We're on a mission to put "out of pocket" out of business.

Beacon is a tech-enabled specialty insurance wholesaler.

Introducing: frictionless Gap Health Insurance

Comprehensive Coverage

  • Covers out-of-pocket expenses, such as deductibles and coinsurance, billed through a fully insured or self-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 claims engine automatically obtains proof of loss from payers and adjudicates claims algorithmically. We don't require ID 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 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.
  • Enables 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.

Built to last.
Always growing.

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Any Questions?

What is Gap Health Insurance?

Gap is the only supplemental health insurance solution that can indemnify incurred out-of-pocket expenses such as deductibles and coinsurance. In contrast, all other supplemental health 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 pay for Gap?

Employers pay for Gap, because it helps them manage their own healthcare costs while keeping their health benefits competitive. For example, if an employer cannot afford a Gold medical plan, they can combine a Silver medical plan with comprehensive Gap coverage to synthesize Gold plan-level cost-sharing at a total premium cost below the Gold plan's.

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 engine doesn't require any proof of loss submissions, auto-adjudicates claims in seconds, and enables patients to self-disburse payouts into their bank accounts immediately.

Legacy Gap administration is a labor-intensive coordination of benefits process that involves up to four parties (TPA, insurer, provider, patient) and can take weeks or even months. In addition, most legacy Gap solutions are priced only based on "average" health plans, fix coverage at the employer level, and have coverage gaps relative to the underlying health plans (e.g. prescription drug cost exclusions). This much friction, operational fragmentation, and lack of transparency alienates patients, confuses providers, and is a non-starter for many employers.  

What is your producer compensation? 

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

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