The Modern Advantage | Strategic Health Share Administrators
HSA Plan + Health Share

The Modern
Advantage

An HSA-compatible plan built to reduce your taxes while protecting your family. Lower monthly contributions, 100% preventive care at $0, and an HSA that builds year over year — paired with EverTrust Health Share for major medical events.

HSA-Compatible 100% Preventive Care $1,500-$10,000 MRA — EverTrust Health Share $0 Virtual Care
Quick Reference — Plan Structure
Virtual Primary & Urgent Care$0 — Unlimited
Preventive Care100% — $0
Office VisitsMRA Applies
Imaging & LabsMRA Applies
Hospital & ERMRA Applies
HSA EligibilityYes — fully compatible
EverTrust MRA$1,500-$10,000
Dependent CoverageChildren to age 26
The tax-smart choice. Lower monthly contributions paired with an HSA let your unspent healthcare dollars grow instead of disappear. Preventive care is fully covered at $0, and when something serious happens, EverTrust Health Share takes over — sharing eligible costs at 100% after your MRA is met.

Your contributions work twice as hard.

An HSA isn't just a savings account — it's a tax strategy. Money you put in reduces your taxable income, grows tax-free, and rolls over every single year. The Modern Advantage is designed to make this work for you.

Triple Tax Advantage
Available to all HSA plan members

Contributions are tax-deductible. Growth is tax-free. Qualified withdrawals are tax-free. No other savings vehicle does all three.

Funds Roll Over — Always
No "use it or lose it" rules

Unlike an FSA, every dollar you contribute rolls over year after year. Healthy years turn into a growing medical safety net you actually own.

Lower Monthly Contribution
Redirect savings into your HSA

The plan's lower monthly contribution means more cash in your pocket — or your HSA — each month compared to a copay plan or traditional insurance.

How the HSA works with this plan
This plan qualifies as a High Deductible Health Plan (HDHP) equivalent, making you eligible to open and contribute to a Health Savings Account. Use HSA funds for medical expenses before your MRA, and let the rest accumulate.
1
Enroll in The Modern Advantage and open an HSA (e.g. Lively HSA — no fees)
2
Contribute pre-tax dollars to your HSA — reduces your taxable income immediately
3
Use HSA funds for eligible medical expenses — or let them grow
4
Unused funds roll over every year, building a tax-free medical nest egg

Preventive care covered. Major medical shared.

This plan leads with 100% preventive care and $0 virtual care — then EverTrust Health Share handles the big stuff. Office visits aren't covered by the plan directly, but your HSA and self-pay rates often make that a non-issue.

$0
Virtual CareUnlimited primary & urgent care via Amaze Health — includes mental health
100%
Preventive CareAnnual physicals, screenings, immunizations — zero out of pocket at in-network providers
$1,500-$10,000
EverTrust MRAYour responsibility before major medical expenses are shared at 100%
HSA
Tax-Free SavingsFully HSA-compatible — contribute pre-tax dollars, grow them tax-free
What is the MRA?
The Member Responsibility Amount is the amount you cover before major medical bills are shared by the community. It's not triggered by routine or preventive care — only major events like hospitalization, maternity, surgery, or an ER visit. Once you hit it, the community picks up eligible costs at 100%. Many members use HSA funds to cover their MRA when needed.
1
A major medical event occurs — hospital stay, surgery, ER, or maternity
2
You check in as self-pay so the provider bills you directly at self-pay rates
3
Once your Member Responsibility Amount is reached, submit a Sharing Request to EverTrust
4
The community shares eligible expenses above your MRA at 100%

Virtual care is free. Preventive care is free.

This plan is built around what you use most — and covers it at $0. For in-office visits that aren't preventive, members pay directly (often at favorable self-pay rates) or use HSA funds. EverTrust picks up major medical after your MRA.

