We're on a mission

to put out of pocket

out of business.

Beacon is a tech-enabled specialty insurance wholesaler.

Introducing genuine, frictionless Gap Health Insurance.

Comprehensive Coverage

  • Covers out-of-pocket expenses, such as deductibles and coinsurance, billed through a fully insured or level-funded major medical plan, up to a specified limit.
  • No exclusions, because it defines out-of-pocket expenses exactly like the underlying medical plan.
  • Prices coverage based on the covered medical plan, instead of an "average" medical plan.
  • Launching in 2024.

Automated Claims Processing

Our claim engine automatically obtains proof of loss from payers and adjudicates claims algorithmically. We don't require member cards, claim forms, provider invoices, Explanation of Benefits statements, medical provider involvement, or human claim handlers. When an insured receives a provider bill (or expects to receive one soon), they simply let us know through our website with the push of a button. Outstanding Gap claims get settled in seconds right then and there.

Instant Payouts

When a claimant reports a claim through our website, they can electronically self-disburse out-of-pocket expenses that their medical carrier has already adjudicated. We can pay out before patients must pay their medical providers and up to 12 months retroactively.

And Much More...

  • Offers flexible funding combinations, including employee buy-ups.
  • Enable employers to set a per capita premium ceiling instead of having to purchase the same fixed coverage amount for every employee.
  • Features an optional cash-based cost of living rider with the same automated adjudication that gets disbursed together with the Gap payout.

Built to last.
Always growing.

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127

Projects done

87%

Chance of coffee

24

Team members

4.7

Average rating

Any Questions?

What is Gap Health Insurance?

Gap is the only supplemental health insurance solution allowed by law to coordinate benefits with major medical group health plans. This means only Gap can indemnify incurred out-of-pocket expenses such as deductibles and coinsurance. In contrast, all other supplemental medical insurance products are fixed indemnity solutions that pay predefined amounts for predefined clinical events, which means they have no logical relationship with an insured’s actual cost-sharing burden.

Is Gap meant for high-deductible health plans?

No. Gap has per se nothing to do with HDHPs. A medical plan's cost-sharing exposure is distributed across 4-8 factors: in-network deductible, coinsurance, copays (office fees), and out-of-pocket maximum, and, if applicable, a second set of these for out-of-network coverage. Gap captures risk across all of these factors, not just the deductible.

Why do employers like Gap?

Gap helps employers manage their own healthcare costs while keeping their health benefits competitive. Employers bundle Gap with affordable primary medical coverage to synthesize a reduction in cost-sharing and total premium costs that wouldn't be possible by purchasing only major medical coverage.

For example, if an employer cannot afford a Gold medical plan, they can combine a Silver medical plan with comprehensive Gap coverage to reduce cost-sharing to Gold plan level, but at a total premium cost below the Gold plan's.

Who pays for Gap?

Gap is typically employer-paid up to a specified limit. Our solution also offers employees a buy-up option to purchase coverage in addition to the employer-provided amount.

How is your Gap solution different?

Our Gap solution tailors both coverage and pricing to an insured's medical plan. Moreover, it leverages a number of electronic data sources to automate adjudication and eliminate the clunky coordination of benefits process with a patient's medical insurer. As a result, our claims process doesn't require any proof of loss submissions, only takes seconds, and enables patients to self-disburse payouts instantly into their bank accounts.

Claims administration for other Gap solutions requires a labor-intensive coordination of benefits process, which involves up to four parties (TPA, insurer, provider, patient), takes several days, and ultimately alienates patients and confuses many providers. In addition, most legacy Gap solutions are priced only based on "representative" health plans, fix coverage at the employer level, and have coverage gaps relative to the underlying health plans.

What is your producer compensation like? 

Our commission is competitive with other Gap products. Please get in touch for details.

How do I quote and enroll my groups?

We work with you like most other insurers. We can ingest census files and provide quick turnaround for both quoting and enrollment. Please get in touch to learn about our census requirements.

Are there any servicing requirements?

No. We quote, enroll, renew, and enable self-billing through census files. Claims and reporting are automated. This means that your Gap groups will run on autopilot, enabling you to focus on your highest value-add work.

Do you also work with retail agents?

At this time, we only work with producers serving groups.

Some of our recent clients

Ready to talk?

Get in touch