How Solo Works
Solo Health — Nationwide PPO Health Plan for the Self-Employed
If you're self-employed, you know the frustration of sifting through a sea of healthcare options — limited plans, short-term coverage, marketplace offerings — overwhelming, and often expensive. Solo takes a different path: your business creates its own self-funded major medical health plan, backed by the strength of a member-owned captive. This page walks through exactly how that works, from structure to sign-up to using your coverage.
Solo runs on a captive model — a membership structure where participating businesses collectively fund their healthcare while sharing the strength of a national PPO network. Your business, rather than you as an individual, joins the captive and establishes its own self-funded plan. That's a genuinely different structure from marketplace coverage, and it delivers major medical benefits in the spirit of the ACA's essential health benefit categories, including preventive care. If the funding model is new to you, our blog explains how self-funded health plans work and why most large employers use them.
Behind the captive sits reinsurance from Odyssey Re, an A-rated, globally recognized reinsurer. If claims ever exceed expected levels, the reinsurer and Vault pay them — with no per-claim or aggregate cap. Members can have full confidence that eligible claims are covered no matter how large they get.
Solo is also a system of partners working together — claims administration, fair-pricing review, care navigation, and concierge support — so there are no wasted dollars and full transparency in how healthcare gets paid for.
Who Solo fits best: self-employed business owners who take their health seriously and want comprehensive major medical coverage without the limitations — and costs — that come with buying alone. Every member passes a health questionnaire, which is exactly what keeps the group's costs down.
Setting up your Solo plan is straightforward, and it all happens online:
- Calculate your cost. Enter your details to see your rate, then weigh which deductible level fits your finances and how you use care — $2,500, $5,000, or $10,000.
- Complete the short health questionnaire. It determines eligibility and is the reason the membership stays healthy and costs stay down. No exams, no records — just honest answers.
- Set up your plan. Choose your plan design and your start date (the 1st of any month, up to six months out), sign your documents, and enter payment details. Your first payment isn't drawn until your effective date.
Want a human walkthrough instead? Talk to our team at any point in the process.
The moment you finish setting up, you'll receive a confirmation email with your plan details. Billing begins on your chosen start date — always the 1st of a month — and that's also when your welcome materials arrive, including:
- Solo Member Portal access — your home base for plan information, documents, and resources.
- Your medical ID card — digital immediately through the portal, physical by mail within 2–3 weeks.
- Benefits Hero — a companion app for understanding and using your benefits.
- Multiplan PHCS (now Claritev) access — everything you need to find in-network providers.
You're supported by Solo's partner organizations from day one — including Vault Admin Services for claims. Some partner services can take 5–7 business days after your effective date to fully activate. At tax season, you'll also receive a 1095-B document for reporting purposes.
Members access the Multiplan PHCS network — providers in all 50 states, no referrals required. Prefer a provider who isn't in the network? Solo is an open-network plan: you can see them too, with out-of-network claims priced fairly under Reference-Based Pricing. Just note that certain services — like planned surgeries and inpatient admissions — require prior authorization whether you're in or out of network. Our network page walks through checking your doctor step by step.
Who does what in the claims process
- Vault Admin Services — Solo's claims administrator. Processes claims, tracks your deductible, and provides claims support.
- Fairos — reviews and reprices claims against objective benchmarks, negotiating directly with providers so pricing stays fair and transparent.
- OccuNet — steps in if you ever receive an unexpected balance bill.
Claims flow through Vault Admin Services automatically when providers bill directly — which is why the golden rule is simple: hand over your ID card, and don't pay in full up front when you can avoid it.
- Tax deduction. Your monthly plan costs are generally tax-deductible as a business expense — coverage becomes a line item of your business, not just a personal cost. Confirm the specifics with your tax professional.
- HSA eligibility. The V2500 and V5000 plan designs are HSA-eligible, letting you set aside pre-tax dollars for qualified medical expenses on top of the business deduction.
- No annual or lifetime dollar limits. Coverage without dollar caps — the same standard as large employer plans.
- Every care dollar counts. What you spend on covered care before your deductible is met applies toward that deductible and your out-of-pocket maximum — and since your deductible is your out-of-pocket maximum, there's no added percentage to cover once you reach it.
Speak with your tax professional about how your business can treat monthly costs as a business expense and what applies in your state.
- Cost advantage, structurally. Because every member passes a health questionnaire, the pool stays healthier — and a healthier pool means more competitive monthly costs. That's a structural advantage, not a promotional discount.
- Transparency and control. You see how healthcare dollars are spent, and as a member-owner you're represented by the captive's Advisory Board in decisions about the plan's future.
- Nationwide access. The Multiplan PHCS network puts over a million providers within reach across all 50 states — plus open-network flexibility for anyone outside it.
- Real support. Solo Concierge helps you find in-network providers, resolve billing issues, and navigate care — one request away.
Solo is built on a simple idea: healthy people make healthy businesses. Staying well benefits you directly — and it strengthens the entire membership, because a healthier group means lower costs for everyone, year after year. That's why membership starts with support to catch things early: preventive care covered at 100% from day one, deductible waived.
Ready to take charge of your healthcare? Schedule a consultation to talk it through, or calculate your monthly cost if you're still exploring.