Core HSA — Everyday Care
HSA Plan
Preventive & virtual care covered · All else MRA applies
Virtual Primary & Urgent CareAmaze Health — includes mental health
$0 · Unlimited
Preventive CareACA-mandated services at in-network PHCS providers
100% — $0
Primary Care Office Visit
MRA Applies
Specialist Office Visit
MRA Applies
Urgent Care Office Visit
MRA Applies
Laboratory WorkQuest Diagnostics & LabCorp
MRA Applies
Diagnostic X-ray / Ultrasound
MRA Applies
Advanced ImagingMRI / CT / MRA / PET
MRA Applies
Psychiatrist, Psychologist & Licensed Therapist
Not covered
Substance Abuse Treatment
Not covered
Dependent Coverage
Children up to age 26
EverTrust Health Share — Major Medical
Health Share
Community sharing after MRA · Check in as self-pay
Inpatient Room & CareSemi-private · Acute or skilled nursing · Unlimited days
Shared after MRA
Outpatient / Ambulatory Surgery & Birthing Centers
Shared after MRA
Emergency Room — Medical Emergency
Shared after MRA
Inpatient Hospital ServicesCardiac, pulmonary, PT/OT/ST, sleep studies
Shared after MRA
Radiation Oncology
Shared after MRA
Maternity — Labor & Delivery
Shared after MRA
Chemotherapy & Advanced Oncology
Shared after MRA
Ambulance
Shared after MRA
Recovery Therapy
Shared after MRA
Advanced Imaging — Hospital Setting
Shared after MRA
Inpatient Mental / Behavioral / Substance Abuse
Not covered
Member Responsibility Amount
$1,500 – $10,000

The care that keeps you well. Covered at 100%.

This plan covers the full scope of ACA-mandated preventive services at $0 — no copay, no prior authorization required. Preventive care is distinct from sick visits: these are scheduled screenings, wellness exams, and immunizations recommended for healthy members.

🛡️
ACA Preventive Care — Covered at 100%. The services below are covered in full when delivered in a preventive context by a participating PHCS provider. If a preventive visit results in diagnosis or treatment of a condition, those services may be subject to your MRA.
Wellness Exams & Screenings
$0 — Plan pays 100%
Annual adult preventive wellness exam — one per benefit year
Blood pressure screening
Cholesterol & lipid disorder screening
Colorectal cancer screening — colonoscopy, sigmoidoscopy, or stool-based tests per USPSTF guidelines
Type 2 diabetes screening
Obesity screening & counseling
HIV screening
Sexually transmitted infection (STI) screening & counseling
Alcohol misuse screening & counseling
Depression screening — adults & adolescents
Lung cancer screening — low-dose CT, adults 50–80 with smoking history (USPSTF)
Women's Preventive & Well-Child
$0 — Plan pays 100%
Well-woman preventive visit — annually
Pap smear / cervical cancer screening
Mammography screening — women 40+, per USPSTF guidelines
Domestic violence screening & counseling
BRCA counseling for women at increased risk
Breastfeeding support, counseling & supplies
Folic acid supplementation counseling
Well-child visits — per AAP & USPSTF schedule from birth through adolescence
Newborn hearing & metabolic screenings
Vision screening — children
Developmental & behavioral assessments — children
Immunizations & Counseling
$0 — Plan pays 100%
Childhood immunizations — per CDC & ACIP schedule
Adult immunizations — per ACIP recommendations (flu, Tdap, shingles, pneumonia, COVID-19, hepatitis A & B, etc.)
HPV vaccine — through age 26
Meningococcal vaccine
Tobacco use screening & cessation counseling
Healthy diet & physical activity counseling — adults with cardiovascular risk
Statin use counseling — adults 40–75 at increased CVD risk (USPSTF)
Aspirin use counseling — cardiovascular prevention (USPSTF)
Preeclampsia prevention counseling — pregnant women with risk factors
Prostate-specific antigen (PSA) — per provider recommendation

We'd rather tell you now than surprise you later.

Like any health plan, this one has boundaries. We'd rather be upfront about what's not included so there are no surprises. Most of what's listed here falls outside what a cooperative sharing model is designed to fund — but when something serious happens, the community is there.

