For Employers
Stop overpaying for care that doesn't need a claim.
Your funding structure does not change. The events that hit it do.
80% of your healthcare spend never needed insurance. We remove most of your healthcare from the insurance system entirely.
We are not anti-insurance. We are anti-misuse of insurance.
OffPlan fixes the structure, not the symptoms.
The Problem
Every dollar of care runs through the same expensive pipe.
Healthcare is the only line item in your budget that grows by double digits every year while access to care gets worse. A strep test generates a claim. A diabetes check-in generates a claim. A sinus infection runs through a claims adjudication system designed for catastrophic risk. That is like hiring an armored car to deliver mail.
- Routine care is treated like unpredictable risk
- Employers pre-fund costs that may never happen
- Pricing is opaque and disconnected from reality
- Insurance is used for care that doesn't require insurance
The system was built around one assumption: every healthcare dollar becomes a claim. And every claim feeds 25 to 35 percent in middleman extraction across carrier admin, PBM spread pricing, network repricing, broker commissions, billing inefficiency, and prior authorization overhead. None of that buys care. It funds a supply chain.
You are funding far more than you actually need.
The OffPlan Thesis
Pull the 80% out. Let insurance handle the 20%.
OffPlan handles the care that should never have been a claim. Insurance handles what it was actually designed for.
OffPlan is how small businesses pay for healthcare without using insurance for the routine stuff. Your employees get a flat monthly membership for primary care, chronic care, and prevention. Insurance stays in place for surgeries, hospital stays, and major events.
For OffPlan primary and specialty care, no claims, no deductibles, no prior authorizations. Insurance still works as insurance for the events that flow to it, with claims, deductibles, and coinsurance that follow your plan design.
The Engine
Reclassify™.
The claims analysis layer that powers the OffPlan model.
Every employer arrangement starts here. Reclassify™ maps your current spend, identifies what moves out of the claims system entirely, what gets repriced through transparent cash-pay delivery, and what genuinely belongs in insurance. The result is the residual portion of healthcare spend your group actually needs to fund.
It is the methodology behind every sentence on this page. The unbundled stack you are about to see, the claims that disappear, the funding that shrinks, the savings comparison we measure against your total spend instead of just your claims. All of it comes from running your group through Reclassify™ first.
Reclassify™ powers the OffPlan model. It is built and operated by OffPlan.
The Model
Healthcare, Unbundled.
OffPlan separates the care your employees use every day from the insurance they need when something goes wrong. Employees get direct access to care. Coverage stays where it actually belongs.
Insurance
Tier 4: Major Event Protection
Hospitalization. Major surgery. Cancer. ICU. Transplants. Stop-loss placed through licensed carriers. This is what insurance was actually designed for.
Tier 3: Gap Event Protection
ER visits. Urgent care. Injuries. Minor surgeries. Hospital indemnity and accident insurance bridge the gap between routine care and major events. HSA-compatible. Voluntary.
Direct Care
Tier 2: Curated Specialty Access
Specialists, diagnostics, imaging, and outpatient procedures coordinated through pre-vetted, pre-priced cash-pay providers. Paid via employer-funded benefit card. No claim filed. No PPO repricing. No surprise bills.
Tier 1: Primary Care
Same-day primary care. Chronic care management. Prevention. Care coordination. Unlimited visits. $0 copay. Included in the OffPlan membership. The foundation.
OffPlan handles care directly. The bottom half never touches insurance. The top half is exactly what insurance was designed for. You do not assemble any of this yourself. OffPlan coordinates the full stack for your company so you see where every dollar goes.
New for 2026: HSA + DPC now work together.
Federal law now allows employees to maintain HSA eligibility while their employer provides a DPC membership. Pair an HDHP with OffPlan: tax-advantaged savings through their HSA for the 20%, $0 primary care through OffPlan for the 80%.
Hospital indemnity and accident insurance layer on as voluntary benefits without affecting HSA eligibility. The HDHP deductible only applies to hospital visits and major procedures.
What Actually Changes
Less of your healthcare ever becomes a claim.
Under a traditional plan, every visit, every test, and every procedure runs through the claims system. That is the assumption built into how plans are priced. OffPlan changes that assumption.
Primary Care
Included in the membership,
not run through a claim.
Same-day visits, chronic care management, and prevention are delivered through a flat monthly membership. No claim is filed. No deductible applies. The cost does not vary with utilization.
