A Smarter Approach to Employee Health Benefits.

Our Mission: At CapitolCare we deliver elevated group health insurance solutions designed to simplify healthcare access while supporting employers and employees with dependable, concierge-level service.

CapitolCare is a self-insured, fully-funded medical benefits program designed to provide greater control, cost stability, and predictability in today's challenging healthcare market.

Team

Jodee Aquino

Senior Vice President

Jodee brings extensive expertise in employee benefits, vendor management, compliance, and broker and client relations. She excels at aligning people, processes, and strategic partnerships to drive growth, enhance operational efficiency, and deliver exceptional outcomes for clients and stakeholders.

Todd Houston

Strategic Partnerships

Todd has spent more than 35 years building health benefit solutions for brokers and employers, with deep expertise in self-funding, level funding, stop-loss, and TPA operations.

Corey Scott

VP, Operations

Corey is Vice President of Account Operations, whose focus is giving our broker and employer partners a seamless, easy and collaborative experience for implementation and account management. He values building meaningful relationships, solving problems, and supporting partnership growth.

Marshall McDonald

VP, Strategic Growth

Marshall leads strategic growth and distribution initiatives, with a focus on expanding broker and agency partnerships and bringing CapitolCare’s self-funded medical solution to employers across the country. His work centers on building scalable distribution strategies, strengthening broker engagement, and helping employers navigate alternatives to traditional fully insured medical plans.

Marc Case

Broker Distribution Manager

At CapitolCare, Marc’s focus is building strong relationships with brokers, general agencies, consultants, and strategic partners nationwide. He believes the best partnerships are built on responsiveness, trust, and a shared commitment to making complicated things easier. That means bringing together innovative solutions, trusted partnerships, personalized support, and a relentless focus on service.

We help brokers, general agencies, and insurance agencies stand out by offering clients an innovative, flexible solution to rising renewal costs and limited coverage options.

12 set plan designs with fixed rates, AI yes/no underwriting, national network options, and no-hassle participation rules.

Plan Design & Funding

Fixed monthly payments, budget predictable
12 set plan designs for employer's appetite
Self-funded mechanics, tailored for any size case
Built-in stop loss protection from day one
Excess claims funds retained by the risk pool for stability

Broker Experience

Easy onboarding
Quick response AI underwriting
Streamlined implementation
Dedicated account manager
Claims reporting & plan management
Renewal consulting

Employer & Member Experience

No participation requirements
Dedicated account manager
Eligibility management
24/7 member concierge care
Member claims support
Mobile app – on demand healthcare

Benefit	Bronze 4.5	Bronze 4.4	Bronze 4.3
Deductible (Indv - Family)	$8,000/$16,000	$6,000/$12,000	$5,000/$10,000
Deductible Type	Embedded	Embedded	Embedded
Plan Type	Co-pay	HSA	Co-pay
Primary/Specialist/Urgent Care	$50/$120/$100	30% After Ded	$40/$80/$60
Wellness/Preventative	100% Covered	100% Covered	100% Covered
X-Ray/Lab	30% After Ded	30% After Ded	30% After Ded
Emergency Room	$500 + 30% After Ded	30% After Ded	30% After Ded
OOP Max (Indiv - Family)	$8,700/$17,400	$7,000/$14,000	$8,700/$17,400
In-Patient Hospitalization	30% After Ded	30% After Ded	30% After Ded
Out-Patient Surgery	30% After Ded	30% After Ded	30% After Ded
Prescription Drugs (Tier 1)	$0	0% After Ded	$0
Prescription Drugs (Tier 2)	$35	25% after Ded	$35
Prescription Drugs (Tier 3)	$75	45% after Ded	$75
Prescription Drugs (Specialty*)	Contact PBM*	Contact PBM*	Contact PBM*

*Specialty drugs with a gross cost of $2,500 per month are covered when coordinated with the PBM’s Patient Advocacy Program. The Plan may permit for at least one (1) 30-day fill for each of these drugs during the Benefit Year.

Plan summary is a brief description for illustrative purposes and is not binding. All benefits will be governed and paid based on the Summary Plan Description.