Not Eligible for Sharing
Permanently Excluded Services
Abortion Substance Abuse Treatment Breast Implant Removal Diabetic Medications & Supplies Elective Procedures GLP-1 & Semaglutides (incl. complications) IVF & Fertility Treatments Hearing Aids Infertility Treatment Light Therapies Organ Donation Expenses Prophylactic Medications Seasonal Allergies Sleep Studies Surrogacy TMJ Therapeutics
Pre-Existing — Phase-in Period Applies
Eligible with Phase-in Schedule
Arthritis / Degenerative Disc Disease Allergy Treatment & Reversal Basal & Squamous Cell Cancer Cataracts Chronic Fatigue Chronic Pain Ear Tubes Injections & Regenerative Procedures Joint Replacement Osteoporosis Mastectomy Tonsil & Adenoid Removal Varicose Veins
Pre-existing Condition Phase-in Schedule
Sharing availability grows each year of membership
Year 1
$5,000
Year 2
$30,000
Year 3
$75,000
Year 4
$150,000
Year 5+
No Limit
Conditions Not Eligible for Phase-in — Ever

Cancer diagnosed, treated, under evaluation, referred to oncology, or symptomatic within 36 months prior to membership · Organ failure, end-stage organ disease, renal failure requiring dialysis · Advanced systemic or degenerative conditions involving irreversible organ damage or dependence on life-sustaining therapy.

Important hightlights of sharing.

EverTrust includes built-in safeguards to keep costs fair and predictable for every member household.

Initial 90-Day Ineligibility

The following are not eligible if signs, symptoms, diagnosis, or treatment occur within the first 90 days of membership:

  • Gallbladder-related care
  • Kidney stones
  • Cancer diagnosis or staging
  • Tumors — benign or malignant
  • Kidney disease
Tobacco Surcharge

Households with one or more tobacco users must pay a $100 monthly surcharge in addition to their standard contribution.

Exceptions — Not Considered Pre-existing

The following will not be considered pre-existing if controlled and the member has not been hospitalized for the condition in the 12 months before enrollment:

  • High blood pressure
  • High cholesterol
  • Hyperthyroidism / Hypothyroidism
  • Type 2 diabetes
Maintenance & Ongoing Management

EverTrust does not share in the maintenance or ongoing management of pre-existing conditions. Routine or maintenance care intended to monitor, manage, or maintain a chronic or pre-existing condition is not eligible for sharing at any time.

The Sharing Safeguard

Each household has a built-in protection: no more than two MRAs required in any rolling 12-month period. After two MRAs are met, EverTrust shares additional eligible requests over $1,000 without requiring another MRA.

Two-MRA Maximum per Household
Only two MRAs can be required within a rolling 12-month period per household.
After Two MRAs Are Met
Additional eligible requests exceeding $1,000 are shared without requiring another MRA.
Exclusions from Safeguard
Pre-existing condition requests and maternity requests do not count toward the two-MRA safeguard.

Finding care. Made simple.

Knowing which tool to use for which type of visit makes this plan work seamlessly. Preventive care uses your ID card at PHCS providers. Everything else follows the EverTrust self-pay process.

🏥
PHCS Network — Preventive Care
For preventive care visits, present your ID card at a participating PHCS provider. Out-of-network providers may require direct payment or bill additional amounts.

Search PHCS Practitioner & Ancillary →
📱
Amaze Health — Virtual Care
$0 virtual primary & urgent care, unlimited visits. Includes mental health, lab ordering, care navigation, and specialist referrals. Access from any device, any time.

Access Amaze Health through your member portal →
💊
RX Valet — Zero-Cost Medications
1,100+ generic medications at $0. Includes birth control, blood pressure, thyroid, cholesterol, antibiotics, and more. 35% off vitamins & supplements.

Call RX Valet: 855-798-2538 →
🏦
HSA — Health Savings Account
This plan qualifies you to open and contribute to an HSA. Consider Lively HSA — no monthly fees, no custodial fees. Use funds for medical expenses before your MRA, or let them grow tax-free.
🏨
Hospital & Major Medical — Self-Pay
For hospitalization, surgery, ER, and major medical events, check in as self-pay and request the provider bill you directly. EverTrust Health Share applies — do not present your plan ID card for these visits.
📋
Sharing Requests
Once your MRA is met for a major medical event, submit a Sharing Request to EverTrust. Eligible expenses above the MRA are shared at 100%. Contact your administrator for forms and guidance.

Lower contributions.
Tax-free savings. Real protection.

The Modern Advantage — build your HSA, reduce your taxes, and know the community has your back when it matters.

This plan is a voluntary health sharing arrangement, not insurance. HSA eligibility depends on individual tax circumstances — consult a tax advisor. Sharing eligibility is subject to EverTrust Member Guidelines.

Plan Details
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