INDIVIDUALS
| Characteristics | PEO4YOU | Traditional Health Plans |
| Covers the 10 Obamacare/ACA* Essential Health Benefits | ✔️ | ✔️ |
| Covers Pre-Existing Conditions (ACA) | ✔️ | ✔️ |
| No Annual or Lifetime Maximums (ACA) | ✔️ | ✔️ |
| No Specialist Referrals Needed | ✔️ | ❌ if HMO, ✔️ if PPO/EPO |
| Claims Denials cannot Become Profits (ERISA) | ✔️ | ❌ |
| Dedicated Claims Representative | ✔️ | ❌** |
| Free Teledoc and Price Comparison Shopping | ✔️ | ❌** |
| Includes Comprehensive Dental and Vision | ✔️ | ❌** |
| Can Cancel Month-to-Month | ✔️ After 12 Months | ✔️ |
| Network Size | Blue Cross PPO | Variable |
| Characteristics | PEO4YOU | Traditional Health Plans |
| ACA Compliant Plan | ✔️ | ✔️ |
| No Profits Generated by Denying Claims (ERISA) | ✔️ | ❌ |
| Dedicated Account Manager | ✔️ | ❌ |
| Strong Incentive to Fix Medical Billing Errors | ✔️ | ❌ |
| Free Teledoc and Price Comparison Shopping | ✔️ | ❌ |
| Includes Comprehensive Dental and Vision | ✔️ | ❌ |
| Makes Ancillary Benefits Available (e.g., 401k & LTD) | ✔️ | ❌ |
| No Payroll and Workers’ Comp Requirement | ✔️ | ✔️ |
| Rates Are Not Medically Underwritten | ✔️ | ❌ |
| No Medical Health Questionnaires Required | ✔️ | ❌ |
| Renewal Increases Not Based on Claims History | ✔️ | ❌ |
| Enroll Dependents Without Certificates | ❌ | ❌ |
| Covers Pre-Existing Conditions | ✔️ | ✔️ |
| No Annual or Lifetime Maximums | ✔️ | ✔️ |
| Claim Denials Can’t Become Profits (ERISA) | ✔️ | ❌ |
| Dedicated Claims Representative | ✔️ | ❌ |
| Can Cancel Within 12 Months | ❌ | ✔️ |
| Can Cancel Month-to-Month | ✔️ | ❌ |
| Required to Pay Medical Bills (ACA) | ✔️ | ✔️ |
| Network Size | Blue Cross PPO | Variable |
| Enrollment Minimum and Participation Requirements | 2+w/50% | 1+w/50% |
| Valid Waivers Count | Yes | Yes (Except for NY and VT) |
| Multi-Plan Offering Available | No | Yes |
| Age-Based Rates | No | Yes |
| Typical Relative Price | $$$ | $$$$ |
We get it — if you’re one of the lucky ones with a solid plan or a generous subsidy, it might not be time to switch yet. But here’s the thing:
That’s why smart people like you have a backup plan ready
We get it — if you’re one of the lucky ones with a solid plan or a generous subsidy, it might not be time to switch yet. But here’s the thing:
That’s why smart people like you have a backup plan ready
Health, Vision, Dental, Life and Benefits.
Approximately 80% of medical bills have errors such as wrong codes and duplicate charges. With PEO4YOU, you will have a dedicated representative committed to helping bring your costs down by identifying and eliminating these errors and finding you discounts and savings. Say goodbye to never-ending phone trees, transfers, and having to explain your situation over and over.
Unlike traditional plans, PEO4YOU doesn’t profit from claim denials or premium hikes—ERISA laws make it illegal. We only earn from admin and union fees, so our focus stays on your care, not squeezing your wallet.
At PEO4YOU, keeping costs low is the goal. That’s why we offer free Teledoc visits and let you compare procedure prices before scheduling. Over the past 5 years, our rates have increased less than 16%, while others jumped 30%+ in just one year. We stay transparent so you can stay protected.
