Resources

Learn, compare, and stay compliant

Everything you need to make confident health plan decisions.

Frequently asked questions

Browse answers organized by plan and topic. Click any question to expand its answer.

Cigna PPO Association Health Plan (AHP)

PHCS PPO + Reference-Based Pricing (RBP) AHP

Northwell Direct + Blue Cross Blue Shield

LevelMax

LevelFlex

MEC Max

MEC Flex

MVP Max

MVP Lite

ACA Penalty A Prevention

ACA Penalty A & B Bundle

Individual Plans (Telemedicine & Smart Hospital Saver)

Learn, compare, and stay compliant

FAQs

Blog

Glossary

ACA Compliance Center

Downloads

Frequently asked questions

Cigna PPO Association Health Plan (AHP)

PHCS PPO + Reference-Based Pricing (RBP) AHP

Northwell Direct + Blue Cross Blue Shield

LevelMax

LevelFlex

MEC Max

MEC Flex

MVP Max

MVP Lite

ACA Penalty A Prevention

ACA Penalty A & B Bundle

Individual Plans (Telemedicine & Smart Hospital Saver)

Learn, compare, and stay compliant

FAQs

Blog

Glossary

ACA Compliance Center

Downloads

Frequently asked questions

Cigna PPO Association Health Plan (AHP)

What is an Association Health Plan?

Is this a fully insured health plan?

Are my premiums fixed?

Is the network nationwide?

Who can enroll?

PHCS PPO + Reference-Based Pricing (RBP) AHP

What is an Association Health Plan?

Is this a fully insured health plan?

Are my premiums fixed?

Is the PHCS network nationwide?

What is Reference-Based Pricing (RBP)?

How is RBP used in this plan?

Who can enroll?

Northwell Direct + Blue Cross Blue Shield

What is the Northwell Direct Health Plan?

Is this a multi-employer health plan?

Is this a fully insured health plan?

Can my company enroll at any time during the year?

Are Personal Health Questionnaires (PHQs) required?

Is there a minimum group size or participation requirement?

Can individuals apply for coverage?

Do employees have to use Northwell providers?

Can employees use doctors outside of New York?

Which plan should I choose?

Why are premiums often lower than traditional health plans?

Can I keep my current doctor?

Where can I search for Northwell Direct Providers?

Is this plan available nationally?

How do I get a quote?

Is this a two-tier health plan?

Who is the agent for this health plan?

Where can I learn more about Northwell Direct?

Can I contact Memberly Benefits directly?

LevelMax

What is LevelMax?

Who manages the LevelMax health plan?

What is the role of the Third-Party Administrator (TPA)?

Do I need to worry about high claims or cost overruns?

What is stop-loss?

Who pays the claims?

Can I start at any time of year?

Do I need claims experience to establish this plan?

Who returns the unused claims funds if there is a surplus?

How is the claims account tracked during the year?

When do I receive the final reconciliation and any surplus funds?

Can I have both PPO and RBP plan options?

Can an RBP plan still use PPO networks?

What PPO networks are available for hybrid PPO/RBP designs?

Can a BUCA carrier PPO be used as the network in a Hybrid PPO–RBP plan?

What determines whether a hybrid PPO/RBP model will work?

What is the difference between LevelMax and LevelFlex?

Can I contact Memberly Benefits directly?

LevelFlex

What is LevelFlex?

Who manages the LevelFlex health plan?

What is the role of the Third-Party Administrator (TPA)?

Do I need to worry about high claims or cost overruns?

What is stop-loss?

Who pays the claims?

Can I start at any time of year?

Do I need claims experience to use this plan?

Who gives me the money back if there is a surplus?

How is the claims account tracked during the year?

Do I receive a final reconciliation and surplus report?

Can I have both PPO and RBP plan options?

Can an RBP plan still use PPO networks?

What PPO networks are available for hybrid PPO/RBP designs?

Can BUCA carrier PPO networks be used in an RBP design?

What determines whether a PPO/RBP hybrid model will work?

If LevelFlex isn't level-funded, why is it called "LevelFlex™"?

Who designs and creates the LevelMax and LevelFlex health plans?

Can I contact Memberly Benefits directly?