Learn More About WiseChoice

WHAT IS THE WISECHOICE HEALTHCARE ALLIANCE?

Benefits consortiums like WiseChoice, expand access and lower the cost of coverage for small businesses. Five pillars underpin benefits consortiums:

Provide Broad Access to Small Businesses

• Designed for small businesses with 50 or fewer employees, regardless of health history
• Health status cannot be a condition of participation or association membership
• Sponsoring association may be a Virginia non-profit formed as a 501(c)(6) or 501(c)(5)

Deliver Lower Costs of Coverage

• Cost of coverage is anticipated to be 15-20% less than current small group rates
• All excess reserves – profit – must be used to the benefit of participating members
• Member-managed trusts fully administer the consortium ensuring that member’s interests are served

Ensure Quality Coverage

• Plans must provide essential health benefits
• Minimum allowable coverage is comparable to an ACA Bronze plan
• All plans are guaranteed renewable

Offer Strong Consumer Protections

• No exclusions for preexisting conditions
• Prohibited from establishing discriminatory rules based on health status
• Utilize pool rating methodology that does not discriminate on age or gender
• Consortiums must be annually audited

Maintain Financial Security & Solvency

• Must be licensed and authorized by the Bureau of Insurance
• Must meet the same financial and solvency requirements as all other domestic insurers
• Requires annual certification of actuarially sound underwriting practices
• Subject to ERISA and DOL requirements