Decent's plans are ACA-compliant and resemble bronze and silver plans sold on the exchanges, but are offered outside of the exchanges year-round. (Photo: iStock)
The combination of self-insurance and direct primary care can pack quite the savings punch for the self-employed, according to Decent, a new third-party administrator that has just launched an innovative twist to health plans.
Indeed, freelancers, 1099 contractors and sole proprietors will be able to save upwards of 30 percent on premiums if they buy health plans self-insured by trade associations, with networks of direct care doctors charging lower membership fees negotiated by the San Francisco-based Decent.
"Health insurance is too expensive, especially for people who buy their own without subsidies — freelancers are seeing premiums rise by more than 20 percent per year," says Nick Soman, Decent's CEO and founder. "The future of work demands the future of insurance. With the most affordable comprehensive plans for self-employed people, we come one step closer to making health care affordable for all."
Decent's plans are currently available just in Austin for members of the Texas Freelance Association, but with $8 million in funding from investors including Menlo Ventures and Foundation Capital, the plans will soon be available to self-employed people in other parts of Texas and the country.
"Americans spend around $3.5 trillion dollars per year on healthcare, yet experts estimate that a quarter of that is wasted on administrative overhead," says Naomi Pilosof Ionita, a partner at Menlo Ventures, Decent's lead investor. "I am eager to see Decent transform the way self-employed people receive healthcare, and support this underserved market by offering more affordable options."
Decent is currently negotiating with direct care doctors in additional markets to charge lower prices to members of freelancer associations in those markets. Once an association strikes a deal with Decent, the association-sponsored self-insured plan will be offered to its self-employed members.
The plans are ACA-compliant and resemble bronze and silver plans sold on the exchanges, but Decent's plans are offered outside of the exchanges year-round — with premiums that are up to 50 percent lower than typical market rates, Soman contends. There are no restrictions or charges for pre-existing conditions and no medical screening is required.
Under the direct care model, enrollees pay the membership fee as part of their monthly premium, and the membership fee is passed through to providers. Enrollees then receive unlimited access to same-day appointments, 24/7 telemedicine services, and almost any procedure performed by a primary care physician — all for $0 out-of-pocket payment. Associations also buy a stop-loss policy to cover expensive claims, including procedures not done by direct primary care providers.
"The work Decent is doing to extend affordable, high quality health coverage to the self-employed is a mission that all of us can get behind," says Dr. Chris Larson, a direct primary care physician in Decent's network. "I own my business and can relate to the struggles others face when trying to find affordable coverage and am happy to be a part of improving their journey."
The capital injected by Menlo and other investors will also be used to grow Decent's team over the next year. The company recently appointed Elijio Salas, formerly Associate Commissioner at the Texas Department of Insurance, as Decent's agency management lead.
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Katie Kuehner-Hebert
Katie Kuehner-Hebert is a freelance writer based in Running Springs, Calif. She has more than three decades of journalism experience, with particular expertise in employee benefits and other human resource topics.
