Nonstop Wellness Health Insurance? Am I missing something?

[El Gringo]

Is anyone familiar with Nonstop Wellness? My wife just got offered a job that includes them as part of the benefits, and frankly, the benefits seem to good to be true...I'm trying to figure out what I'm missing.

For my wife's health insurance she can chose between two HDHPs: a Kaiser HMO or a BlueCross PPO. But then there's this Nonstop Wellness (https://www.nonstopwellness.com/), which is specifically geared towards serving nonprofits. For either HDHP plan that you chose, you then get a debit card associated with Nonstop Wellness. And any out of pocket medical expense you have, you use this debit card to pay - which is not funded by your own money. It's funded by the employer, I think? So your HDHP has a deductible, but you yourself don't pay the out of pocket expenses to reach that deductible. Rather, it's paid by Nonstop Wellness/your employer. So you're essentially getting the low premiums of a HDHP plan, but not having to worry about the out of pocket expenses that come with a high deductible. It seems to good to be true.

Attached are screenshots from the benefit package.

Everything about Nonstop Wellness is also billed as a win-win for both the employer and the employee, but I don't understand how it's a benefit for the employer? My understanding after reading about different types of healthcare funding is that it's a partially self-funded insurance program, which means that it's not as expensive as a fully-funded program covered entirely by the insurance company, but it's not as risky as a self-funded program where costs could unexpectedly balloon for an organization, is that right? If it's so good, why isn't everyone doing this?

And how does Nonstop Wellness make money? Anyone have any experience or insight? As am employee, is there anything to be concerned about? If it's as good as it seems, then I might as well put both of us on her insurance instead of on mine.

Here's some other resources I was reading from:
http://blog.nonstopwellness.com/know-your-options
https://cdn2.hubspot.net/hubfs/569324/NACHC/2017-0714-Nonstop-ViB_FAQs.pdf
https://cdn2.hubspot.net/hubfs/569324/White_Papers/Exploring%20PSI%20July%202017%20v1.pdf

[Chris @ Saturday Financial]

I'm not familiar with Nonstop Wellness, but it certainly seems like a great supplemental plan for employees.

After a quick review of the plan documents you posted, the one thing to be careful of would be getting hit with out-of-network charges, which is sometimes impossible to avoid in hospitals because not every provider is in the same network. Is there an out-of-pocket maximum for out-of-network charges per calendar year? (If I'm reading correctly - there's not. That's the biggest red flag that I would consider from an employee perspective.)

I'm really curious about the cost-savings on the employer side. Compared to fully-funded insurance, I think it's easy to imagine how something like Non-Stop Wellness could save money for a non-profit. For a non-profit that is already self-insured, it's harder for me to imagine how Non-Stop Wellness could save significant money. That being said, I'm curious enough to look into it and consider talking with my VP of HR about doing more in depth research.

ETA: Do you mind sharing how big your wife's new employer is?

[El Gringo]

ETA: Do you mind sharing how big your wife's new employer is?

Hm, I'm not sure. It's a network of community health centers, so it's probably a fairly sizable non-profit. Their LinkedIn page puts them in the 1,001-5,000 employees category.

[Chris @ Saturday Financial]

ETA: Do you mind sharing how big your wife's new employer is?

Hm, I'm not sure. It's a network of community health centers, so it's probably a fairly sizable non-profit. Their LinkedIn page puts them in the 1,001-5,000 employees category.

Good to know. They are definitely big enough that they could choose to self-insure if they wanted. That tells me Nonstop Wellness must be able to provide savings to some organizations even compared to self-insurance.

[happychineseboy]

Health actuary checking in.

Basically this is a lever to encourage you not to seek services out-of-network.

The reason being there are contracts with in-network providers to limit cost and in-network providers are vetted so the quality of care is deemed acceptable.

So really it is a HDHP plan but since the employer basically covers all of the employee in-network cost sharing this acts as a traditional HMO/PPO. There are probably some tax benefits I cannot think of at this time but that is for the employer to worry about

[dandarc]

HSA eligible? It says it is an HDHP, but with the employer paying the "HD", wondering if it still qualifies.

[El Gringo]

HSA eligible? It says it is an HDHP, but with the employer paying the "HD", wondering if it still qualifies.

I'm not entirely sure. The debit card that covers out of pocket expenses is called a Health Reimbursement Account (HRA) and only covers medical and prescription expenses. The packet says "Nonstop VISA card may only be used for your covered medical and prescription expenses: Unlike a Health Savings Account (HSA) your nonstop VISA HRA debit card should only be used to pay for eligible medical and prescription expenses covered under your CareFirst and Kaiser plan. You can use your HSA funds or enroll in the FSA Medical account to cover your dental and vision expenses."

But there's no other mention about HSA in the packet. It only talks about FSA elsewhere.