The consumer demand for virtual healthcare options continues to grow, as the 24/7 accessibility and affordability that virtual care offers is invaluable.
Millions of Americans are also dependent on employer coverage for their health insurance needs, presenting employers with an opportunity to be innovative in their benefits strategy without risk or increasing their overall spend.
Enter Overlay Health, the fully insured hospital indemnity plan that provides anytime, anywhere access to virtual integrated primary care… and it doesn’t change your current group health insurance, broker, or HR process.
To be sure, there have been a growing number of employee wellness and virtual care plans competing for your attention, but they are not all created equal and compliance isn’t the only differentiator.
Overlay Health is the IRS compliant, population-health solution designed to work alongside existing group medical coverage. It is not a replacement for major medical, but a supplemental program that integrates three key components: 1) an integrated virtual care model, 2) a fully insured fixed indemnity policy, and 3) an employee engagement framework.
Overlay Health creates value and immediately lowers your healthcare spend.
Employer Savings Through Tax Efficiency
Employees voluntarily elect coverage under a fully insured fixed indemnity policy, with premiums paid on a pre-tax basis through a qualified Section 125 plan. Because these premium elections reduce taxable wages, employers realize a corresponding reduction in payroll taxes (including the employer FICA match of 7.65%); creating a predictable, compliant source of savings without altering employee base compensation.
Meaningful Employee Benefits
Employees gain access to a fully integrated, virtual care experience (including virtual primary care, virtual urgent care, mental health, care navigation, and a prescription drug plan) and the ability to receive fixed indemnity claim payments tied to qualified health-related activities. These claim payments are issued by an admitted insurance carrier and can be used to offset qualified medical expenses for the employee and their household, improving net take-home value when used appropriately.
Engagement-Driven Outcomes
Unlike wellness programs that lack compliant structure, Overlay Health is designed to drive consistent employee engagement––improving access to care while closing the gaps and influencing site-of-care decisions––which supports better health outcomes while reducing unnecessary claims and downstream medical spend.
Most importantly, Overlay Health is built on fully insured coverage, with risk transferred to the carrier and policies filed and approved by state departments of insurance. This structure clearly distinguishes the program from self-insured reimbursement arrangements and ensures alignment with established IRS guidance.
Overlay Health blends 24/7 virtual care with a hospital indemnity policy.
The Overlay Health program provides an individually filed and state Department of Insurance approved coverage. Participating employees receive:
Dedicated Primary Care Team
Employees gain anytime, anywhere access to a dedicated healthcare team for their primary care needs, which closes the PCP gap for most employees.
Hospital Indemnity Policy
Peace of mind with coverage for larger medical expenses and hospital visits.
Zero Cost Benefits & Net Pay Incentives for Participation
Employees receive 24/7 access to care with zero deductibles, zero copays, and increased net income with carrier-paid claims for engaging with the program.
Offsets Medical Expenses Offsets
Financial rewards can be used to offset qualified medical expenses.
The future of employee benefits isn’t about choosing between innovation and compliance… it’s about demanding both. And if you’re evaluating new health benefit solutions to help reduce costs, compliance shouldn’t be an afterthought. It should be the foundation.
As experts in implementing the Overlay Health plan across a broad range of industries, now is the best time to plan and start saving. We are happy to advise you of your options and see if your business qualifies.
Contact us to schedule a free consult: [email protected]
