Major Medical PPO
(Small Business Owners & Employees)
At JP Direct Health we offer traditional major medical health plans for you and your employees. These group plans are a robust mix of health benefit plans for eligible Small Business Owners and Employees to support overall health and well-being. This option is ideal for a self-employed individual and up to 49 employees.
Types of Plans:
- Co-Pay Based PPO
- Traditional PPO
- Visit Limit PPO
- HSA Compatible PPO
- Dental / Vision
Plan Features:
- Choose any In-Network Doctors/Facilities without a referral.
- Some plans offer In-Network and Out-of-Network benefits.
- PHCS PPO is one of the nation’s largest, most recognizable provider networks with over 60 million members, and over 1 million providers, giving you broad access to quality care.
- No penalties for cancellation.
- Once enrolled, you may change your plan annually.
These plans help cover a range of services, including:
- Preventive care
- Doctor & Hospital
- Emergency & Urgent Care
- Pregnancy & Maternity
- Rehabilitation
- Mental Health
Disclosure: Coverage is subject and limited to plan options selected as described in the policy packet.
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Frequently Asked Questions
ERISA PPO Plan FAQs
What is an ERISA Plan?
An ERISA plan is any employer-sponsored group health benefit plan in the private
sector that falls under the Employee Retirement Income Security Act (ERISA).
sector that falls under the Employee Retirement Income Security Act (ERISA).
What is an example of an employer who offers an ERISA plan?
A Research Corporation that is dedicated to enhancing global well-being by delivering actionable national health insights and wellness market statistics. They employ Research Associates (RAs) to provide information about their health and consumer habits. Employees complete activities in return for guaranteed payments. W- 2s are issued to the employee.
Who can qualify as a hired Research Associate?
Any prospective individual who meets the employment standards and agrees to the terms of employment. Employment standards have some health questions as they are hiring healthy people to answer healthy people surveys.
What benefits are afforded to Research Associates?
Active Research Associates will be eligible to participate in group medical and wellness benefits. Benefits are made available to other similarly situated Research Associates in return for timely payment of premiums. Failure to pay premiums timely may result in loss of coverage under the terms of the plan.
What are the expectations of a Research Associate?
Each month, Research Associates will be sent an email and/or text for the opportunity to add to their de-identified and anonymous data set by participating in a health research activity. Health research activities are accessed through their Research Associate portal. The dashboard also is the employee’s single site for accessing and understanding their benefits. Activities can vary, such as surveys, videos, quizzes, protocols, health coaching, telemedicine, healthcare satisfaction utilization surveys, and others. In return for sharing their data, the Research Corporation will pay them a payment.
If a Research Associate chooses not to complete activities, will this result in termination?
Activities are optional but encouraged as they help monitor and improve health, reducing the risk of dangerous health conditions and lowering healthcare costs. Failure to perform activities may result in termination of employment.
What are qualified health activities?
Research Associates are compensated at an hourly rate for completing health research activities. Payment is calculated on a pro rata basis according to the time spent on each task. Each activity is designed to take 15 minutes or less to complete. Examples of activities include watching videos, surveys, health coaching, logging vitals, and many more!
Who has the option to complete activities in their employee portal?
The employee who holds the Research Associate status is the individual who may complete activities in their employee portal.
When do employee benefits recurring payments come out?
Benefit payment auto-drafts on or around the 15th of each month.
How do Research Associates look up their current providers to make sure they are contracted with the network?
To search for a provider, please access the link below. Additionally, networks
regularly update their provider network list. It is recommended that current or potential
employees check with their provider to confirm participation in their selected network.
PHCS PPO
1.) Highlight PHCS (Logo on front card) and click Select and Search
2.) Enter your search parameters, your zip code, and select Search.
Can changes be made to the policy, i.e., add dependents, move up or down plan levels, change effective dates, etc.?
Changes can be made during the open enrollment period. Outside of open enrollment, changes require a Qualified Life Event (QLE).
Can I cancel at any time? What are the restrictions?
Employees may cancel at any time. No partial refunds are given. For example, if an employee cancels on November 15th, they will be covered for the remainder of November, will not be charged again, and will no longer be covered starting December 1st.