Moda Health small group medical plans
When you’re choosing a medical plan for your small business, you want to find quality coverage for your employees at the best value. Moda Health small group medical plans provide coverage that includes quality providers, additional value, and added benefits to help your employees on their health journey.
Finding the plan that’s right for you
Small group medical plans are a balance of quality and value, with flexibility and choice. We have a large selection of plans that will meet your company’s and employees’ needs.
Choice and value from a quality network
All Moda Health small group plans include a large provider network that gives your employees options when looking for a provider, clinic, pharmacy, lab or hospital. They’ll have the freedom to choose a provider that fits their needs and the confidence to know they’re getting quality care.
Comprehensive coverage and valuable add-ons
Moda Health medical plans protect your employees with comprehensive benefits including primary care, specialty care, and pharmacy services. Our plans also cover behavioral health and preventive care, ensuring your employees keep feeling their best.
Compassionate customer service
Our caring customer service team is here to help your employees. Trained and experienced service team members — real people — take your calls, find the answers your employees need, and help them anticipate what’s next.
Deciding on a plan
A Moda Health medical plan for small groups (1-50 employees) varies by plan type and by metal levels (categorized by out-of-pocket costs). As you review the different plan types, keep in mind the differences between plan costs and their features and benefits to find the plan that’s right for your group.
Metal levels
- High monthly premiums
- Cover ~ 80% of cost of care
- Mid-level monthly premiums
- Cover ~ 70% of cost of care
- Lowest monthly premiums
- Cover ~ 60% of cost of care
Preferred Provider Organization (PPO)
Traditional PPO plans offer the broadest provider coverage. Members can visit any provider they choose, but they'll get the best benefits, a great selection of doctors and broad geographic coverage when visiting an in-network PPO provider.
Moda Select's preferred provider option (3-Tier)
These plans are designed to serve members living in the Municipality of Anchorage, Fairbanks North Star, Haines, Ketchikan Gateway, Kenai Peninsula, Mat-Su, Petersburg and Municipality of Skagway Boroughs, City and Borough of Juneau, City and Borough of Sitka, City and Borough of Wrangell, Hoonah-Angoon Census Area and Prince of Wales-Hyder Census Area. There are additional Moda Select service areas in Idaho and Texas.
The Moda Select Network was developed to provide cost-effective, coordinated care. Moda Select offers three benefit levels (tiers) of healthcare:
- Tier One. Includes Central Peninsula Hospital, Alaska Regional Hospital, PeaceHealth Ketchikan Medical Center, South Peninsula Hospital, Bartlett Regional Hospital, Mat-Su Regional Medical Center, Fairbanks Memorial Hospital, SEARHC and other Tier One contracted providers.
- Tier Two. Includes the First Choice Network in Alaska
- Tier Three. Includes all other Alaska providers not in Tier One or Tier Two.
Members can use any professional provider or hospital. However, Tier Three providers can balance bill when permitted by law. Members receive the best benefit by using Tier One providers.
High-deductible health plan (HDHP)
HDHPs work best when paired with a health savings account (HSA). This allows members to use tax-free funds for eligible healthcare expenses.
HDHP + HSA plans are best for:
- Members who are relatively healthy and don’t expect to need frequent healthcare
- Members who want lower monthly premiums and can cover out-of-pocket costs
Vision coverage
Some Moda Health small group medical plans include vision coverage for adults.
The small business health care tax credit
If you are a small employer, there is a tax credit that can put money in your pocket. The small business health care tax credit benefits employers that:
- Have fewer than 25 full-time equivalent employees
- Pay an average wage of less than $65,000 a year (adjusted for inflation annually)
- Pay a uniform percentage of employee premium for all employees that is equal to at least 50% of the premium cost of employee-only insurance coverage
Questions?
There’s a lot to consider when selecting a plan for your employees. We’re happy to help. Contact our Sales and Account Services team at 800-578-1402.