OPTIV ADVANTAGE: PRIMARY CARE, WORKPLACE PROTECTION, AND COVERAGE FOR EVERYONE.

Employer-sponsored premiums are projected to rise about 9.5 percent in 2026, the steepest increase in 15 years. The increase affects every employer making benefits decisions: those who offer major medical and are absorbing the renewal, those who have stopped offering it because the math no longer works, and those who have never offered it because the cost has always been out of reach. The pressure lands the same way in every case. On the employee.

Your employees need primary care. They need urgent care when something goes wrong. They need prescriptions to manage chronic conditions. They need behavioral health support. They need the kind of care any working adult needs across the course of a year. The barrier between them and that care is cost. The deductible they cannot meet. The co-pay that stops them at the door of the clinic. The full bill they face when there is no employer-provided plan at all. About forty-one percent of adults carry unpaid medical bills. Roughly one in four postpones care over cost. Care gets delayed. Prescriptions get rationed. Conditions get worse.

This is the coverage gap. It is the most expensive problem in employer benefits, because the underlying health conditions that go untreated produce larger claims later, and the workforce that cannot get care today is the workforce that turns over tomorrow.

Optiv Advantage closes the gap. The plan delivers the full care suite directly to your employees: a dedicated primary care physician, virtual urgent care 24/7/365, behavioral health, dermatology, chronic care, and a 400-plus prescription formulary, all at no copay. At the same time, the Health Maintenance Benefit pays cash directly to the employee through their paycheck every month, against any out-of-pocket cost the care suite does not absorb.

Your employees stop delaying appointments. They stop rationing medications. They get care infrastructure your existing setup never delivered. They keep more money in their paycheck every month.

If you currently offer major medical, your plan stays in place. Your carrier stays in place. If you do not offer major medical, Optiv Advantage delivers a complete care infrastructure for your employees without the cost of a traditional major medical plan. Either way, the architecture turns coverage on paper into care in practice.

Optiv Advantage closes that gap. Paired with Access, every employee on your payroll has employer-provided care.

This is what care in practice actually looks like. Your employees get a dedicated primary care physician they can book with directly, a virtual care team available within 15 minutes for urgent needs, access to 13 specialty disciplines, a 400+ medication formulary delivered to their door, and behavioral health, dermatology, and chronic care included. All at $0 copay. All for the whole family. None of it produces a bill at the end of the visit.

Most §125 supplemental plans offer on-demand telehealth: the employee opens an app, requests a visit, connects to whoever is on call. The visit ends and the employee never sees that physician again. The relationship is transactional. The physician does not know the patient. The next visit is with a different physician.

Optiv Advantage is different. Each enrolled employee gets a dedicated virtual primary care physician. They book with that specific physician. They see them again and again. The physician knows their history, their medications, their chronic conditions, their family situation. Follow-ups happen with the same doctor. The relationship is continuous, the way a relationship with a brick-and-mortar primary care doctor would be.

This is the brand-defining differentiator. Most §125 telehealth is a help line. Optiv Advantage is a primary care relationship.

Behind the dedicated PCP, an integrated care team is available 24/7/365 for urgent needs. Most virtual visits connect to a physician in under 15 minutes. No copay. No deductible to meet. No six-hour wait in an emergency room for something that should have taken fifteen minutes. The care team handles urgent care, behavioral health, dermatology, and chronic care coordination, with the dedicated PCP coordinating the longer-term care plan.

Beyond primary care, every enrolled employee has access to the full Optiv care suite. Everything is included. Everything is for the whole family. Everything is at $0 copay.

A care suite only works if your employees can actually use it, and a tax-advantaged benefit only holds together if the substantiation is captured cleanly. Optiv Advantage builds both into the plan. The Member App carries the care: one digital front door for every employee and their family. Compass carries the substantiation: §213(d) tracking that runs automatically across the year. Neither is an add-on. They are how the architecture operates in real life.

A benefit only works if employees actually use it. The Member App is the single digital front door to every part of Optiv Advantage. Employees and their dependents open one app and tap straight into the care suite. Primary care, urgent care, behavioral health, dermatology, prescriptions, specialist messaging, care navigation, and their Health Maintenance Benefit, all in one place.

No portal training. No referral maze. No multiple logins for different benefits. Most virtual visits connect to a physician in under 15 minutes, anywhere in the country, any time of day or night.

The whole family is covered. A working parent with three kids does not pay per-dependent fees, does not enroll dependents separately, does not navigate different portals for different family members. Everyone on the policy has the same access through the same app.

Across the plan year, your employees make hundreds of §213(d) qualifying purchases. Provider visits. Prescription fills. Pharmacy items. Procedures. Co-insurance payments. Each one substantiates the Health Maintenance Benefit and protects the §105(b) tax treatment that lifts the employee's take-home pay.

Tracking that by hand is impossible. Receipts get lost. Categories get confused. Most members would only catch a fraction of their eligible spend, and the Health Maintenance Benefit would only partially materialize. The substantiation problem would become the employee's problem at tax time.

Compass solves it before it starts. Employees link their cards, bank accounts, and pharmacy rewards programs once. Compass then reads every receipt across the plan year automatically. AI flags the §213(d)-eligible spend. Ineligible items get filtered out. The employee sees a running total all year, and the substantiation supporting their Health Maintenance Benefit is captured without any manual work.

The result is the Health Maintenance Benefit fully realized on the paycheck. Not the partial benefit an employee gets when they forget half their receipts. The full benefit, every pay cycle, all year.

Two tools. One bundled architecture. Both included with every Optiv Advantage implementation at no additional cost. The Member App makes the care accessible. Compass makes the substantiation automatic. Together, they turn the architecture into something that actually runs in the real world, not just on paper.

© 2026 The Optiv Group. All rights reserved.

Educational content only. Savings estimates are not guarantees and require plan-specific review.