Prescience

Employers, especially startups and SMBs, typically buy health insurance through brokers, PEOs, and fully-insured carriers, paying for layers of carrier margin, PBM spread, broker commissions, and PEO admin fees on top of actual medical costs. The page itemizes a sample 100-250 employee PEO plan totaling $2.3M per year ($13,200 PMPM) across claims, pharmacy, network, broker, admin, ancillary, and static HSA categories, many of which are described as hidden markups or loadings. Employees in this model face deductibles, limited transparency into wait times or copays, and benefits that are seen as a weaker part of a job offer compared to salary. HR teams also spend significant hours on plan setup, COBRA, ACA filings, and payroll sync under this traditional model.

Prescience is a health benefits platform that designs a custom plan for a company in days, led by an MD team, and replaces broker and carrier-driven administration with automated handling of claims adjudication, COBRA notices, ACA filings (1094/1095, Form 5500), and payroll sync (shown integrated with Gusto). Its Diamond plan includes a $0 deductible, GLP-1s, a wearable, gene sequencing, and a 24/7 AI Care Companion that combines wearable data and medical records to triage health issues and route employees to care, with real MDs looped in when needed. The platform funds employee HSAs on a just-in-time basis rather than requiring employees to carry deductibles, with contributions described as triple-tax-advantaged and usable on a marketplace including Eight Sleep, WHOOP, Function, and Oura. A 'Time Machine' model is described as predicting health event costs and routing employees to lower-cost 'ideal route' care, with a worked example contrasting a predicted $26,600 path against an $890 AI-routed path. For the same itemized 100-250 employee group, Prescience presents a comparison plan totaling $1.5M per year ($8,400 PMPM), and states it does not charge admin fees, broker commissions