.
The program does not replace major medical coverage. Employers keep their current health plan, and the program adds preventive care and wellness support on top of it.
Our Medical Partner
The medical and health management side of the program is delivered by US HealthCenter, a complete health management company and the creator of the PredictiMed™ platform. US HealthCenter designs the Preventive Care Plan framework and provides the health analytics, care navigation and engagement that make the program work.
Its approach is built to improve health outcomes through health management science, technology and advocacy, and it is designed to complement an employer’s existing medical plan and wellness programs.
We identify risk early, empower individuals with meaningful insights, and support sustainable lifestyle change.
— US HealthCenter
ERISA-based preventive care frameworks, aligned with the employer’s goals, with support for implementation, documentation and coordination with existing benefit platforms.
Evidence-based, third-party validated risk analytics that start with a personalized online health assessment and identify health risks early.
Care navigation, personalized advocacy and targeted health management resources that help employees make lasting changes.
Employers see an overall snapshot of the health risks in their workforce, never an individual employee’s health information.
What’s Included
A health risk assessment, biometric results and wearable syncing in one place, with personalized care paths.
Access to licensed practitioners by phone or video, including common prescriptions.
Access to behavioral therapists and an Employee Assistance Program.
Certified health coaches for lifestyle changes and chronic condition management.
Preventive screenings and lab work that help catch health risks early.
Apps and self-help programs for mental health, family, lifestyle and financial wellness. See the suite.
Healthcare costs in the U.S. rise sharply year after year, and businesses need new solutions that work for both the business owner and the employee.
Additional Employee Benefits
Living 2.0 is a bundle of science-based health and wellness apps and self-help programs designed to improve employees’ lives and help them save money. Members connect through their Personal Health Dashboard on the “My Benefits” page.
Living 2.0 services are provided by third parties and are subject to their own terms, eligibility requirements and fees. Financial services are not insurance and are not part of the Preventive Care Plan’s medical benefits.
How It Works
Eligible employees are automatically enrolled in the Preventive Care Plan through the Cafeteria Plan, using pre-tax salary reduction. Any employee can opt out during the opt-out window.
Participants complete qualifying preventive activities, such as a health assessment, screening or coaching session.
The Preventive Care Plan pays a benefit through payroll, clearly identified as a plan payment.
The administrator keeps records that substantiate each benefit, as the tax rules require.
Program Materials
Compliance
Preventive care programs are regulated at several levels. Here is how each rule applies to ours, in plain terms.
Governs cafeteria plans. It allows employees to pay for qualified benefits with pre-tax dollars under a written plan document.
Define what counts as medical care and how benefits from an employer health plan are treated for tax purposes.
Sets the rules for wellness programs. Participation must be voluntary, open to all similarly situated employees, and never based on health status.
Requires written plan documents, clear communication to participants, and fiduciary responsibility in how the plan is run.
Protects employees’ health information. Individual health data is never shared with the employer.
Prohibit discrimination based on disability or genetic information, and limit what health questions can be asked.
How to Get Started
Complete the business associate agreement and new client forms.
Share an employee census so we can review eligibility and prepare a client-specific analysis.
The third-party administrator provides the Cafeteria Plan documents and sets up payroll.
Employee communication, a payroll dry run, and live enrollment.
Email your census to frank@cennairus.com with the subject line “Preventive Care Census.”
Worth Knowing
Employers keep their current health plan. Need one? See Health Benefits.
The program does not replace specific or aggregate stop-loss insurance.
Tax treatment depends on plan design. Employers should review the program with their own advisors.
Employees can opt out. No one is required to share health information.
FAQs
No. The program works alongside the current plan, whether it is fully insured, self-funded or level-funded.
Yes. The program can be paired with any plan type, and employees get the same preventive care and wellness benefits. The claims redirection and stop-loss renewal benefits apply only to self-funded and level-funded plans, because with a fully insured plan the carrier holds the claims risk.
Yes. Every eligible employee can opt out, in line with ACA wellness program rules.
No. Individual health information is protected under HIPAA and is not shared with the employer.
The tax treatment of fixed indemnity wellness benefits is supported by independent legal opinion, but it remains an evolving area of IRS guidance. Employers should review the program with their own tax and legal advisors before they implement it.
A third-party administrator provides the Cafeteria Plan documents and handles ongoing administration and recordkeeping.
Request a program review. We’ll look at the group’s eligibility and current plan and walk you through how the program would work.
Request a program review. No obligation.
Frank J. Alessio, Executive Director · (D) 941.866.3403 · Frank@cennairus.com · www.cennairus.com
The Cennairus Preventive Care Program is not major medical insurance and does not replace an employer’s health plan. The tax treatment of fixed indemnity wellness benefits is supported by independent legal opinion but remains an evolving area of IRS guidance. Results depend on plan design, participation and proper substantiation. This material is for informational purposes only and does not constitute legal, tax, or accounting advice. Employers should consult their own advisors before implementation.
