The PRISMHealth Program was created in 2003 to provide members with a cost-effective alternative to their current healthcare coverage options. Available to both small (<200 eligible participants) and large (>200 eligible participants) member segments, the PRISMHealth Program capitalizes on the concept of risk share pooling in order to reduce healthcare premiums and ensure that all members are afforded equitable participation based on their benefit plans and specific claims performance.
The pooling approach creates value and long-term stability for your entity by securing the lowest possible fixed costs from our premier carrier partners and combining similar risk profiles in a financially stable pool. With the PRISMHealth program, you will have the flexibility to match current plan designs and implement product offerings to contain costs for both active and retired employees.
As the second largest public sector healthcare purchasing program in California, PRISMHealth now covers more than 41,000 employee /retiree primary subscribers. To maximize savings for the PRISMHealth pool, in 2006, PRISM entered into a risk sharing contract with SISC (Self Insured Schools of California). The partnership resulted in the PRISMHealth program becoming part of an even larger pool, covering more than 400 agencies with 150,000 primary subscribers.
Since its inception, the PRISMHealth Program has consistently outperformed the marketplace, effectively competing with standalone plans, other pooled arrangements and CalPERS. The PRISMHealth Program is founded on the basis of the RIGHT RATE, RIGHT NOW, focusing on maintaining a balanced renewal trend, with less year to year rate volatility.
Our carrier partners:
Beginning in 2023, PRISM partnered with UMR, a third-party administrator, to bring members and prospects a flexible and high-touch customer service option utilizing the United Healthcare provider network. The UMR option can be combined with Accolade, a Care Navigation Service, as well as Surest, a Dynamic Copay Plan Option.
For more information on PRISMHealth , please contact: