Why Detego Health and the Population Science Management Working Owner Model?

Population Science Management (PSM) is a data research and analytics company with the mission of empowering individuals to earn a small amount of money by sharing survey data responses regarding health and wellness. This information is used to create and improve cost saving options for healthcare coverage. Participation in PSM provide Working Owner Participants access to Affordable Group Benefit Plans. This unique Gold Standard for Working Owners, 1099 self-employed, and Gig Economy workers finally offers a solution with benefits unseen in the individual market.

Self-Employed & Working Owners

These custom plans are designed to offer 1099 employees, Independent Contractors and W-2 employees who do not have access to an employer sponsored plan access to affordable group healthcare plans

(for weatlthwave page) The WealthWave plan is designed to serve our Pro Plus members who don’t have access to a traditional employer-sponsored group health plan.

Participation Assessment:

The Prospect Assessment Questionnaire features 11 questions that screen for serious health conditions or treatments.

• (e.g., organ failure, cancer requiring chemo, kidney disease, severe diabetes, recent major surgeries) to determine if the health programs offered by PSM would be an appropriate fit for the prospect.
  • A ‘yes answer from the prospect or their dependents means that the group health care offered by PSM is not a good fit for the member.

What is a PPO? A PPO, or Preferred Provider Organization offers plan participants flexibility in choosing healthcare providers. With the PPO, you can see providers inside and outside of your network, but you will pay less for in-network providers.

What is an EPO? An EPO, or Exclusive Provider Organization, is a type of insurance plan that only covers services from doctors, specialist, and hospitals within its network except in emergencies. EPO’s typically cost less than PPOs.

Critical Note on Medications: PSM’s plans do not cover specialty medications.

• During suitability, check the prospect’s medications against the plan formularies (available on e123 platform). Pay attention to indicators like ‘PA’ (prior authorization) or specialty status—don’t assume a listed drug is covered.
  • If a prospect uses specialty high cost medications, again, PSM isn’t a fit.

What do I do if I do not Qualify? If you do not qualify for the PSM GigCare plans you should call our partner No Fear Insurance. They have a team of healthcare navigators who will work with you to find the most affordable and comprehensive plan for you and your family.

You can reach a No Fear Agent for assistance at: 833-818-1650.

What happens to the data? The data is de-identified or blind to the source. The data is aggregated with the claims data from the participating population to make certain the coverages offered are comprehensive and relative to plan participants. This model is designed to keep cost down going forward.

Who is responsible for paying claims? Detego Health administers plans, provides customer support, and pays claims.

Who can buy the plans? The tier one plans are called GIGCare plans, and they are designed specifically for a population without certain pre-existing conditions, chronic illnesses and who are not taking expensive specialty medications. Prior to enrollment prospective members will be screened through a quick Milliman HIPAA assessment.

When is Enrollment? The initial enrollment period begins on November 1 and runs through December 18, 2025, for an effective date of January 1, 2026. However, you can enroll any time during the year by the 18^th of the month for coverage the 1^st day of the following month. The plans re-set every year on January 1^st.

Are plans available nationwide? Each plan is a little different but there are plans available in all states except: Washington, Oregon, California, Hawaii, Vermont, Minnesota, Wisconsin, New Hampshire, Pennsylvania, Connecticut, and Maryland.

Customer Care (Detego Health)

• PSM GIGCARE Thrive (BCBS) has Care Guides available at 866-200-2513 from 7:30AM - 6:00PM CST to support your every need.
• PSM GIGCARE Intelligent (Cigna), PSM GIGCARE Livelihood (Aetna), PSM RBPs and PSM MaxGuard Limited Med plans have Care Guides available at 866-815-6001 from 7:30AM - 6:00PM CST to support your every need.

Member Portal via web (Detego Health) When you are logged on, you can access your ID card, view EOB's and claims, download forms, access your plan documents and much more!

Covered365 mobile app (Detego Health) When you are logged on, you can access your ID card, complete your required surveys, look-up providers and much more!

How do I get a quote? It is easy to find out the cost of each plan. Our costs are fully transparent, and age banded. Choose the coverage you want and simply go to the All-Plans Chart and go to the age of the primary member. Select the deductible that best suits you and the price is listed for each category.

How do I see the plans? Once we determine which plans are best suited for you, we will provide a summary of benefits.

How do I enroll? Click here for a secure link to complete an information sheet for your family or email ENROLL to helpme@highperformanceins.com OR You can call 833-494-6669. A team member will call you and set up a video link to do a live enrollment.

How long does it take to enroll? The video enrollment takes about 10-15 minutes.

How do I pay? Monthly premiums can be paid via ACH draft or credit card.