New solution brings reference-based pricing, transparent pharmacy benefits, claims transparency, and member advocacy to employers who have historically been shut out of self-funded cost containment.
Amarillo, Texas - The OccuNet Company today announced the launch of Fairos Level-Funded Health Plans, a health plan solution that extends the cost containment tools of self-funding to employers who have not been able to access them.
The employers under the most healthcare cost pressure have generally had the least access to the levers that meaningfully reduce it. Reference-based pricing, transparent pharmacy benefit management, direct access to claims data, and structured stop-loss protection have been the province of large self-funded groups, while everyone else has been left with a fully insured renewal, a spread-priced drug benefit, and no visibility into what drove either. Fairos Level-Funded is built to close that gap.
A More Predictable Approach to Healthcare Costs
Employers make one predictable monthly payment covering administrative costs, stop-loss protection, and expected claims funding. Specific and aggregate stop-loss coverage caps downside exposure, and employers keep 100% of unused medical claims funding after the plan year and applicable runout period.
Built on Fairos Reference-Based Pricing
At the center of the Level-Funded plan is Fairos reference-based pricing (RBP), which prices claims against a defensible benchmark rather than an unknown network discount. Behind it sits the same infrastructure already supporting larger self-funded groups: The OccuNet Company’s proprietary operating system, OnPoint, which reprices each claim according to the specific provider and service rather than applying a flat benchmark; a provider contracting team that secures agreements ahead of care and resolves disputes when they arise; and Fairos+, a first-of-its-kind member advocacy experience designed specifically for RBP. This level of specificity lowers plan costs while improving access to care and reducing the balance bills members receive. Fairos reports savings of more than 30% versus PPO allowed amounts, with full access to medical and pharmacy claims data.
Medical, Pharmacy, and Claims Transparency in One Plan
Every Fairos Level-Funded plan includes FairosRx, The OccuNet Company's pharmacy benefit management solution. Integrating medical and pharmacy benefits under one plan gives employers a single view of the two largest drivers of healthcare spending and a more coordinated experience for members.
Employers also receive their claims data directly, allowing them to understand their own cost drivers and negotiate renewals from evidence rather than a carrier's projection.
"The employers feeling the most pain from healthcare costs are the ones with the fewest tools to do anything about it," said James Skutt, EVP of Fairos at The OccuNet Company. "Everything in this plan already worked, we just made it available to groups that were told they weren't big enough. A broker can initiate a quote in just a few minutes, an employer gets one number to budget against, and a member gets a person who picks up the phone when a bill shows up they don't understand."
Fairos Level-Funded joins The OccuNet Company's existing Fairos offering. Employers can access Fairos RBP through a traditional self-funded plan structure or through the new Level-Funded plan, depending on which structure fits their situation.
Brokers and employers can request a Fairos Level-Funded quote by completing the form below. Quotes are returned in approximately five business days.
About The OccuNet Company
The OccuNet Company develops healthcare solutions focused on lowering costs, improving transparency, and creating a better experience for employers, health plans, providers, and members. Its solutions span Group Health and Out-of-Network healthcare, including Fairos RBP, Fairos Level-Funded Health Plans, and FairosRx Pharmacy Benefit Management, as well as solutions that help health plans manage out-of-network claims, provider negotiations, and payment integrity. Learn more at www.occunet.com