The Last Healthcare Plan You'll Ever Need

Stop Overpaying.
Start Owning Your Plan.

Your carrier charges a 25% markup to own a plan you'll never control. CVRD changes that — giving you full visibility, custom design, and capped risk. Stop renting. Start owning.

25%
Insurance carriers price every plan as if your worst-case claims happen 3-4x per decade.
99%
Client retention rate — clients stay because savings and service are real, not promises.
21+
Reinsurance carriers competing for your stop-loss, including 6 specializing in limited claims experience.
24/7
Live member support — all calls answered in under 30 seconds, plus MyNurse and Teledoc.

How CVRD's Platform Works — Built for Your Business, Not the Carrier's Profit

With a plans you pay only for real claims incurred, while stop-loss coverage protects you from large or anomalous claims.

💰
Pay Only Actual Claims
Instead of a fixed premium with a 25% carrier profit margin baked in, you fund a claims account and pay exactly what your employees use.
🛡️
Specific Stop-Loss Kicks In
If any single member's claims exceed your specific deductible (e.g. $200K), your reinsurance carrier covers the rest. You're never exposed to catastrophic individual claims.
📊
Aggregate Protects the Plan
If your total claims exceed the aggregate attachment point (e.g. 125% of expected), a second layer of stop-loss kicks in — your worst-case scenario is capped.
🔍
Full Transparency & Control
Real-time dashboard with every claim, every member, every pharmacy transaction. No more guessing what you're paying for.
📈
Save More Every Year
Year 1: transition & data collection. Year 2: optimize your plan. Year 3: maximize savings. Unlike carriers, CVRD's incentives are aligned with yours.
Where Your Premium Dollar Goes
Line Item Fully Insured CVRD Plan
Paid Claims ~65% ~65%
Carrier Profit ⚠️ 25% $0
Admin, Network & PBM ~15% ~20%
Stop-Loss Protection Bundled in ~15%
💊 Rx Rebates to You $0 50% of Rx
Good claims year savings Carrier keeps it Stays with you
Cost transparency None Full visibility

The PBM Rebate Game — and How We Fix It

The top 3 PBMs control 80% of the U.S. drug market. In a traditional plan, drug manufacturer rebates flow to them — not you. With us, all pharmacy rebates flow back to you.

Fully Insured — Where Rebates Go
🧑
Employee
Pays negotiated price
🏭
Drug Manufacturer
Pays rebate to Insurance Carrier Owned PBM
🏢
PBM
Keeps all of it
Employer
Gets nothing
CVRD — Pass-Through Model
🧑
Employee
Pays negotiated price
🏭
Drug Manufacturer
Pays rebate to the group directly
⚙️
CVRD PBM
100% passed through
💵
You
Quarterly check
💸
50% of All Rx Claims Paid — Returned to You Quarterly CVRD's pass-through PBM model ensures drug manufacturer rebates flow directly back to your plan.
⚠️ The Conflict of Interest

Traditional PBMs earn more when they favor expensive drugs. CVRD's pass-through model eliminates this conflict — every rebate goes directly to your plan, not to the middleman.

80%
of U.S. drug market controlled by just 3 PBMs — a near-monopoly with every incentive to keep rebates for themselves.
4×/yr
Quarterly rebate checks returned to your plan.
60–80%
savings on 750+ brand medications through International Drug Program — same drug, fraction of the cost.

See exactly what you'd save — and your worst-case scenario

Enter your current plan details. We'll show your projected annual savings and exactly how stop-loss protection caps your exposure.

Your Current Plan Details

👤
501,0002,000
$
$100K$7.5M$15M
$
Fixed at $50,000 per member — stop-loss carrier covers individual claims above this
Expected Claims
Employer responsible up to this
Attachment Point (125%)
Stop-loss kicks in above this
Employer is responsible for all claims up to the attachment point. Stop-loss insurer covers all claims above it.
%
5%25%50%
% of Rx spend (40% of premium) returned as rebates to the group
%
40%67%95%
* Estimates based on industry averages. Carrier markup assumed at 25%. Stop-loss admin ~12% of expected claims. Actual savings vary by group.

$14.8M Saved Over 5 Years

A Mid-Size Tech Company — 449 employees, Anthem network. Here's exactly what switching from fully insured to the CVRD / plan delivered.

Fully Insured (Anthem)
$6,462,812
Your annual cost no matter what — fixed rate, carrier keeps all profit
Good claims year?Carrier keeps it
Carrier profit margin~20% every year
Rx rebates to you$0
Your cost visibilityNone
CVRD Plan — Worst Case Claims Year
$6,231,761
Maximum possible cost — if every member hits their deductible and aggregate cap is triggered
vs. Fully InsuredSave $231,052
Cost reduction−3.58%
Carrier profit margin$0
Stop-loss protects you above$50K/member
🛡️ Even in your absolute worst claims year, you still spend less than fully insured.
CVRD Plan — Expected (Normal) Claims Year
$5,218,592
What you'd pay in a typical year based on your group's actual claims experience
vs. Fully InsuredSave $1,244,220
Cost reduction−19.25%
Carrier profit margin$0
Rx rebates back to you25% of Rx claims
💰 In a healthy claims year, the savings compound — and they stay with your company.
What's Included in Fixed Costs
Specific & Aggregate Stop-Loss
Medical Claims Administration
Billing & Eligibility Management
Utilization Review / Care Management
PPO Network Access (Anthem)
Pharmacy Benefit Management
Executive Reports & Analysis
Regulatory & Compliance Services
Online Benefits Management Portal
Golden Triangle Dialysis Network
HIPAA Administrative Services
Virtual Physician Access & COBRA Admin
Actual Example of Cost Breakdown - Total Cost Monthly
449 employees across PPO 750 (Utah/CA), HSA 3300 (Utah/CA), and HMO plans
Plan / Tier Anthem Fully Insured
Current 1/1/2025
CVRD Maximum
−3.58% · 1/1/2026
CVRD Expected
−19.25% · 1/1/2026
PPO 750 (CA) — 259 enrolled
Employee $704.92 $679.72 $569.21
EE + Spouse $1,550.84 $1,495.40 $1,252.27
Family $2,185.29 $2,107.16 $1,764.58
HSA 3300 (CA & Non-CA) — 149 enrolled
Employee $566.85 $546.58 $457.72
Family $1,757.25 $1,694.43 $1,418.94
HMO — 31 enrolled
Employee $538.34 $519.09 $434.70
Family $1,668.81 $1,609.15 $1,347.53
Total Monthly (449 enrolled) $538,568 $519,313 $434,883
Total Annual $6,462,812 $6,231,761 $5,218,592
* The client proposal data for illustrative purposes. Actual results vary by group size, demographics, and claims experience. Based on proposal dated 9/3/2025.

Everything you need, nothing you don't

Everything in one place — from stop-loss to pharmacy to HRIS integration. No gaps, no surprises, no middleman keeping your money.

🔒
Keep Your Margins
Fully-insured carriers charge a 25% profit margin above expected claims. With CVRD, you pay only for real claims — and keep the difference.
📊
Total Visibility
Real-time interactive dashboard: medical and pharmacy claims, member eligibility, coverage levels, demographics, utilization, and benchmarks.
⚙️
Harness Care
Proactively combine your insurance and coverage with your doctor's offices. Get instant assistance with upcoming appointments, seeking the best care and cost solutions and flagging for additional coverage assistance.
💊
Smarter Pharmacy
Carve out pharmacy for full rebate transparency. Target high utilizers, source drugs internationally, and stop paying middleman PBM markups.
🏥
Cost Containment Programs
65% auto-adjudication that drives down TPA costs.
📞
24/7 Member Support
All calls answered in under 30 seconds. Plus MyNurse 24/7, Teledoc, lifestyle coaching, mobile messaging, and a dedicated claims manager.

Client experience begins the moment you onboard with CVRD

Client experience begins the moment a group is sold. A dedicated Implementation Manager works in tandem with your Client Management team from day one through go-live.

