Program Basics

Did you know, less than 50% of small businesses in the US offer healthcare? We’d like to change that in South County.

Gilroy Chamber of Commerce’s Garlic City Healthcare Program, in partnership with the Small Association Leadership Alliance (SALA), is a comprehensive and cost-effective alternative to traditional plans. This new program offers affordable, accessible, and effective healthcare options for Gilroy Chamber of Commerce members – both businesses and individuals alike. The Garlic City Healthcare Program provides a high-quality, affordable healthcare solution for employers, employees and sole-proprietors. While not health insurance, the program provides 100% coverage for preventative care, options for co-payment features with 100% coverage, and addresses unforeseen medical expenses, such as illness and injury.

The Garlic City Healthcare program is proven insurance alternative for members to consider for their healthcare. The program has several components to choose from to customize their healthcare. When each component is brought together, the result is a comprehensive and affordable option for healthcare. The components include (and are detailed below):

  • Apex Preventative Care Plan that best fits your needs, family, and budget (2 Choices)
  • Add-on a Sedera membership for medical cost sharing to be used for accidents, illness, and unforeseen medical needs. (5 IUAs to choose from)
  • Take advantage of Teladoc telemedicine for increased savings and services (included with Sedera membership)
  • The comfort of 2nd.MD to ensure you and your family receive the most up-to-date medical treatment available (included with Sedera membership)

This program is not insurance. It is an alternative solution that features a choice of two preventative care plans, each coupled with a medical cost sharing membership for sharing expenses related to unexpected medical needs. Participants can expect to save as much as 60% when compared to health insurance!

The Garlic City Healthcare Program, in partnership with SALA, is one solution to the high cost of healthcare in the western region!

We are pleased to provide you an exciting new comprehensive national healthcare program that provides an average monthly savings of 60%!  Participants choose either the Basic MEC Plan (HDHP) or the Advantage Plan and then pair it with the Cost Sharing Plan that best fits their needs and age.  This innovative two-part program simplifies healthcare and reduces cost by rate-locking the preventative care plan and offering a wide range of prices options to fit any monthly budget.

Your choice of two preventative service plans

Plans to cover routine and annual checkups

Apex is the preventative care component of the SALA Healthcare Program. The Apex plans are not an insurance product, but a self‐funded plan sponsored by the Small Association Leadership Alliance (SALA). The Apex plans qualify as Minimum Essential Coverage (MEC) plans for preventative care coverage. A MEC plan must cover 100% of the Centers for Medicare & Medicaid (CMS) listed preventative and wellness benefits. The Apex plans are designed to meet your day-to-day healthcare needs.

Participants choose either the:

  • Apex Basic MEC Plan (HDHP)
  • or Apex Advantage Plan

Both plans comply with ACA mandated preventative services with 100% coverage for all 21 preventative services for adults, 26 services for women, and 27 services for children.
Click here to learn more about the ACA requirement 

Apex HDHP/Basic MEC: The Apex HDHP (High Deductible High Premium) Plan provides the Minimum Essential Coverage at a lower monthly cost but does not include a prescription plan or coverage for specialists. The Apex HDHP plan does allow for the addition of a Health Savings Account (HSA).

This plan includes:

  • 100% coverage for preventive care services
  • The plan provides the required framework allowing members to setup and use a Health Savings Account (HSA) for qualified medical expenses

View Current Rate Sheets for Apex HDHP/Basic MEC 

Apex Advantage Plan: Apex Advantage provides 100% coverage for preventive care, copayments for small and medium cost medical expenses, and prescription coverage.

This plan includes:

  • 100% coverage for preventive care services
  • Small co-pays for Specialists, Urgent Care, Lab, Imaging and Prescription Drugs.
  • Prescription drug coverage managed by WellDyneRX

View Current Rate Sheets for Apex Advantage 

To learn more about the Apex options, we recommend reviewing the following:

Sedera Medical Cost Sharing

Sedera Medical Cost Sharing

The Sedera medical cost sharing model boldly challenges the insurance status quo. Through an innovative layering of healthcare services, we enable individuals and family’s access to high quality healthcare that is affordable, flexible and effective.

In addition to sharing medical expenses, Sedera provides access to valuable Counseling, Medical Bill Negotiation, Telemedicine, Expert Second Opinion, and Personal Member Advisor services to all members.

