Indiana Elite Care Network: Alternative Group Healthcare Coverage for Schools & Cities

Question 1

Predictable Costs and Real Savings

Answer

Transparent, validated pricing and lower inpatient and outpatient rates help employers save 12% to 18% on average, without cutting benefits.

Question 2

Expanded Network Options

Answer

Employees gain access to trusted providers across Indiana, including Franciscan Health, Ortho Indy, Unity Healthcare, and more. This means less travel, more choice, and care they can rely on.

Question 3

Plan Flexibility & Control

Answer

You can customize plan designs to meet workforce needs while maintaining predictable budgets—reducing renewal surprises and unexpected costs.

Question 4

Reinsurance & Liability Savings

Answer

Optimized plan structures and reinsurance options reduce total liability and protect you from high-cost claims.

Question 5

Do employees have to change their primary care doctors?

Answer

No. Employees maintain the freedom to choose their own physicians and facilities. The plan uses a tiered system that incentivizes employees with lower deductibles and out-of-pocket costs to use Tier 1 providers for major procedures (like surgeries), but they are not forced to switch their everyday doctors.

Question 6

How does the three-tier plan structure work?

Answer

The plan is structured to provide choices: Tier 1 consists of the high-performance Indiana Elite Care providers, Tier 2 utilizes a wrap network (like First Health or Multi-Plan/PHCS), and Tier 3 is a true out-of-network option. There are meaningful differences in deductibles and coinsurance (often a 40% differential) to steer employees toward Tier 1.

Question 7

Which local providers are included in the Tier 1 network?

Answer

The Tier 1 preferred network includes Franciscan Alliance facilities, Ortho Indy, Unity Surgical Center, Sagamore Surgical Center, and Unity Healthcare physicians.

Question 8

How do employees know where to go or how to navigate the network?

Answer

The plan includes built-in participant advocacy and education resources. Employees have access to the Pathways Concierge customer service line to verify benefits and help them locate Tier 1 providers before they receive care.

Question 9

Are there complicated pre-certification requirements for employees?

Answer

No, the plan features a limited pre-certification list that only applies to a limited number of areas.

Question 10

What is the expected financial impact on our overall health plan spend?

Answer

The estimated cost impact is 12-18% for claims incurred. For example, an employer can expect about $150,000 in savings for every $1,000,000 of health plan spend inside the proposed model.

Question 11

How does the pricing actually compare to the broader Indiana market?

Answer

The network utilizes a predictable, Medicare-based direct contracting model. Inpatient pricing is 19% less than the Indiana state average and outpatient pricing is 26% less than the Indiana state average.

Question 12

How will this impact our stop-loss and reinsurance costs?

Answer

Reinsurers are embracing this strategy with significant pricing concessions that range from 15% to over 30% depending upon the networks that are available in Indiana.

Question 13

How does this strategy help municipalities or schools facing property tax shortfalls?

Answer

Healthcare is typically a top-three line item for any organization. By implementing this solution, municipalities and school districts can save roughly 20% on their healthcare budgets, which can single-handedly wipe out multi-million dollar budgetary shortfalls caused by property tax changes.

Question 14

Is the pricing transparent and verifiable?

Answer

Yes, the plan includes a pricing audit mechanism conducted by an outside third party to ensure consistent and predictable pricing.

Question 15

Does this model expose our employees to balance billing?

Answer

No, the Indiana Elite Care Network model is designed to eliminate balance billing exposures for participants.

Question 16

How does the plan ensure overall savings if employees use the broader, less-discounted Tier 2 network instead of the Tier 1 network?

Answer

Through plan design steerage, such as meaningful 40% deductible and coinsurance differentials, the plan incentivizes enough people and high-dollar claims to utilize the Tier 1 network.

Even with some utilization of the broader Tier 2 network, the overall net discount across the entire plan remains stronger than traditional carriers like Anthem or United Healthcare.

Currently, about 73% of all high-dollar claims (claims over $1,000) are successfully running through the Tier 1 network.

Question 17

What should employees do if a provider's front desk staff doesn't recognize the IN Elite Care insurance card?

Answer

This is a known issue being aggressively addressed through provider education and front desk signage. Employees should point the receptionist to the HPI (Health Plans Incorporated) logo on their card, as HPI is the recognized administrator. If there are still issues, the front desk can call the (888) 811-3419 on the card to quickly verify benefits.

Question 18

Will employees have local support to help them understand and navigate their care options?

Answer

Yes. Within the Lafayette area, PCI is a partner with IEC and can address questions or topics related to network and plan utilization.

Question 19

Do employee deductibles cross-accumulate between the different network tiers?

Answer

This is a customizable feature based on the individual employer's plan design. Employers can choose to have deductibles cross-accumulate across tiers to make the plan less intrusive for employees, or they can keep the deductibles separate to create a stronger financial incentive for employees to use Tier 1 providers.

Question 20

How does the plan manage prescription drug and specialty medication costs?

Answer

The network utilizes dedicated Pharmacy Benefit Management (PBM) and specialty Rx partners, specifically TrueRx and SHARX, to provide advocacy solutions that have already demonstrated meaningful value in managing pharmacy spend.

Question 21

Is there local proof that this strategy actually works?

Answer

Yes. Early progress from the first employers utilizing the complete offering (which became available in July 2025) shows that the high-performance network is achieving the predicted savings. For example, the longest-running case study for this model has seen their cost per employee drop from $19,000 to $11,000.

Question 22

What happens if an employee goes completely out of network?

Answer

The plan features the ability to custom build a plan design that is most suitable for your organization, whether that’s a "wrap network" approach or some other management tool for pricing integrity.

Indiana Elite Care Network: Alternative Group Healthcare Coverage for Schools & Cities

Recent Indiana property tax changes are creating sudden budget shortfalls for local cities & school districts.

You can no longer afford to wait this out.

Indiana ranks among the most expensive states for employer-sponsored plans.

There is a better option.

Indiana Elite Care Network is a smarter, proven approach to employee healthcare for cities & schools.

Anchored by Franciscan Health and partner providers across Indiana, including Ortho Indy, Unity Healthcare, and Sagamore Surgical Center.

Indiana Elite Care FAQ

Independent data & local usage shows Indiana Elite Care Network saves employers 12% to 18%.

Currently, 73% of all high-dollar claims are successfully flowing through the high-performance network.

No other option we’ve seen delivers this combination of savings & predictability.

Take control of your healthcare costs.

Schedule a consultation.

Review the potential savings.

Design a healthcare plan built for your employees.

Renewals shouldn’t climb 15% or higher each year.

You don't have to accept double-digit renewal rates & poor access to healthcare.