👤
Senior Insurance Broker
Senior Consultant — your primary strategic lead
📋
Client Manager
Day-to-day contact, coordinator & eligibility rep
🏥
Claims Team
Claims coordinator, manager, and clinical coordinator
📞
Support Staff
Customer service reps and experienced claim examiners, 24/7 customer service support
6-Step Implementation Process
Your Team — light lift
CVRD — handles it
1
Your Team
Client Kick-Off Meeting
Join a 1-hour kick-off call. Tell us your current plan structure, who your HR contacts are, and any must-haves.
⏱ 1 hour of your time
2
CVRD
PBM, EDI & Banking Set-Up
We configure your entire vendor ecosystem — pharmacy, EDI connections, and banking infrastructure. Zero IT burden on your side.
✓ Fully handled by our team
3
Your Team
Employee Census File
Export your employee roster from your existing HRIS — name, DOB, address, plan tier. We do everything else with it.
⏱ 1 data export from your HR system
4
CVRD
EDI Eligibility Load
We load, map, and verify every member's eligibility electronically. No manual data entry, no spreadsheets for your team.
✓ Fully handled by our team
5
CVRD
Open Enrollment & ID Cards
We run open enrollment, assist members with plan selection, and deliver ID cards directly. Your HR team just communicates dates.
✓ We run it — you announce it
6
CVRD
Plan Testing & Go Live 🚀
We test the full system end-to-end before day one. You flip the switch — and your new plan is live, on time, with 24/7 support from the start.
✓ Tested, verified, and ready
🙋
Your team's total lift
1 kick-off call · 1 census file export · announce open enrollment dates. That's it.
⚙️
CVRD handles everything else
PBM setup, EDI, eligibility load, enrollment management, ID cards, testing, and go-live.
🔗 Fully Integrated
Payroll, time, attendance, and benefits administration all in one platform — seamless open enrollment included.
📊 Data at Your Fingertips
Performance reporting, benchmarking, cost trend analysis, and forecasting — real-time, not quarterly PDF reports.
⚙️ Carrier Connections
Onsite training, HR support team, ACA compliance review, and best practices guidance from day one through renewal.

FAQ

We hear this question often. Traditional brokers sometimes describe alternative funding strategies as "too risky," but the reality is that insurance carriers use the same underlying risk principles. The difference is that fully insured plans are priced as if every year will be a worst-case scenario for your group's claims — which often leads to higher long-term costs.

In addition, traditional insurance models can include commission structures and overrides that increase as premiums rise, which doesn't always align with an employer's goal of controlling costs. If you are in a fully insured plan you're already doing this with your insurance carrier.

Our approach focuses on transparency and smarter funding strategies that better reflect your actual risk — helping you control costs while still protecting your employees.
With CVRD, employers pay for all employees' eligible healthcare claims — but only those claims. That's different from fully insured plans, which typically charge a 25% margin above actual claims incurred. Unlike fully self-insured plans, CVRD's model includes a reinsurance carrier to limit risk through specific and aggregate stop-loss coverage. You never overpay for insurance again.
Plans are ideal for companies with 100–500 employees, or organizations spending more than $200,000 annually on health insurance. They provide greater control over costs, plan options, and data — while giving access to an extensive physician network and strong pharmaceutical benefits.
Stop-loss comes in two forms. Specific stop-loss kicks in if any single member's claims exceed your deductible (e.g. $200,000) — the reinsurance carrier covers everything above that. Aggregate stop-loss caps your total annual exposure: if your group's total claims exceed the attachment point (typically 125% of expected), the carrier covers the overage. This means your worst-case scenario is always defined and limited.
Fully insured plans (Blue Cross, Aetna, etc.) include a ~25% carrier profit margin that you pay regardless of actual claims. If your employees are healthy and claims come in low, the carrier keeps the difference. With CVRD, you pay actual claims plus a fixed cost for administration and stop-loss. Low claim years mean real savings that stay with your company.
CVRD takes a 3-year strategic approach: Year 1 is transition — we move you to the new plan, set up HRIS integration, and begin collecting data. Year 2 is optimization — we analyze Year 1 data and refine your plan to minimize risk and maximize savings. Year 3 is transformation — by now your plan is running efficiently and generating substantial savings, while we continue proactive management and data-driven adjustments.
CVRD provides access to three of the four largest national networks, including Anthem Blue Cross Blue Shield. For stop-loss, there are 21+ reinsurance carriers to choose from — including 6 that specialize in limited claims experience — ensuring you get the most competitive rate. For pharmacy, CVRD works with multiple PBM partners including MedImpact, with access to an International Drug Program delivering 60–80% savings on 750+ brand medications. The program focuses on international drug sourcing and proactive approaches to reducing costs.
CVRD's plans work best for employers with 100–1,500 employees, or any organization spending more than $200,000 annually on health insurance. All quoted lines of coverage require a minimum 75% participation level of eligible employees. The client proposal shown on this site is a real example for a 449-employee company.
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