Fully Insured Employers with HDHP
Keep your current carrier and HSA plan. Add OffPlan underneath it for the care employees actually use.
Make your HDHP actually work.
Most employees with an HDHP feel uninsured until something catastrophic happens. The deductible is high. Routine visits feel out of pocket. Specialty referrals are chaotic. The plan technically exists but is rarely used the way it was supposed to be. OffPlan fixes that without changing your carrier, your network, or your funding structure.
The HDHP Problem
The plan technically exists. It is rarely used.
Employees feel uninsured until something catastrophic happens.
You moved to a high-deductible plan because the premiums were sustainable. Most employers with 5 to 250 employees did the same thing for the same reason.
The math worked on the spreadsheet.
The deductible was supposed to make employees better consumers of healthcare. In practice it makes them avoiders of healthcare. The plan that was supposed to protect them becomes the plan they cannot afford to use.
- Employees skip the primary care visit because of the deductible
- Small problems become bigger problems six months later
- Urgent care becomes the default for issues a doctor should have caught
- Chronic conditions go unmanaged because there is no relationship with a physician
- The ER becomes the path of least resistance when something finally breaks
How it Fits
OffPlan goes underneath your existing plan.
Two layers. Each one does what it was actually built for.
Layer 1 · Existing Plan
Your HDHP, unchanged.
Your current carrier. Your current network. Your current renewal cycle. Your current broker. The HDHP continues to do what HDHPs do well: protect against catastrophic events.
- Hospitalization and ICU
- Major surgery
- Cancer treatment and chronic complex care
- HSA-qualified plan design preserved
Layer 2 · OffPlan
The care layer underneath.
A direct primary care membership and care navigation platform that handles the 80% of healthcare employees actually use day to day. No claim filed. No deductible applied. No surprise bill.
- Unlimited primary care visits
- Same-day and next-day access
- Chronic care management
- Curated specialty access at transparent cash-pay rates
Keep the insurance. Replace the everyday care experience underneath it.
The Employee Experience
What changes for the people on the plan.
Your CFO and HR team eventually have to explain this to employees. Here is what to say. The HDHP and HSA stay exactly as they are for hospital and major events. Everything else gets noticeably better.
| Experience | Today | With OffPlan |
|---|---|---|
| Routine sick visit | Wait two weeks. Pay toward the deductible. Probably skip it. | Same-day visit. $0 out of pocket. No claim filed. |
| Chronic condition follow-up | 12-minute appointment. Different doctor each time. | 45-minute visit with a physician who knows the patient. |
| After-hours need | Urgent care or ER. $150 to $2,500 toward the deductible. | Direct line to the OffPlan physician. No deductible applied. |
| Specialist referral | Find one in network. Wait six weeks. Pay toward the deductible. | OffPlan coordinates a curated specialist at a transparent cash-pay rate. |
| Hospital or major event | HDHP and HSA cover it as designed. | HDHP and HSA cover it as designed. No change. |
HSA Strategy for 2026
HSA + DPC now work together.
For years, federal rules made it difficult to combine an HSA-qualified HDHP with a direct primary care membership without disqualifying the HSA. The 2026 rule change removes that barrier. Your employees can keep contributing to their HSA while their employer adds OffPlan underneath the plan.
HSA eligibility preserved
Employees remain in an HSA-compatible HDHP while participating in a qualifying DPC arrangement. The structure that made tax-advantaged contributions possible stays intact.
HSA dollars may apply
Under the new federal rule, DPC membership fees can be paid from HSA dollars up to $150 per month for individual coverage and $300 per month for family coverage.
Funding flexibility
Employers can fund OffPlan as a benefit, structure a hybrid contribution, or position it as voluntary. The right answer depends on the group, the workforce, and the budget.
How OffPlan gets funded under your HDHP.
OffPlan's individual rate sits above the federal HSA reimbursement cap, which means HSA dollars alone cannot fully fund the membership. That said, there is no single funding answer that fits every employer. Some groups fund OffPlan fully as an employer-paid benefit. Some structure a hybrid model where the HSA covers a portion and the employer absorbs the rest. Some position OffPlan as a voluntary, employee-funded benefit. We design the funding mechanic with each employer based on the budget and the workforce.
Curated Specialty Access
The deductible zone, simplified.
High-deductible members are paying first-dollar costs for most services until the deductible is met. OffPlan guides them toward lower-cost, transparent care pathways that reduce out-of-pocket spend without changing what their carrier covers when they need it.
