Direct Pay Designs is a general agency that builds direct pay health plans for brokers and self-funded employers. We combine direct care services, traditional insurance, and a layer we call Tier Zero into three flexible blueprints. Start with one. Add the rest when you are ready.

Traditional plans run on insurance networks and fee-for-service pricing. Most of what they pay for is everyday care the plan was never designed to absorb. We use direct contracting, virtual care, and transparent pricing to handle the everyday care underneath the insurance plan. Lower cost. Simpler experience. A plan that finally behaves the way it was designed to behave.

Tier Zero is the layer of healthcare we built below the insurance plan. It includes direct primary care, virtual urgent care, behavioral health, generic pharmacy, and basic labs. When Tier Zero handles the everyday care, your insurance plan stops absorbing claims it was never built for. Renewals stabilize. Employees get a better experience. See the Tier Zero page for the full story.

The best-fit groups are self funded or level funded, have 25 or more employees, are facing rising healthcare costs (often 25 to 40% renewals), and are open to a new approach at their next renewal. We are not the right partner for groups who want a one-time price cut without changing anything else. We are the right partner for groups who want a plan that actually works.

Our typical groups see 30 to 40% in total cost savings in year one. The savings depend on plan design, current spend, and how aggressively you adopt Tier Zero. One Florida group with 2,700 lives saw $8.2 million in projected annual savings without changing carriers.

Yes. Depending on the blueprint you choose, insurance plays a different role:

• CashCare Core sits alongside your existing insurance plan.

• CareFlex pairs a new network and stop loss design with direct pay services.

• CareComplete is a fully integrated plan with direct care on the front end and insurance on the back end.

Through our care navigation team, run by Actuate Care, our sister brand under the DPD umbrella. One number to call. One app to open. Real humans on the other end who help members get to the right care for the right cost.

Care navigation is the layer that guides members to the right care at the right time. The right doctor, the right setting, the right price. It is the difference between a member who delays care and a member who actually uses the plan. The result: fewer ER visits, better outcomes, lower claims.

Most groups go live in 30 to 60 days, depending on complexity and plan structure. We have done it faster when the renewal calendar required it.

We pay brokers a flat consulting fee. Not a commission. Paid monthly. No clawbacks. No declining schedule. We call it a consulting fee because that is what it actually is, a payment for the design work the broker does with us on behalf of the client. The full fee schedule is available on request.

Co-branded sales materials. Plan design support. Implementation guidance. Ongoing strategy and renewal support. We also join your first client call so you do not have to learn self funded by yourself.

No. Three blueprints. One menu. One consulting fee. If you can explain a restaurant menu, you can explain Direct Pay Designs.

Yes. That is the design of the three blueprints. Start with CashCare Core alongside the existing plan. Add CareFlex when the back end needs work. Move to CareComplete when the group is ready to integrate fully.

Insurance does what insurance was actually designed to do. Catastrophic coverage. Stop loss protection. Large claims. Specialty pharmacy. We reduce reliance on insurance for everyday care, not for the things you actually need insurance for.

We handle the parts that usually break. Vendor coordination. Implementation. Member experience. Claims optimization. Brokers and employers get a single point of contact and a coordinated plan, not a stack of vendor invoices and a phone tree.

Brokers: book a 30 minute call. Bring one renewal. We will design the blueprint with you on the call.

Employers: submit a plan review request. Bring your last renewal and the last 12 months of claims data. We will show you what a Direct Pay Designs plan would look like for your group.

Yes. Direct Pay Designs is a nationally licensed general agency operating in all 50 states. Non-resident producer licenses for individual team members are handled on a deal-by-deal basis.