Benefit	Silver 3.3	Silver 3.2
Deductible (Indv - Family)	$3,400/$6,800	$3,000/$6,000
Deductible Type	Embedded	Embedded
Plan Type	HSA	Co-pay
Primary/Specialist/Urgent Care	20% After Ded	$35/$55/$55
Wellness/Preventative	100% Covered	100% Covered
X-Ray/Lab	20% After Ded	20% After Ded
Emergency Room	20% After Ded	$500
OOP Max (Indiv - Family)	$6,800/$13,300	$6,000/$12,000
In-Patient Hospitalization	20% After Ded	20% After Ded
Out-Patient Surgery	20% After Ded	20% After Ded
Prescription Drugs (Tier 1)	0% After Ded	$0
Prescription Drugs (Tier 2)	25% after Ded	$35
Prescription Drugs (Tier 3)	45% after Ded	$75
Prescription Drugs (Specialty*)	Contact PBM*	Contact PBM*

*Specialty drugs with a gross cost of $2,500 per month are covered when coordinated with the PBM’s Patient Advocacy Program. The Plan may permit for at least one (1) 30-day fill for each of these drugs during the Benefit Year.

Plan summary is a brief description for illustrative purposes and is not binding. All benefits will be governed and paid based on the Summary Plan Description.

Benefit	Gold 2.3	Gold 2.2	Gold 2.1	Gold 2.0
Deductible (Indv - Family)	$1,500/$3,000	$3,250/$6,500	$3,400/$6,800	$1,000/$2,000
Deductible Type	Embedded	Embedded	Embedded	Embedded
Plan Type	Co-pay	Co-pay	HSA	Co-pay
Primary/Specialist/Urgent Care	$35/$55/$55	$30/$50/$50	0% After Ded	$15/$40/$40
Wellness/Preventative	100% Covered	100% Covered	100% Covered	100% Covered
X-Ray/Lab	20% After Ded	0% After Ded	0% After Ded	20% After Ded
Emergency Room	$500	$400	0% After Ded	$300
OOP Max (Indiv - Family)	$3,000/$6,000	$3,250/$6,500	$3,400/$6,800	$3,500/$7,000
In-Patient Hospitalization	20% After Ded	0% After Ded	0% After Ded	20% After Ded
Out-Patient Surgery	20% After Ded	0% After Ded	0% After Ded	20% After Ded
Prescription Drugs (Tier 1)	$0	$0	0% After Ded	$0
Prescription Drugs (Tier 2)	$35	$35	0% After Ded	$35
Prescription Drugs (Tier 3)	$75	$75	0% After Ded	$75
Prescription Drugs (Specialty*)	Contact PBM*	Contact PBM*	Contact PBM*	Contact PBM*

*Specialty drugs with a gross cost of $2,500 per month are covered when coordinated with the PBM’s Patient Advocacy Program. The Plan may permit for at least one (1) 30-day fill for each of these drugs during the Benefit Year.

Plan summary is a brief description for illustrative purposes and is not binding. All benefits will be governed and paid based on the Summary Plan Description.

Benefit	Platinum 1.2	Platinum 1.1	Platinum 1.0
Deductible (Indv - Family)	$0/$0	$1,250/$2,500	$250/$500
Deductible Type	Embedded	Embedded	Embedded
Plan Type	Co-pay	Co-pay	Co-pay
Primary/Specialist/Urgent Care	$25/$45/$45	$25/$45/$45 100%	$25/$45/$45 100%
Wellness/Preventative	100% Covered	Covered	Covered
X-Ray/Lab	30% After Ded	0% After Ded	20% After Ded
Emergency Room	$300	$300	20% After Ded
OOP Max (Indiv - Family)	$1,250/$2,500	$1,250/$2,500	$1,250/$2,500
In-Patient Hospitalization	30% After Ded	0% After Ded	20% After Ded
Out-Patient Surgery	30% After Ded	0% After Ded	20% After Ded
Prescription Drugs (Tier 1)	$0	$0	$0
Prescription Drugs (Tier 2)	$35	$35	$35
Prescription Drugs (Tier 3)	$75	$75	$75
Prescription Drugs (Specialty*)	Contact PBM*	Contact PBM*	Contact PBM*

*Specialty drugs with a gross cost of $2,500 per month are covered when coordinated with the PBM’s Patient Advocacy Program. The Plan may permit for at least one (1) 30-day fill for each of these drugs during the Benefit Year.

Plan summary is a brief description for illustrative purposes and is not binding. All benefits will be governed and paid based on the Summary Plan Description.

Support

Get in touch.

Head Office

CapitolCare
4128 Innslake Dr, Glen Allen, VA 23060
[email protected]
Ph: 804-255-9143