2016-03-01 / Medical Info

Small businesses have a more affordable option for medical insurance

By John P. DeTullio, M.D., M.B.A., F.C.C.P.

The recession of 2008 sparked the launch of many small businesses here in central New Jersey, and many have continued to expand and flourish today. While their success supports the backbone of our local economy, many business owners are bogged down by confusion and frustration when it comes to providing affordable, high-quality medical insurance for their employees and families.

CentraState Medical Center, one of the few independently operated community hospital systems in New Jersey, is now addressing this critical issue by sponsoring an exclusive, cost-effective, medical plan that includes the services of nearly 300 Monmouth and Ocean County-based hospital-affiliated doctors, clinicians and specialists.

Affordable local health care without the administrative challenges of the ACA

The CentraState Community Health Plan was established in partnership with QualCare, at the time New Jersey’s largest provider-sponsored managed care organization, and the Affiliated Physicians and Employers Health Plan (APEHP). The APEHP program through which members can access the CentraState Community Health Plan, is a federal and state regulated self-funded Multiple Employer Welfare Arrangement that enables small to midsize employers and physician practices to pool their combined member enrollment to reduce costs and increase service benefits to a level which might otherwise be reserved only for larger employers. It is a member-owned program with all profits used to benefit the enrolled members.

The program’s goal is to improve and protect the community’s health by offering a local, high-quality medical coverage program without the administrative challenges and expenses associated with large insurance companies.

I was fortunate to be part of an extensive team of industry experts who developed this independent medical plan. It enables business owners to forego the Affordable CareAct (ACA) exchange and go directly to the health care provider.

Plan benefit overview

The first health plan of its kind in New Jersey, the CentraState Community Healthcare Plan includes a comprehensive roster of health care options at a cost that may be markedly lower than traditional small business insurance or the ACA exchange.

These unique features include:

• A full-service health plan for businesses with as few as two or more than 50 employees

• Distinct employee plan options at different cost and service levels

• Extensive local and national health care provider list featuring CentraState’s local network of nearly 300 participating providers

• Local program management support tea m•Flexible Spending Account and Health Reimbursement arrangement administration (administrative fee applies)

• Access to CentraState Healthcare System’s campus and services — medical center, Star and Barry Tobias Ambulatory Campus,Women’s Health Center and Health Awareness Center.

A local partnership of physicians ready to serve you, your employees and family members

The CentraState Community Health Plan is available to businesses located in Central Jersey who are current or newly-joining members of the Greater Monmouth, Howell or Jackson Chambers of Commerce. Non-members may join any of these chambers for a nominal fee (health care practices are exempt from this membership requirement).

The Plan is anchored by CentraState Healthcare Partners, LLC, a hospital-affiliated physician organization comprised of nearly 300 participating doctors. This highly qualified group of leading health care providers, including an extensive roster of primary care providers and specialists in every medical discipline, are conveniently located throughout the region.

Supporting the “Live Life Well” campaign

CentraState Healthcare System supports its primary mission,“Live Life Well,” to help every member of its community to live their healthiest life possible by providing access to local, world-class medical care. In order to accomplish this goal, residents — from infants to seniors — must have access to affordable, high-quality, preventive, diagnostic, treatment and rehabilitation health care services.

For more information about the CentraState Community Healthcare Plan, contact a local program representative at 732-428-7025 or info@pierpartnernetwork.com.

Dr. John DeTullio is a pulmonary disease and critical care physician on staff at CentraState Medical Center. He serves on the CentraState Board of Trustees, Strategic Planning Committee and is co-director of Physician Integration. Dr. De- Tullio is also president of CentraState Healthcare Partners. He can be reached at Monmouth Ocean Pulmonary Medicine by calling 732-577-0600.

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