Traditional health plans often deny claims to increase profits. PEO4YOU is different. ERISA laws prohibit claim denials from turning into corporate profits. Instead, we partner with Valenz to streamline approvals and protect your access to care.
Valenz's advanced cost-man- agement technology proactively reduces medical expenses, ensuring you pay less for the same high-quality care. Whether it's a hospital visit or routine checkup, your costs stay lower compared to traditional plans.
BCBS PPO National Network
| Deductible: | $1,000 |
| Coinsurance: | 80/20 |
| Out-of-Pocket: | $3,800 |
| Primary Care Co-pay: | $25 |
| Specialist Co-Pay: | $50 |
| Medications: | Generic 10%; Brand 35% (see SBC for more details) |
| Wellness & Teledoc Visits: | No Charge |
(In-network only)
See Health Plan Outline for More Details
Principal PPO Dental Network
| Annual deductible network | Coinsurance network pays | |
| Preventative | $0 | 100% |
| Basic | $50 | 80% |
| Major | $50 | 50% |
Max benefit: $2,000 per calendar year
New Benefit: Implant coverage (see SBC for details).
Out-of-Network Coverage Available (Click Here to See Claim Example)
VSP Vision
| Exams: $10 copay, 1 exam every 12 mo |
| Glasses: $25 copay for single lenses |
| Frames: Up to $250 every 24 mo |
| Contacts: Up to $250 every 12 mo |
6 year average renewal of less than 3% – Trust established in 1958 – BCBS network since 2004 – Enrollment available year round.
Features | H&W 125 | DENTAL 125 | VISION 125 | ACCIDENT | LIFE 10K | ADMIN 125 | Union | Processing Fee | Total |
|---|---|---|---|---|---|---|---|---|---|
Individual | $746.00 | $75.00 | $15.00 | $12.00 | $10.00 | $100.00 | $27.00 | $33.00 | $1,018.00 |
Couple | $1,530.00 | $150.00 | $30.00 | $12.00 | $10.00 | $200.00 | $27.00 | $33.00 | $1,992.00 |
Parent + Child(ren) | $1,169.00 | $150.00 | $30.00 | $12.00 | $10.00 | $200.00 | $27.00 | $33.00 | $1,628.00 |
Family | $1,669.00 | $220.00 | $45.00 | $12.00 | $10.00 | $200.00 | $27.00 | $33.00 | $2,216.00 |
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Better Benefits for Independent Contractors and Companies
Independent Worker
| Characteristics | PEO4YOU | Traditional Health Plans |
| Covers the 10 Obamacare/ACA* Essential Health Benefits | ✔️ | ✔️ |
| Covers Pre-Existing Conditions (ACA) | ✔️ | ✔️ |
| No Annual or Lifetime Maximums (ACA) | ✔️ | ✔️ |
| No Specialist Referrals Needed | ✔️ | ❌ if HMO, ✔️ if PPO/EPO |
| Claims Denials cannot Become Profits (ERISA) | ✔️ | ❌ |
| Dedicated Claims Representative | ✔️ | ❌** |
| Free Teledoc and Price Comparison Shopping | ✔️ | ❌** |
| Includes Comprehensive Dental and Vision | ✔️ | ❌** |
| Can Cancel Month-to-Month | ✔️ After 12 Months | ✔️ |
| Network Size | Blue Cross PPO | Variable |
Our services provide comprehensive solutions for individuals and independent workers seeking reliable and affordable coverage. By offering group health plans, we ensure access to essential benefits like preventive care, specialist visits, and prescription coverage, along with additional options for dental and vision care. Our services also include life benefits to help you plan for the future and protect your loved ones. With streamlined enrollment and personalized support, we make it easy to find coverage that meets your needs without the high costs often associated with individual plans.
Read how Clever has transformed productivity for our users
and hear their success stories.
– Exclusions:
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“We respect your privacy. Your contact information will be used solely for the purpose of responding to your inquiry and will not be shared with third parties.”
Affordable health and benefits plans for small businesses, freelancers, and independent contractors.
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