The Mainstay Health Plan · quoting in 2027
Replace your carrier. Build on the care.
A health plan built around Whole Care, for employers with 50 to 500 people. Your people get a doctor who knows them and a plan that pays for the care they actually use.
The plan isn’t available yet. This page describes what we’re building; final terms come with your quote.
- Built for
- Employers with 50 to 500 people
- Two ways to use it
- Coordinated or self-directed
- First quotes
- Spring 2027
Two ways to use it
One plan. Your people choose the path each time they need care.
Coordinated
Go through your care team.
$0 copay. $0 deductible.
Your care team knows you, so they send you to the right place the first time. When they refer you, that referral is the approval. No forms and no waiting on a phone call.
- Your doctor, nurse and care concierge
- Specialists your care team trusts
- Nothing to pay when you use it
Self-directed
See anyone you want.
Still covered.
Book the doctor you found on your own. The deductible applies, and prices are set fairly by reference to Medicare, so a visit costs what it should. Choosing for yourself is covered, never punished.
- Any licensed doctor or hospital
- Fair prices, set by reference to Medicare
- Your deductible applies first
Both paths come with the same care team behind them.
One member, one mole
Susan finds a mole.
It’s a Tuesday, and she isn’t sure it’s anything. Here’s how the next few days go.
Coordinated
Tuesday, 7:40 am
She texts her care team a photo.
Tuesday, 11:15 am
A clinician looks the same day and wants a dermatologist to see it.
Tuesday, 2:00 pm
Her care concierge books a dermatologist the team trusts, for Thursday.
Thursday
Her records are there before she is. One visit, one biopsy.
What she pays
$0.
$1,100
The same visit and biopsy at a hospital-based dermatologist.
$130
At the dermatologist her care team sends her to.
Allowed amounts for a new-patient visit and punch biopsy. Source: in-network rate files for a large DMV plan, June 2026.
Self-directed
Susan books a dermatologist she found herself. She’s covered. The claim pays after her deductible, at a price set by reference to Medicare.
Illustrative member. The Mainstay Health Plan, from 2027.
For employers
One known cost. Nothing hiding behind it.
Fund to a known maximum.
You set the year’s funding up front. It can never be more than that.
One even monthly payment.
The same amount every month. No surprise bills when someone has a hard year.
Paperwork done for you.
We prepare the plan documents and handle the federal filings.
Money back at settlement.
If your people stay healthy, the surplus comes back to you. Our fee is at risk inside it.
For brokers
Simple to quote. Simple to explain to your client.
One census template.
That’s the whole submission. No stack of forms, no chasing signatures.
Quotes in 5 to 10 days.
Priced with stop-loss coverage we shop across a panel for every group.
Clean, disclosed pay.
Paid per employee per month, and disclosed to your client up front.
What’s inside
Chosen and wired together, for you.
A health plan is several companies working as one. We pick each piece, connect it to your care team, and answer for all of it.
The administrator
Pays claims, keeps eligibility current, and follows your care team’s referrals.
The pharmacy benefit
Prescriptions covered and managed inside the same plan, with the same care team watching out.
The stop-loss coverage
Protects the plan from one very large claim or a hard year. It’s what makes the maximum a maximum.
The network
Doctors and hospitals across the DMV, with fair prices where your care team sends people.
When
Start with the care now. Switch the plan at renewal.
Now
Whole Care, on any carrier.
Give your people a doctor, a nurse and a care concierge today, alongside the plan you already have.
Spring 2027
First quotes.
We start quoting the Mainstay Health Plan for groups of 50 to 500 people.
At your renewal
Switch plans. Keep the care team.
Your people keep the same doctor and the same concierge. Only the card in their wallet changes.
Get on the list
Be first to see a quote.
Tell us about your group and your renewal. We’ll reach out when quoting opens in 2027. Want Whole Care for your people sooner? We can start it now.