You can choose from 5 IUA’s (Initial Unshareable Amount) that range from $500 to $5000.

To learn more about Sedera we recommend reviewing the following:

Telemedicine through TelaDoc

Telemedicine through TelaDoc

Sedera members have 24/7/365 access to a board-certified physician through Teladoc telemedicine. This service provides on-call physicians available to help resolve routine medical issues by phone or video consultations. Members considering a trip to the Emergency Room, urgent care center, minute clinic or who just cannot wait to get scheduled for a doctor’s office visit can use Teladoc to access medical care, saving both time and money.

Benefits include:

  • On-demand care – talk to a doctor anytime, no matter where
  • Prompt diagnosis for faster treatment
  • No consultation time limits
  • Treatment of children of any age
  • Secure and portable health records
  • Cost savings on expensive ER or urgent care visits
  • Physicians can prescribe non-narcotic medication or refills when appropriate
2nd.MD Medical Second Opinion

We’ve all hassled with doctor waitlists, gone back and forth to get a referral and searched the web for answers to medical issues. As a member of Sedera Health, you can bypass these frustrating steps through a program called 2nd.MD. This offering allows members to quickly and easily connect with some of the world’s best doctors for consultation via phone or webcam.

Benefits include:

  • Distinguished Network: 2nd.MD recommends the best medical specialist for your care.
  • Virtual Consults: Schedule a video or phone consultation at a time that’s most convenient for you.
  • Concierge Care: Provides you with a dedicated medical professional who handles your case from beginning to end.
  • Follow-Up Notes: Once your consultation is complete, you will receive a written summary from your doctor.
  • Local Referrals: 2nd.MD will help you find local doctors and institutions best equipped to carry out your treatment.
Real participant stories from around the country!
  • An individual in Washington, DC is saving $497 or 55% per month
  • A family of four in Lafeyette, CA is saving $1,225 or 64% per month
  • A couple in Douglasville, GA – saving $1,395 or $61% per month
  • An individual in Gaithersburg, MD – saving $390 or 64% per month
Key Takeaways
  • Available to businesses AND individuals
  • Available to full-time, part-time and seasonal staff
  • The Garlic City Healthcare Program, provided by SALA, lowers healthcare costs by as much as 60%
  • Enrollment is monthly – you may join at any time
  • Offers a choice of two high-quality, affordable healthcare solutions
  • Includes a four (4) year “Rate Lock” – offering rate stability in a very unstable market*
How to Get Started

Your step-by-step guide to the Garlic City Healthcare Program:

  1. Your step-by-step guide to the Garlic City Healthcare Program:
    1. Be a Gilroy Chamber of Commerce Member in good standing. If you are not a Chamber member, please contact Eric Howard for information on how to join(ehoward@gilroy.org or 831-588-3544)- Employees of Chamber Members are eligible to apply for SALA.
    2. Residents of Gilroy and surrounding areas, along with employees of businesses who are not Chamber members may join the Chamber at the basic membership level and become qualified for SALA and other benefits.
    3. Watch the informational webinar.
      Viewing the webinar will be the best introduction to this program and will help you understand the documents and resources below.
    4. Explore the program & plans.
    5. Click on the document links along the right hand side of this page to explore program details, FAQ, Key Terms and real-world savings examples!
    6. Decide if this program is right for you, your family, your employees or your business.
    7. If it’s the right fit, continue to step 8.
      If it isn’t, don’t be discouraged – the Gilroy Chamber of Commerce is committed to providing options for our members to access affordable healthcare and ways to fill coverage gaps.
    8. Time to join! Please contact the Gilroy Chamber at 408-842-6437, or email chamber@gilroy.org. Once we have verified your membership, we will send you the enrollment link.

For more help and answers to your questions,
p
lease contact our healthcare program support center by email:
hpsupport@smallassociations.org or toll free at 888.994.4979

 

DISCLAIMER:  SEDERA, INC. IS NOT AN INSURANCE COMPANY AND THE SEDERA MEDICAL COST SHARING MEMBERSHIP IS NOT ISSUED OR OFFERED BY AN INSURANCE COMPANY.  WHILE EVERY EFFORT IS MADE TO MEET MEMBER’S MEDICAL NEEDS, SEDERA, INC. AND THE SEDERA MEDICAL COST SHARING COMMUNITY DO NOT GUARANTEE PAYMENT OF ANY MEDICAL EXPENSE