What OffPlan coordinates
- Transparent imaging at pre-priced cash-pay rates
- Cash-pay specialist access through pre-vetted providers
- Ambulatory surgery center pathways for outpatient procedures
- Second opinions and care navigation
- PCP-led referral guidance with eConsult deflection
- Lower-cost alternatives surfaced before care escalates
Concrete Example
Knee MRI under an HDHP versus OffPlan.
An employee has a sore knee. The orthopedist orders an MRI. Through the HDHP, the MRI bills at $1,200 to $3,000 and applies entirely toward the deductible. Through OffPlan, the same imaging is coordinated at a partner facility for roughly $350 paid via employer-funded benefit card.
The OffPlan physician reviews the result and coordinates the next step. The employee sees a faster, simpler experience. The employer sees lower utilization against the carrier network. No claim filed. No PPO repricing. No surprise bill.
Why Employers Like This Model
Add a layer. Do not blow up the plan.
This is the version of the OffPlan story for employers who know their HDHP is financially necessary but want to make it feel less broken for employees. No carrier replacement. No broker disruption. No multi-quarter implementation.
Keep the insurance.
The HDHP, the carrier, the network, and the renewal structure stay in place. The page does not ask you to migrate to self-funding or change your contract.
Improve employee satisfaction.
Same-day access, 45-minute visits, $0 routine care, and care navigation. The benefit employees feel is the benefit they actually use.
Improve care utilization.
Employees use primary care because primary care is genuinely accessible. Conditions get caught earlier, managed proactively, and resolved before they escalate.
Renewal data improves.
Lower utilization in the carrier's claims data over 12 to 18 months gives your broker a stronger renewal conversation. Better claims experience tends to soften renewal pressure.
Mid-contract flexible.
You do not have to wait for renewal. OffPlan can layer in immediately as a supplemental benefit without touching your existing carrier contract.
Predictable cost.
OffPlan's primary care layer is a fixed monthly fee, not a claims-driven cost. The number you sign up for is the number you pay.
OffPlan does not change your risk model. It reduces how often employees hit it.
For Your Benefits Advisor
OffPlan works with your broker.
OffPlan does not replace the broker relationship. We work alongside your benefits advisor and provide co-selling support, ROI modeling, and the clinical and utilization data that makes the renewal conversation easier. Your advisor stays at the center of the relationship.
Mid-Contract Employers
You do not have to wait for renewal.
If you are mid-contract with your carrier, OffPlan can layer in immediately as a supplemental benefit. Your existing carrier contract, plan design, and renewal cycle are untouched. Implementation is a matter of weeks, not quarters.
Who This Path Fits
Best for HDHP employers who want change without disruption.
Not every employer is ready to restructure their entire benefits architecture. Many are ready to make one strategic addition that improves what their workforce actually experiences.
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✓Fully insured employers offering an HDHP today
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✓5 to 250 employee groups
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✓HSA-qualified plan designs paired with employee HSA contributions
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✓Owner-led businesses with budget discipline
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✓Employers frustrated with employee complaints about the plan
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✓Groups with low primary care utilization despite an available plan
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✓Distributed workforces where physician access varies by location
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✓Employers not ready for self-funded or level-funded transitions
A Practical First Step
Start where you are. Let the data tell you where to go next.
Adding OffPlan underneath your HDHP is a low-friction first move. It does not require carrier replacement, broker disruption, or plan redesign. Over time, your OffPlan utilization data gives you better visibility into where your healthcare dollars actually go, which helps you make better decisions about your overall benefits strategy.
Keep the existing HDHP.
No carrier replacement. No broker disruption. No immediate plan redesign required. The HDHP, the HSA, and the renewal cycle stay exactly where they are.
Add OffPlan as the care layer.
Employees gain direct access to primary care, care navigation, and curated specialty pathways before they ever hit the deductible. Implementation runs in weeks.
Use the data to evaluate next steps.
Twelve to eighteen months of OffPlan utilization data shows you where your healthcare dollars are going. From there, you decide whether to stay layered or evaluate broader benefits restructuring.
See What This Looks Like for Your Group
Keep your insurance. Fix the experience.
Bring us your current HDHP details and a basic group profile. We model what OffPlan looks like layered underneath your existing plan, including expected employee adoption, deductible avoidance behavior, the funding mechanic that fits your budget, and what the conversation with your broker looks like at next renewal.
Your insurance protects against major events.
OffPlan handles the care employees actually use.