Have Questions? We’ve Got Answers

Find answers to the most frequently asked questions about OPOC.us.  Please reach out if you don’t see the answer to your question!

OPOC.us — Helping companies take CARE of their most important asset – their employees.

FAQ

Our Model

How is OPOC.us different from a traditional broker or insurance company?

The industry traditionally works on a “bid and quote” model that doesn’t solve the root issue of rising costs. OPOC.us uses a data-driven Strategic Planning process that aligns your costs with your outcomes. We eliminate hidden fees, create transparency, and focus on long-term results rather than quick fixes.

Do we need to change carriers or networks to work with OPOC.us?

No. In many cases, we keep the same carriers and networks employees are comfortable with. The difference is in how the plans are structured and managed, giving you greater control and savings.

How long does implementation take?

We get started immediately on working towards better benefit plans and reduced expenses. Our team handles the heavy lifting so your HR team isn’t overwhelmed.

Healthcare & Benefits

Are your plans self-funded, level-funded, or fully insured?

We can work with all structures. The best fit depends on your company’s size, goals, and tolerance for risk. Our job is to help you evaluate options and recommend the structure that balances cost control and employee satisfaction.

What networks are available?

We provide access to all major national networks, so employees can keep broad access to providers.

Are there participation or contribution requirements?

Yes, but they vary depending on the plan type. We’ll walk you through what applies to your organization and make sure you stay compliant while maximizing flexibility.

How do you ensure benefits don’t get reduced while lowering costs?

Our model is built around improving benefits while lowering costs. Savings typically come from removing inefficiencies, not reducing coverage. Our commitment is for employees to actually experience better benefits with lower out-of-pocket costs.

What results can we expect in year one and beyond?

Most clients see measurable savings in year one (Averaging 11.1% net reduction) while maintaining or enhancing benefits. Long-term, the model helps flatten the renewal curve and protect against double-digit increases.

Support & Service

What is the CARE Center, and how does it support employees?

The CARE Center is our in-house advocacy center where employees can call, email, or chat to get real-time help. Whether it’s finding a doctor, resolving a billing issue, or understanding a claim, our team is ready to step in so HR doesn’t have to.

How do employees access the CARE Center?

Employees can reach us by phone, email, or text – whatever’s most convenient for them.

What do PersonalCARE Advocates do?

Each group is assigned a PersonalCARE Advocate who acts as an extension of your HR team. They help employees before, during, and after care – reducing confusion, preventing surprises, and improving satisfaction.

How It Works

How is OPOC.us different from a traditional broker and the annual bid/quote cycle?

Traditional models center on once-a-year marketing. OPOC.us runs a year-round, data-driven process: claims and PBM audits, formulary and site-of-care optimization, and a CARE Center that supports employees every day. The result is lower total cost, better benefits, and a top-rated member experience.

Will partnering with OPOC.us cost more? How are you compensated?
We are committed to delivering all of the additional services at No Additional Cost. The embedded fees already built into your current structure will come to OPOC.us.
Will working with OPOC.us add work for HR?

It reduces HR workload and makes life easier for them. We work as a partner to your HR team, helping handle the onboarding and paperwork and work alongside them for all their benefits administration needs.  Plus, OPOC’s customer-branded CARE Center and Personal CARE Advocates™ handle everyday employee benefits, claims, Rx, and prior-auth issues, so HR can focus on hiring, retention, and strategy. We also provide clear dashboards and implementation support.

Our renewal is six months away—should we wait?

Starting now creates leverage. A 60–90 day assessment surfaces quick wins and positions you to make informed decisions ahead of renewal.

Can OPOC.us prove results?

Yes. We share audited case studies and association endorsements showing measurable cost reductions, stronger benefits, and higher member satisfaction. We’re happy to provide references relevant to your industry.