Delivering affordable health benefits
A level-funded health plan for employers with as few as 25 employees.
Great health benefits shouldn't be a luxury only big companies can afford.
Whether you're running a family-owned business, scaling a fast-growing startup, or managing employees across multiple states, Zuniga Health helps you deliver health benefits your team will actually value—without blowing your budget. Our full suite of plans—MEC (Minimum Essential Coverage), MVP (Minimum Value Plan), and level-funded PPO and HDHP—gives you the flexibility to find the right fit, backed by a robust network of national and regional providers in all 50 states. Zuniga Health's level-funded PPO and HDHP premiums are typically 15–20% lower than fully-insured carriers.
Exclusive partnership with Advocate Health Care.
Find care near you at Advocate Health Care, one of the leading health systems in the Chicago area.
Zuniga Health has an exclusive partnership with Advocate Health Care, part of Advocate Health — the 3rd largest nonprofit integrated health system in the United States.
Zuniga Health co-developed with Advocate Health Care 3 PPO plans (Bronze, Silver, Gold) and 7 HDHP level-funded medical benefits.
Access to providers is easier than ever before because employees can choose from hundreds of Advocate Health Care providers through one of the largest primary and specialty networks.
Multiple plan options: PPO and HDHP
Multiple plan options can be used by the same employer group
Access to Advocate Health Care hospitals, primary care physicians, specialists, and ancillary services
Advocate's telehealth services for urgent care, primary care, and select specialties
Rebates from PBMs deposited into the client's claim account
At contract end, 100% of the account balance is the employer's money
AI-powered virtual health assistant that answers employees' questions about benefits, providers, copays, coverage, and more — instantly and accurately. Saves HR an average of 9 hours every week on benefits-related tasks
The plans also include a comprehensive pharmacy benefit strategy that offers specialty medication oversight, rebate transparency, and cost-conscious formulary management
Coverage options
MEC and Minimum Value plans for your team
Choose WellCare, KeyCare or VitalCare for Minimum Essential Coverage, or Essential MV, Premium MV or Max MV for Minimum Value coverage. MEC and MV plans are not level-funded.
Your caregivers keep your clients safe at home, but their hours shift week to week, their paychecks move with them, and most health plans were designed for 9-to-5 salaried staff. When coverage comes with deductibles and copays they can't afford, they don't enroll, and they don't stay.
Why hourly teams are hard to cover
- Shifting schedules. Variable hours make it tough to track who's eligible and keep your offers of coverage accurate.
- Paychecks that swing. A large fixed monthly premium is hard to budget on an hourly wage, so many caregivers simply opt out.
- Care that costs a shift. For an hourly worker, a doctor visit can mean a copay and lost wages, so small problems go untreated.
- A real affordability gap. Mercer found only 63% of hourly workers can afford the care they need without hardship, versus 83% of salaried employees.
Affordability data: Mercer, Inside Employees' Minds survey.
Everyday benefits, with clear costs
Preventive care and virtual urgent care are included at no cost. Other covered services have plan-specific copays, deductibles, coinsurance and limits.
Included in every MEC and MV plan
Preventive care and virtual urgent care
- In-network preventive and wellness services covered at 100%
- Unlimited 24/7 virtual urgent care through Recuro Health with a $0 copay
- Prescription benefits vary by plan: discounts or formulary-based copays
Additional coverage by plan
Office visits, prescriptions and more
- KeyCare and VitalCare: $25 primary care copay and $0 virtual behavioral health
- VitalCare: $25 specialist copay; $50 urgent care, laboratory and X-ray copays
- All MV plans: $15 in-network primary care and specialist copays; $50 urgent care, laboratory and X-ray copays
- All MV plans: $0 unlimited telehealth with behavioral health
- MV plans include hospital benefits, subject to reference-based pricing and annual limits
MEC and MV plans use the PHCS network. MEC plans exclude out-of-network services. Unlike our level-funded PPO and HDHP plans, MV hospital and certain other services use reference-based pricing at up to 125% of Medicare; members may owe balances beyond the stated out-of-pocket maximum. Precertification is required for specified services. Chemotherapy, radiation therapy and dialysis are not covered by these MV plans. Plan documents govern all benefits, limits and exclusions.
Minimum Essential Coverage · ACA Penalty A
Minimum Essential Coverage (MEC)
- WellCare — In-network preventive care covered at 100%, $0 virtual urgent care, prescription discounts and a discount companion card. Does not include virtual behavioral health.
- KeyCare — Adds $25 primary care visits, $0 virtual behavioral health and prescription copays of $15 / $30 / $50 / $75 by drug tier.
- VitalCare — Includes KeyCare benefits plus $25 specialist visits and $50 copays for urgent care, laboratory services and X-rays.
