MedPair Frequently Asked Questions

▾   What is MedPair?

MedPair is secondary or supplemental health insurance. It pays the member’s portion of a qualified medical event (copays, deductibles, and coinsurance) up to a predetermined amount per calendar year.

▾   Who files and pays the claims?

The medical providers file all of the claims. Members simply have an additional insurance card that allows providers to file claims electronically on their behalf and be paid directly by the insurance company.

▾   Is MedPair intended to replace my current health plan or provider?

No. It is NOT intended to replace your current provider or health plan, but rather it works in conjunction with any plan or provider in the marketplace.

▾   Does MedPair have a restrictive network?

No. MedPair does not have a specific network. In fact, the network will mirror your current provider’s network. In other words, if a doctor (or facility) is in your major medical provider’s network, then he or she will also be in the MedPair network.

▾   Is MedPair a HSA, FSA, or HRA plan?

No, but MedPair is similar to those plans in that it is funded with pretax dollars and pays for members’ out-of-pocket medical expenses. However, with HSA’s, FSA’s, and HRA’s, for every $1 you contribute you have $1 of benefit, where as MedPair funding operates on a premium and typically a $1 contribution equals $6 to $8 of benefit.

▾   How is MedPair affected by the PPACA ("Obamacare")?

In short, it is not subject to PPACA oversight because it is not a major medical plan. In fact, MedPair gives companies the ability to improve their overall plans while reducing major medical premiums and claims experience, thereby helping companies stay in compliance with the PPACA’s “Affordability Clause” and increase the potential for rebates under the MLR provision.

▾   Are preexisting conditions excluded?


▾   Who underwrites and administers MedPair?

MedPair is administered by Gilsbar, LLC and underwritten by Nationwide Life Insurance Company, an A+ (2nd strongest of 16) rated company by A.M. Best.

▾   What is needed for an initial analysis?

(1) Current Summary of Plan Description;
(2) Current rates;
(3) Census of employees on your plan;
(4) Amount of HSA, HRA, or FSA employer contributions (if any);
(5) A meeting with a MedPair consultant.