The short answer is yes-but the how depends on the structure of your employer's benefits program and the type of customization you need. Traditional health plans (like those from large carriers) often feel rigid, but modern benefits systems like WellthCare prove that real customization-especially when it comes to adding coverage that improves health and saves money-is not only possible but increasingly in demand. You don't have to rip and replace your existing plan to get the coverage you want.
Two Paths to Customization
Most employers and employees can customize coverage through one of two approaches: adding a supplemental layer or moving to a self-funded model that allows full benefit design flexibility. Let’s break down both.
1. Add a Complementary System (The Zero-Risk Approach)
You can add a system like WellthCare alongside your existing health plan-no rip-and-replace required. This gives employees additional coverage options immediately:
- $0-co-pay preventive care used before the primary plan, reducing claims and out-of-pocket costs.
- Free money at the WellthCare Store™-real dollars earned through preventive actions like scans and lab work.
- Automatic retirement contributions tied to healthy behaviors, building long-term wealth.
- Bill reduction services that lower out-of-pocket expenses by an average of 70%.
This method is the least disruptive and carries zero out-of-pocket cost to employers while giving employees far more than a traditional plan offers.
2. Switch to a Fully Customizable Self-Funded Plan
For organizations ready for deeper change, moving to a self-funded model like WellthCare Complete™ unlocks full customization. You’re no longer locked into a carrier’s one-size-fits-all coverage. Instead, you can:
- Design your own network using transparent, negotiated rates (30-45% savings vs. BUCA).
- Integrate pharmacy benefits through WellthCare Pharmacy™, replacing opaque PBMs with transparent pricing (20-40% savings).
- Tailor coverage for high-cost populations-like transitioning eligible employees to WellthCare Medicare™ to reduce employer risk.
- Incorporate wellness incentives directly into plan design, rewarding prevention instead of just paying for sickness.
What About Adding Specific Coverages (e.g., Dental, Vision, HSA)?
Yes, you can customize to include dental, vision, health savings accounts (HSAs), 401(k) plans, and supplemental insurance. In the WellthCare ecosystem, these can be layered on through a unified benefits administration platform. The key is to ensure incentives are aligned-so adding coverage doesn’t create waste or duplicate spending. For example:
- HSAs work well alongside a high-deductible health plan (HDHP) and can be funded using store-earned dollars.
- Medicare supplements can be integrated so retirees stay in the same ecosystem, maintaining continuity of care.
- Wellness programs become more effective when tied to measurable health actions and automatic rewards.
Compliance Considerations (Don’t Skip This)
Customization must always comply with ERISA, HIPAA, and ACA regulations. When you add or change coverage:
- ERISA requires clear plan documents and summary plan descriptions (SPDs) that outline all benefits.
- HIPAA mandates that health information is protected, especially when using data to drive rewards.
- ACA rules on preventive care coverage and essential health benefits must be maintained.
- Non-discrimination testing ensures that highly compensated employees don’t receive disproportionate benefits.
WellthCare handles all compliance recordkeeping automatically-maintaining audit-ready records for every participant action. This removes the administrative burden from employers while ensuring full legal protection.
How to Start Customizing Today
If you’re an employer, the easiest first step is to audit your current plan for waste and underused preventive benefits. Then consider adding a zero-cost, high-engagement system like WellthCare to test what works. The patented Readiness Index™ will show you, with real data from your own employees, exactly where customization saves money-without any upfront commitment.
Employees can also advocate for options by asking their HR department: “Can we add a program that rewards prevention and builds wealth?” The WellthCare model is designed to be easy to adopt and easy to prove-so the answer is increasingly, “Yes, and here’s the ROI.”