Exemplary Health Product Overview

A breakdown of the integrated components that make Exemplary Health the smart choice for self-funded groups.

The Integrated Stack

Exemplary Health isn’t just a plan; it’s a vertically integrated ecosystem designed to strip out waste and improve care.

Stop-Loss Protection

Integrated A-rated stop-loss insurance protects the employer from catastrophic claims and high-dollar claimants, ensuring budget stability.

National Networks

Access to broad, national provider networks ensuring employees have coverage wherever they live or travel.

Medical Management

Proactive case management and disease management programs that help members navigate complex care and improve health outcomes.

Plan Highlights

Group Size
50+ Enrolled
Funding Type
Level or Self-Funded
Claims Platform
Real-Time Access
Telemedicine
$0 Copay Included
Reporting
Monthly Detailed

* Plans are customizable to meet the specific demographic needs of your client’s workforce.

Frequently Asked Questions

Q1: What are the main features of the Exemplary Health plan?
A: Key features include a national provider network, integrated pharmacy benefits, complete cost transparency, measurable quality improvements, and a focus on employee well-being.
A: The PBM provides access to more than 70,000 pharmacies nationwide and operates on a flexible claims platform with 100% transparent, pass-through pricing. Our PBM helps reduce prescription costs for members through optimized pricing strategies and allows us to customize approved medication lists to meet the specific needs of each employer group.

A: You receive detailed reports on claims, savings, and quality metrics, supporting informed decision-making.

A: Yes, plans can be tailored to meet the unique needs of different employer groups and industries.

A: Members enjoy a streamlined experience, clear benefits information, and access to a responsive support team. In addition, our clinical team of MDs and RNs actively supports employees by helping them understand their medical situations, evaluate treatment options, and locate high-value providers. For example, we can guide members to independent imaging centers within our nationwide network, often securing the same services at significantly lower costs than local hospitals—reducing expenses for both the plan and the member.

Get the Full Spec Sheet

* Plans are customizable to meet the specific demographic needs of your client’s workforce.

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