Carrier, network, deductibles, copay structure, and renewal cycle stay exactly as they are. The ESPA is a separate plan.
Employees keep their existing major medical plan. The ESPA adds preventive health benefits and supplemental insurance benefits on top of what they already have.
Your broker keeps the major medical relationship. The ESPA does not require rebidding your medical, dental, or vision lines.
ESPA is structured to add meaningful employee benefits while managing the payroll impact of the program. Individual paycheck results can vary based on compensation, elections, withholding and other payroll factors.
Putting an ESPA in place adds three layers on top of the major medical plan:
An average of $150 a month per employee in supplemental insurance benefits. These are separate, licensed insurance products (Critical Illness, Life, Accident) that pair with the rest of the plan.
When employees use the ESPA for routine and preventive needs, they rely less on the ER, urgent care, and specialist visits. Each of those visits costs the major medical plan something. Over time, fewer of those visits softens claims pressure at major medical renewal.
The ESPA does not promise to lower your major medical premium. What it does is shift routine care to a separate, lower-cost path so that the major medical plan is used for the things it was designed for: hospitalization, major procedures, and ongoing chronic care management.
No. The ESPA pairs with your existing major medical plan. Carrier, network, and renewal cycle stay exactly as they are.
No. Your broker keeps the major medical relationship. The ESPA does not require rebidding any line of coverage.
Not directly. What the ESPA does is shift routine and preventive care to a separate path, which softens claims pressure on the major medical plan over time. The result is typically reflected at renewal, not on next month’s invoice.
No. The ESPA is not major medical insurance. It provides preventive health benefits access (virtual urgent care, primary care, mental health support, specialist navigation, prescription access) plus an annual comprehensive lab panel and an average of $150 a month in supplemental insurance benefits. Hospitalization, major procedures, and chronic disease management remain under your major medical plan.
