Resources · Glossary
The terms, in plain English.
Self-funded. Level-funded. PEPM. PMPM. Stop-loss. PBM. The vocabulary HR, brokers, and CFOs run into when shopping onsite primary care — defined without the jargon-on-jargon.
Plan types
- Self-funded plan
- An employer pays member medical claims directly out of company funds, usually with stop-loss insurance protecting against catastrophic claims. The employer keeps the savings when claims run low — and absorbs the cost when they don't. Required for Archer to make economic sense.
- Level-funded plan
- A self-funded plan with a monthly maximum claims cost — the carrier credits unspent claims back to the employer at year-end. Combines self-funded upside with the predictability of fully-insured cash flow. Archer fits these plans cleanly.
- Fully-insured plan
- The employer pays a fixed monthly premium to a carrier and the carrier owns all claims risk. Archer doesn't structurally fit fully-insured plans because the employer doesn't see the savings when claims drop.
- ASO · Administrative Services Only
- An arrangement where a self-funded employer hires a TPA (third-party administrator) or carrier to handle claims processing without taking on insurance risk. Most self-funded mid-market plans run on ASO.
Pricing models
- PEPM · Per-employee per-month
- A flat monthly fee charged per enrolled employee. Standard pricing model for vendor services like benefits admin, telehealth, and onsite clinics. Archer pricing is functionally PEPM, structured as flat tiers based on onsite days per week.
- PMPM · Per-member per-month
- Same idea as PEPM, but priced per covered member (employees + dependents) rather than per employee. Used in PBMs and some carriers.
- PMPY · Per-member per-year
- Annualized cost per covered member. The KFF and Mercer national surveys publish PMPY benchmarks Archer references in its calculator (e.g., $9,325 single / $26,993 family in 2025).
Cost categories
- Stop-loss insurance
- Catastrophic-claim insurance for self-funded employers. Two layers: specific stop-loss caps any single member's claims, aggregate stop-loss caps the plan's total claims for the year. Archer is wraparound — your stop-loss stays in place.
- Claims pressure
- The fee-for-service equivalent dollar value of care that would have hit a self-insured plan as billable claims if not delivered through Archer. Archer's flat PMPM converts variable claims pressure into a fixed line item.
- Cost redirection
- The pattern of moving care from high-cost settings (ER, urgent care, fee-for-service PCP) into low-cost settings (onsite clinic, virtual). Archer reports cost redirection in PCP / UC / ER columns benchmarked against AHRQ MEPS, FAIR Health, and CMS rates.
- Year-1 ROI
- The point at which year-one savings exceed year-one cost (Archer flat fee + setup). Most Archer-managed populations cross this in the first 12 months.
Care models
- Onsite clinic
- A medical clinic physically located at the employer's site. Archer's flagship model — same NP, same chart, free at the point of care, supplemented by virtual care between visits.
- Near-site clinic
- A medical clinic shared by employees of multiple nearby employers, typically located within a short drive of their workplaces. Useful for distributed workforces where dedicated onsite doesn't pencil.
- Direct primary care · DPC
- A primary care delivery model where the employer or member pays a flat monthly fee for unlimited primary care, eliminating fee-for-service billing. Archer is a B2B direct-primary-care model purpose-built for the 100–1,500 employee segment.
- Continuity of care
- Same provider, same chart, every visit. The single biggest lever in chronic disease outcomes — and what telehealth-only models structurally can't deliver. Continuity is non-negotiable in the Archer model.
- NP-led care
- Nurse-practitioner-led primary care with MD oversight. Lets the unit economics work at lower headcount than the legacy MD-led onsite model — while maintaining clinical quality.
Pharmacy
- PBM · Pharmacy benefit manager
- A middleman that negotiates drug pricing between drug manufacturers, pharmacies, and health plans. PBMs make money on rebates and spreads — much of which doesn't reach the member or employer. Archer's onsite pharmacy bypasses PBM markup entirely.
- Formulary
- The list of drugs a plan or pharmacy stocks and how each tier is priced. Archer's formulary is tuned to the population, not negotiated for rebate maximization.
- Walk-out fill
- Filling and dispensing a prescription on the spot during the clinic visit, so the member leaves with their medication. Archer's onsite pharmacy enables this for most common scripts.
Coding
- ICD-10
- International Classification of Diseases, 10th revision. The diagnostic code system used in clinical documentation and claims (e.g., I10 = essential hypertension, E11.9 = type 2 diabetes uncomplicated).
- CPT · Current Procedural Terminology
- The code system for medical services and procedures (e.g., 99214 = office visit, level 4). CPT codes drive the dollar amounts on a fee-for-service medical claim.
- BAA · Business associate agreement
- HIPAA-required contract between covered entities (the employer's health plan) and business associates (Archer) that handle PHI. Standard part of any vendor onboarding.
Outcomes
- ER diversion
- Care delivered in a lower-cost setting that would otherwise have triggered an emergency-room visit. Best-performing Archer populations show 51% reduction in ER utilization.
- Member utilization
- Annualized member visits divided by covered lives. Archer-managed populations average 206% (≈2 visits/year/member), with best-performing populations like Neely Coble at 306%. Compares to ~70% for traditional employer-sponsored primary care.
- Incremental medical cost
- The additional medical-only cost a self-insured plan absorbs when a chronic condition is uncontrolled, untreated, or unmanaged — relative to a controlled baseline. Archer's quarterly reports cite this per condition with peer-reviewed sources.