Chronic Conditions
Managed proactively,
not escalated reactively.
Diabetes, hypertension, and other chronic conditions are managed in 45-minute visits with a physician who knows the patient. Conditions stabilize instead of escalating into hospital admissions and ER visits.
Specialists, Imaging, and Procedures
Routed through curated cash-pay,
not billed through PPO repricing.
Specialist consultations, diagnostic imaging, and outpatient procedures route through pre-vetted providers at pre-negotiated cash-pay rates. An MRI that bills at $1,200 to $3,000 through insurance is paid at roughly $350. A specialist visit that bills at $600 to $900 is paid at $200 to $400. No claim filed. No PPO repricing. No surprise bills.
Hospital Events
Insured,
as designed.
Hospitalizations, major surgery, and serious medical events are funded through stop-loss placed with licensed carriers. This is the layer that requires insurance, and the only layer that runs through the claims system.
The result: dramatically less of your healthcare spend ever flows through the claims system. The 80% that should never have been claims is removed. The 20% that requires insurance is protected. The structure changes. The cost changes with it.
What You Actually Fund
The question changes. So does the answer.
Most plans are priced to a single question: how much should we set aside for claims? OffPlan starts somewhere different.
Traditional
"How much should we set aside for claims?"
OffPlan
"After most healthcare cost is removed or reduced, what is left to fund?"
Residual funding, not expected claims.
A traditional self-funded or level-funded plan asks employers to pre-fund expected claims every month, whether or not those claims materialize. OffPlan changes the math by removing most of that spend before it ever enters the claims system.
Primary care is included in the membership. Specialty care is paid at transparent cash-pay rates. Pharmacy is sourced through a transparent PBM. Hospital indemnity bridges the gap. Stop-loss handles the catastrophic layer.
What remains is a residual. A targeted liquidity reserve sized to absorb the timing and volatility of the events that genuinely require funding, replenished as those events occur. Most employers find this residual is a fraction of what they were funding under their previous plan structure. The exact figure depends on your group, your current arrangement, and how much of your spend is reclassified, which is what we model directly with your numbers.
How we measure savings
We compare against your total healthcare spend, not just claims. That includes premiums or claims paid, stop-loss, administration, network access, PBM and pharmacy, and broker or consulting fees. The same components OffPlan replaces or restructures on the other side of the comparison.
Why this matters
Most savings claims in the market are misleading because they compare against claims-only baselines and ignore the hidden costs sitting around them. We measure savings against what you actually pay today, end to end. Apples to apples.
The Multi-Year Picture
The gap widens every year.
Traditional plans inflate at 7 to 10 percent annually. That increase compounds every renewal, because the underlying middleman extraction grows with claims trend. The premium goes up. The deductible goes up. The employee contribution goes up. Year over year over year.
OffPlan core membership pricing is built on a fixed monthly fee, not network-rate inflation. The savings story does not just hold. It widens every year.
Traditional Plan
7 to 10% annual increase
Premium, deductibles, and contributions all compound. Driven by claims trend and middleman extraction that grows alongside it.
OffPlan Stack
2 to 3% annual increase
Membership is fixed-fee, not claims-driven. Specialty layer is cash-pay, not PPO-repriced. Annual lift comes from indemnity and stop-loss market conditions, not the structural OffPlan layers.
The longer you stay, the bigger the gap.
The Platform
More than a doctor. A platform.
Any DPC practice can give your employees a good doctor. OffPlan gives them a good doctor inside a system built to manage your entire population's health, coordinate every referral, and produce the data that earns you better rates at renewal.
Population Health Analytics
Employer-grade reporting on utilization patterns, chronic disease prevalence, claims avoidance, and ER diversion. Not a patient portal. A dashboard that shows your HR and finance teams what is actually happening across your employee population.
This is the data that earns better stop-loss pricing.
Predictive Risk Stratification
OffPlan identifies which employees are trending toward high-cost events before they happen. A diabetic whose A1c is climbing. A pre-hypertensive employee who missed follow-ups. The physician acts proactively because the platform surfaces it.
This is what turns better primary care into lower catastrophic claims.
Employee Onboarding + Engagement
Enrollment communications, benefit education, and ongoing engagement to drive utilization. If employees don't use their OffPlan physician, the claims avoidance doesn't happen. The platform drives adoption so the model actually works.