Minimum participation: 10 primary enrollments, in any combination of MEC plans.
Minimum Value · ACA Penalties A & B
Minimum Value Plans (MV / MVP)
- Essential MV — $2,500 individual / $5,000 family deductible. $15 primary care and specialist copays; $50 urgent care, lab and X-ray copays. Hospitalization limited to 5 days and 2 surgeries per year, with 30% coinsurance after deductible. $10 Tier 1 generic prescriptions; higher tiers are discount-only.
- Premium MV — $0 deductible. $15 primary care and specialist copays; $50 urgent care, lab and X-ray copays. Hospitalization limited to 7 days and 3 surgeries per year, with a $500 copay per admission. Outpatient surgery: $350 copay, limited to 1 per year. $10 Tier 1 generic prescriptions; higher tiers are discount-only.
- Max MV — $0 deductible. $15 primary care and specialist copays; $50 urgent care, lab and X-ray copays. Hospitalization limited to 14 days and 4 surgeries per year, with a $500 copay per admission. Outpatient surgery: $350 copay, limited to 2 per year. Prescription copays of $10 / $50 / $75 by covered tier; specialty drugs are discount-only.
Minimum participation: 5 primary enrollments, in any combination of MV plans. All three MV plans have a $9,100 individual / $18,200 family out-of-pocket maximum for covered services; reference-based pricing balances may be additional. MV billing and implementation are handled by Beni Solutions.
MEC meets minimum essential coverage requirements but does not, by itself, address ACA Penalty B. Minimum Value coverage must also be offered to enough eligible full-time employees and meet applicable affordability requirements to address both penalties. Ask our team for a quote and the current plan documents.
Why agencies choose Zuniga Health
- Lower, predictable cost. MEC and MVP options let you match coverage to your agency's budget and your caregivers' needs.
- Bilingual support. A high-touch English/Spanish service team plus an AI-powered app for finding care and understanding benefits.
- Nationwide. National network in all 50 states.
Level-Funded PPO and HDHP Plans for Employers with 25 to 2,000+ Employees
A better story to bring to every renewal.
Your employer clients are overpaying for their fully insured coverage — and getting nothing back in return
We partner with forward-thinking brokers to deliver cost-effective, high-quality benefit solutions that help clients reduce costs without sacrificing care. Zuniga Health empowers your clients with smarter health plans that improve outcomes, enhance the employee experience, and provide greater value for employers, employees, and their families.
Innovative Level-Funded PPO and HDHP Plan Design
Deliver a health plan employees will value and use. Our innovative level-funded PPO and HDHP plan design removes financial barriers to care, encourages preventive treatment, and helps employees get the care they need without unexpected costs.
National & Regional Provider Networks
Give your clients' employees unmatched access to quality, in-network care through national and regional provider networks across all 50 states — wherever they live, work, or travel.
Employee Experience
Give your clients' employees an exceptional experience from day one. Our AI-powered digital app makes finding care, understanding benefits, and managing claims effortless — while our high-touch bilingual customer service team delivers real human support in the language members prefer. Happy employees mean fewer complaints, higher satisfaction scores, and a benefits program your clients actually brag about.
Zero Balance Billing Risk
No surprise bills for employees. Your clients get a clean PPO experience — not the RBP headaches that damage broker relationships.
Competitive Broker Compensation
You don't sacrifice comp to offer a better product. Earn competitively on par with fully insured, plus stronger retention year over year.
Stronger Renewal Position
Stop defending 30%–40% premium increases. Walk into renewal with a refund-check story and cost-trend data. That's retention — and referrals.
Our mission
Better Health Coverage for Employees and Their Families
At Zuniga Health, our mission is to help employers provide affordable, high-quality healthcare benefits that support the health and well-being of their employees and families.
We serve employers of all sizes and from every community with flexible health plan solutions, broad provider access, and personalized support. By helping employers manage healthcare costs without sacrificing the quality of their benefits, we strive to make dependable healthcare coverage more accessible to the people and families who rely on it.
Our commitment is simple: better access, greater affordability, and healthier outcomes for every community we serve.
FAQ
Frequently asked questions.
Zuniga Health offers health plans for employers with as few as 25 employees. MEC and MVP plans are not level-funded; only PPO and HDHP plans are level-funded.
Minimum Essential Coverage (MEC) and Minimum Value Plans (MVP) for hourly employees and to manage ACA penalties A and B, plus level-funded PPO and HDHP plans, Dental and Vision plans. MEC and MVP are not level-funded.
Yes. We meet all regulations surrounding the Affordable Care Act.
Zuniga Health operates in all 50 states.
Let's talk.
If you're an employer or broker focused on offering affordable health benefits, drop us a line. A member of our sales team will be in touch shortly.