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About

The WiseChoice Healthcare Alliance, led by the Virginia Chamber of Commerce, is a diverse, growing coalition of statewide businesses and organizations supporting benefits consortiums.

Formed from a 30-year partnership between the Virginia Chamber of Commerce and Anthem Blue Cross and Blue Shield in Virginia, the WiseChoice Healthcare Alliance is designed to help drive healthcare engagement and literacy that will lead to improved long-term health and lower healthcare costs.

 

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WHY ARE BENEFITS CONSORTIUMS IMPORTANT?

Benefits consortiums 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

  • For some groups, 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