High participation is what makes the math hold.
Dedicated Employer Account Manager
A named point of contact for your HR team. Handles onboarding, manages enrollment, runs quarterly business reviews with utilization data, coordinates with your benefits advisor. Not a call center. A person who owns your relationship.
OffPlan feels like a benefits partner, not a doctor referral.
Specialty Care Coordination
When a physician determines a specialist is needed, OffPlan coordinates the referral to a pre-vetted, pre-priced cash-pay provider. Provider vetting, rate negotiation, scheduling, and payment via benefit card. The employee shows up. That is it. For cases where a specialist's clinical input is needed but an in-person visit may not be, OffPlan physicians access eConsults to get answers faster and avoid unnecessary referrals entirely.
No standalone DPC practice can build this infrastructure.
Stop-Loss Evidence Packaging
OffPlan compiles clinical and utilization data into an actuarial evidence package your advisor uses at stop-loss renewal. The bridge between "our employees are healthier" and "our carrier believes it and prices accordingly."
Most TPAs don't do this.
No DPC practice even thinks about it.
Your Starting Point
How do you fund healthcare today?
The answer determines how OffPlan slots into your plan. The thesis is the same across all three. The path in is different.
Self-Funded
You already
own the risk.
You understand claims volatility, stop-loss, and admin complexity. You did not choose self-funding for the simplicity.
Routine care is removed from claims. Specialty care is repriced. Fewer events reach stop-loss. You still own the risk. You just hit it far less often.
Learn More
Level-Funded
You took the first step.
This is the next one.
Level-funded plans still ask you to fund expected claims every month, whether or not those claims materialize.
We do not try to fund claims more efficiently. We reduce how much of your healthcare ever becomes a claim. You are not funding expected claims. You are funding what actually remains.
Learn More
Fully Insured
You are paying for a
system you cannot see.
Claims, administration, network access, carrier margin, and broker fees are bundled into one premium. You just pay the total.
Care delivered directly. Pricing visible. Insurance separated and focused. Mid-year transitions are possible depending on your carrier and contract.
Learn MoreThe Employee Experience
Private physician membership.
For every employee.
A dedicated doctor. A direct line. Same-day access. 45-minute visits. This is the care model executives and professional athletes pay $5,000-$20,000 a year for. Your company just made it standard for everyone.
We did not take away their insurance. We gave them a private doctor plus a backup plan. Blue Cross does not give your employees a direct line to a physician. OffPlan does.
Doctors Access
Same day.
See your doctor.
NO
Wait 3 weeks.
See a stranger.
Visit Length
45 minutes, thorough. They
know your name.
NO
12 minutes, rushed.
Cost to See
Your Doctor
$0. Unlimited visits.
No claim.
NO
$40 copay. Claim filed.
After Hours
24/7 access to care. Urgent
needs handled day or night.
NO
Go to urgent care. $150+.
Specialist Referral
We coordinate it.
You show up. You pay $0.
NO
"Good luck finding one."
Imaging
MRI: ~$350. Employer-funded
benefit card. No claim.
NO
You pay ~$1,200 toward
your deductible.
For Benefits Advisors
Working with
an advisor?
OffPlan integrates with your existing TPA, stop-loss carrier, and plan design. We never disintermediate the advisor relationship. We provide co-selling support, ROI modeling, and the clinical data that makes the renewal conversation easier. If you are working with a benefits advisor, have them reach out and we will engage with them directly on your behalf.
More for benefits advisorsWhat Does Not Change
Your stop-loss, your plan, your advisor
stay. Your risk profile improves.
OffPlan changes how care is delivered, not how risk is held. Here is what stays the same, and what is up to you.
Your stop-loss stays in place
Stop-loss stays where it is. In most cases, it improves at renewal because the underlying claims data improves.
Your timing is your call
Cancel your plan and replace it with OffPlan. Layer OffPlan onto your existing plan, especially if it is a high-deductible plan. Or wait until renewal. The decision is yours, and we work with all three.
Your risk profile improves
Your funding structure stays the same. What changes is the frequency of events that hit it. Care is managed before it escalates, claims data improves, and your stop-loss carrier sees the difference.
Your advisor stays at the center
Your benefits advisor stays at the center of the relationship. We work alongside them, not around them.
See your numbers
Stop defending the increase.
Start changing the math.
This isn't a better plan design. It's a different way healthcare gets paid for.