With SBMA Restricted Medical plans, you can offer employees meaningful, everyday health coverage without the high cost of major medical. These plans deliver real value, covering essential services your workforce actually uses, while helping you stay compliant and in control.
Restricted medical plans are designed to deliver high-impact, frequently used benefits without the cost-burden of traditional major medical. These aren’t stripped-down plans. When structured and administered with precision, they offer dependable coverage that supports everyday health needs.
At SBMA, our restricted medical packages may include:
Each plan is built to adapt, modular by design and customizable by employer need. That means coverage that fits your workforce, your budget, and your workforce planning objectives.
A 150-person manufacturing company with a rotating shift workforce and high turnover integrated SBMA’s restricted medical plan featuring preventive care, urgent care, Rx coverage, and limited hospitalization.
Coverage went live in under 30 days. Supervisors noted fewer employee questions about benefits, and HR cited improved consistency in compliance reporting and onboarding workflows.
FAQs
Can I offer employee benefits without a traditional group health plan?
Yes. SBMA’s restricted medical packages paired with a Minimum Essential Coverage (MEC) plan allow you to meet ACA Employer Mandate requirements—without the cost, complexity, or participation minimums of a traditional group plan.
What’s included in a restricted medical plan?
Restricted medical plans focus on real-world, high-frequency care. Coverage typically includes preventive care, telehealth, urgent care, dental, vision, mental health, diagnostics, limited inpatient support, and prescription benefits.
Do restricted medical plans meet ACA compliance standards?
Yes—when paired with a MEC plan. This combination satisfies both ACA Penalty A (offer of coverage) and Penalty B (affordability and minimum value), protecting your business from costly compliance penalties.
How are these plans different from traditional group health plans?
Traditional group plans are expensive, rigid, and built for a stable, salaried workforce. SBMA’s restricted plans are modular, affordable, and designed for employers managing hourly, part-time, or high-turnover teams.
Are there minimum participation requirements?
No. SBMA offers coverage with low or no minimums, making it a viable solution for businesses of all sizes—including those with fluctuating headcounts or decentralized workforces.
How do employees access their benefits?
All benefits are available through SBMA’s centralized Gold Standard platform and the HealthWallet App. Employees get digital ID cards, provider access, benefit summaries, and claims tracking—all in one place.
What administrative support does SBMA provide?
We handle onboarding, offboarding, ID card generation, claims reporting, consolidated billing, and real-time enrollment tracking. Our U.S.-based team supports both employers and brokers directly, reducing HR burden and ensuring plan performance.
How fast can these benefits be implemented?
With SBMA’s streamlined infrastructure, most plans can be configured and deployed in under 30 days—complete with digital enrollment and employee communications.
Who are restricted medical plans best suited for?
They’re ideal for employers in hospitality, agriculture, logistics, facilities, and retail—any industry with part-time, hourly, or distributed teams that need affordable, usable coverage with minimal administrative drag.
Why choose SBMA over other vendors?
Because we deliver more than just coverage—we deliver execution. Our restricted medical model is proven, our admin platform is unmatched, and our commitment to service sets the Gold Standard.