edHEALTH offers advisors the opportunity to provide a cost-effective healthcare solution to their higher education and secondary education clients. By recommending edHEALTH, you will bend your educational clients’ healthcare cost trend. Additionally, as a member school advisor, you participate in plan design and other group meetings so that you are aware of topics that your client and others are discussing. These opportunities allow you to increase your visibility and knowledge while enhancing your strategic role.

Disruption to coverage, healthcare provider access, and plan design is minimal. Through our hands-on approach, our new members experience seamless transitions with little or no coverage or provider interruptions. edHEALTH has an active Plan Design Committee made up of representatives from each member institution and their advisors who work with the third-party administrators (TPAs) to determine plan designs customized to meet the needs of edHEALTH member schools.

edHEALTH has a range of plan designs that meet the needs of edHEALTH members. Representatives from each member institution (typically the benefits administrators) meet monthly to determine design options for the upcoming plan year. Again, the Plan Design Committee’s collaboration with the third-party administrators (TPAs) helps to ensure the optimal suite of choices. 

The edHEALTH team works closely with new member institutions and their advisor to create plan designs that will meet the needs of schools that join edHEALTH.

Yes. edHEALTH customizes its medical and pharmacy programs to meet the needs of religious institutions.

edHEALTH is available throughout the United States.

edHEALTH has both a regional and national healthcare TPA. We also use a prescription drug carve-out administrator.

edHEALTH’s purchasing power allows us to negotiate low third-party administrator (TPA) fees. Each member selects its own TPA and plan design from our suite of health plan options. We underwrite an institution’s rates based on a school’s plan design, claims experience, census data, and the self-insured retention level the school has selected.

Here’s what to know about obtaining a working rate for your client.

edHEALTH charges prospective members a nominal non-refundable working rate quote fee. This amount is applied to the school's capital contribution upon joining. The fee represents the actuarial cost to calculate the working rate, including a breakdown of all expected costs for the plan year.

Additionally, below highlights the steps taken to receive a working rate based on a January 1 effective date. Educational institutions may join edHEALTH at any time, in which case the actual dates below will change.

Once a school joins edHEALTH, we provide a more detailed timeline and work with its staff and advisor every step of the way.

While it varies by state, the minimum number that a school should have to receive a working rate quote is between 100 and 150 benefit-eligible employees.

As edHEALTH welcomes a new school, we work closely with its Finance and Human Resources staff and the school’s advisor to ensure a smooth onboarding for faculty and staff alike.

The following chart provides key onboarding dates based on a January 1 effective date. Educational institutions may join edHEALTH at any time, in which case the actual dates below will change.

Once a school joins edHEALTH, we provide a more detailed timeline and work with its staff and advisor every step of the way.

No. There are no fees to join edHEALTH. When a school joins edHEALTH, the State of Vermont requires a new member-owner to make a capital contribution, which remains an asset to the institution.

Member-owners can access the following reports on the edHEALTH portal:

• High-cost claims report
• Quarterly actuarial report
• Prescription drug rebate information
• Important owner information
• Plan design minutes and presentations
• Member services guide