Another Level of Expertise
Insights That Bring Your Benefits Program Back to Life
At Memberly, we understand that every industry and business structure has unique healthcare challenges. Whether you’re a large multi-state employer, labor union, franchise chain, or a business under common ownership, we provide customized self-funded health plans and healthcare programs designed to meet your specific needs.
Multi-State Employers
Managing healthcare benefits across multiple locations requires flexibility and cost control. Memberly designs scalable health plans that maintain consistency while adapting to regional variations in healthcare access and regulations.
Labor Unions & Associations
Unions need comprehensive, member-focused healthcare solutions. We create self-funded plans that offer affordable, high-quality benefits, helping unions support their members while managing costs effectively.
Franchise Chains
Franchises often struggle with group purchasing power and benefit standardization. Memberly structures custom health plans that allow franchise owners to offer competitive benefits while maintaining affordability and flexibility.
Businesses Under Common Ownership
Companies with multiple entities or subsidiaries require integrated healthcare solutions that streamline administration and maximize cost efficiency. Memberly helps structure plans that consolidate resources while maintaining compliance and quality care.
Tailored Benefit Programs for Your Unique Workforce
Whether you’re navigating multi-state regulations, managing union benefits, or unifying healthcare across franchise locations, Memberly delivers innovative solutions that make healthcare more affordable, efficient, and sustainable. Let’s build a healthcare strategy that works for your business and your employees.
Complex Cases: Work with Memberly When Things Get Complicated
Expert Support for OON Disputes, IDRs, Stop-Loss, TPA Migrations & More
In the complex world of benefits, challenges can arise quickly. Memberly has successfully managed out-of-network (OON) negotiations, Independent Dispute Resolutions (IDRs), Federal Health Appeals Services (FHAS), stop-loss sourcing and negotiation, and TPA migrations, ensuring seamless transitions and cost-effective solutions. With our expertise, we help employers navigate challenges, resolve disputes, and optimize their benefits programs with confidence.
IDRs
Independent Dispute Resolutions (IDRs): Protecting Employers from Mismanaged Claims
Navigating Independent Dispute Resolutions (IDRs) can be challenging for employers facing incorrect claim determinations, excessive out-of-network charges, or unfair payment disputes. Memberly advocates for businesses by challenging mismanaged cases, ensuring that claim costs are controlled, and securing fair resolutions that align with plan terms.
Common Ownership
Common Owner Health Plans: Maximizing Savings by Combining Businesses
Memberly helps businesses take advantage of Common Owner Health Plans, allowing multiple entities with as little as 1% common ownership to combine under a single health plan. By leveraging this structure, employers can unlock larger group pricing, reduce administrative costs, and gain access to better plan options typically reserved for bigger companies.
Stop-Loss
Sourcing Stop-Loss Coverage for Complex Cases
Securing stop-loss insurance for high-risk or complex cases can be challenging, but Memberly specializes in finding solutions for even the most difficult scenarios. We leverage our deep industry relationships and market expertise to source competitive stop-loss coverage for employers facing high claims volatility, large ongoing conditions, or unfavorable risk profiles.
Case Review
Comprehensive Case Review for Self-Funded Plans
Memberly provides in-depth case reviews for self-funded health plans, ensuring employers maximize cost efficiency and risk management. We evaluate claim trends, network discounts, administrative fees, and contract terms to uncover inefficiencies and optimize plan performance. By conducting a thorough assessment, we help employers enhance cost control, improve vendor negotiations, and ensure alignment with financial and coverage goals.
Dom Maggiore, CEO
Memberly was founded by Dom Maggiore, an experienced entrepreneur with a background spanning hospitality, manufacturing, and software. By applying engineering and analytical expertise to the complexities of health plans, Dom and the Memberly team bring a fresh, data-driven perspective to the benefits industry. Prioritizing execution and deep industry knowledge over traditional marketing or sales efforts, Memberly has built a strong foundation of client relationships purely through referrals and exceptional results.
Sleep Better with Memberly
Our proprietary analysis tools provide employers with insights they’ve never had before, giving them the confidence that their health plan is being managed with precision. Clients often tell us they sleep better knowing Memberly is in charge—because we go beyond what any agency or consultant offers. What sets us apart is our ability to deliver savings that far exceed our compensation, ensuring every client engagement generates a substantial return on investment.
Partner with Memberly for Smarter Healthcare Solutions
Navigating the complexities of health benefits can be challenging, but Memberly makes it easy by offering expert guidance and tailored solutions. Whether you’re considering a fully insured or self-funded plan, looking to compare carriers, or seeking dental, vision, life, disability, and critical illness coverage, we help you find the best options at the most competitive rates. With our data-driven approach and industry expertise, we ensure your business gets the right coverage while optimizing costs and compliance.
Health Plans
At Memberly, we help businesses navigate health plans of all types, from fully insured to self-funded, including PPO, RBP, level-funded, and more.
Self-Funded PPO
RBP
MEC
Fully Insured
Pair Your Health Plan with Comprehensive Ancillary Benefits
Enhance your employee benefits package by partnering with Memberly to find the best dental, vision, life, disability, and critical illness coverage. We compare top carriers to secure competitive rates and seamless integration with your health plan. With our expertise, you can offer well-rounded protection that supports employee well-being while optimizing costs.
Dental Coverage
Vision Coverage
Life Insurance
Disability Insurance
Critical Illness
Memberly’s Innovative Health Programs & Custom Solutions
Memberly offers innovative benefits solutions, including our 2-Tier Health Plan, which provides cost-effective coverage options for employers of all sizes. Our Virtual Care Program enhances accessibility by offering telehealth services, ensuring employees receive quality care anytime, anywhere. Additionally, we design custom solutions tailored to each organization’s unique needs, integrating mobile apps for seamless plan navigation, cost-saving strategies, and comprehensive coverage options.
2-Tier Plan
Virtual Care
