Healthcare contracts. Public. Free to use. No middlemen.

We're putting healthcare contracts on the internet. Real ones, with real numbers. Every term, every rate, every pricing rule, all out in the open. The companies on this site agreed to drop the confidentiality, so there's no fine print, no NDAs, no "call us for a quote."

Think of these as an open alternative to insurance carrier networks. Any employer can grab them and use them. Copy them, tweak them, hand them to your TPA. They are completely open source.

Some were negotiated by our team for Mark Cuban's own companies in Dallas. Others come from providers, brokers, and TPAs around the country who think the numbers should be public too. Want an intro? Just ask.

Feedback or questions? info@costpluswellness.com

Walk into a hospital with a credit card and you'll almost always get a better price than the largest insurance companies negotiate. That's not an accident. Every carrier-hospital contract is bound by a confidentiality clause, plus payment terms that make it way more expensive for providers to do business. The whole industry is built on you not being able to see what you're paying.

Until now.

We started Cost Plus Wellness because employers are overpaying for healthcare. A lot. The biggest buyers in the country cover tens of millions of lives, and they still pay more than the person walking in off the street. So we asked the obvious question: why not just negotiate direct prices for all of Mark Cuban's companies and employees?

So we did. We've been running them for over a year. Every contract is now on this site, in full. Rates, terms, all of it. We're sharing what we've learned so any employer can borrow from it. That's the whole idea. We've also started posting contracts from other providers around the country, so any employer can use those too.

Exactly what it sounds like. You (the employer, or your self-funded plan) sign a contract straight with the doctor or hospital. No carrier in the middle. You read the contract. You know the price before care happens. You pay the provider directly, instead of routing through a carrier's complex pricing system that you aren't allowed to see.

Employers who start direct contracting routinely cut total plan spend by double digits, and members usually like the experience better. Why? Because the system sitting between you and that hospital is built to take a cut at every step with multiple layers of middlemen in between. Some of the favorites:

• They pay low and bill high (spread pricing). Carriers and PBMs pay one rate for a service or drug and charge your plan another. The gap is theirs.
• They own the providers you pay (affiliated entities). Carriers now own clinics, specialty networks, medical management companies, and other vendors that submit claims to be paid by your plan - at the prices the carrier has "negotiated" with themselves.
• You pay more than the carrier's own customers (ASO arbitrage). The same carrier often charges a self-funded employer more for the same procedure at the same hospital than it pays under its own fully-insured book.
• You can't steer members to a better deal (anti-steering and anti-tiering clauses). Even when a cheaper, equally good provider exists, network terms can forbid your plan from sending members there or rewarding them for choosing it.
• They charge you for "saving" you money (shared-savings fees). Carriers bill a percentage of every "discount" they negotiate, measured against an inflated list price you never agreed to.

Cost Plus Wellness extends the direct contracting model by publishing the contracts themselves, in full. Most employers don't have the legal team, market data, or provider relationships to negotiate their own. We're making this work reusable, so a 200-person employer can sit down across the table from a major health system on equal footing.

We don't lock in one pricing formula. Most contracts use a percentage of Medicare, since Medicare publishes regularly updated rates for almost every service and handles most edge cases through its built-in rules. For services Medicare doesn't price well, or doesn't price at all, contracts use fixed fees per case, custom rate schedules, or hybrids. Which approach fits best depends on the specialty and the provider.

What stays consistent across every contract we negotiate is what's not in there:

• No balance billing. Members never owe the difference between billed charges and the contracted rate.
• No shared-savings or "percentage of savings" fees. Anyone whose pay scales with "savings" has an incentive to invent them.
• No kickbacks bundled into rates.
• No admin fees disguised as claims.
• No anti-steering or anti-tiering clauses.

Every contract is published in full. And these contracts are explicitly off-limits to insurance carriers, or anyone acting on their behalf. The site also hosts contracts submitted by other parties. Those may have different terms or rates than the ones we've negotiated directly.

Depends on how your plan is set up. Quick primer.

Employers fund their health plans one of three ways: fully-insured, self-funded, or level-funded.

	Fully-insured	Self-funded	Level-funded
How you pay	Fixed monthly premium per employee	The plan pays each claim as it happens	Fixed monthly fee covering admin, stop-loss, and a maximum claims fund
Who bears claim risk	The carrier	The employer, with stop-loss above a per-person threshold	The employer up to the cap; vendor and stop-loss above
If claims run low	The carrier keeps the difference	The employer keeps the savings	The employer may get a refund or credit
If claims spike	Premiums rise next year regardless of population health	The employer pays; stop-loss covers individuals over threshold	The cap holds; stop-loss covers excess, but premiums increase next year
Visibility into pricing	Almost none	Full claims data	Partial. The vendor still controls most contracting

Cost Plus Wellness is built for self-funded plans. If you self-fund, you're basically running a small insurance company. That's a responsibility (you're a fiduciary for the plan's dollars now) and a superpower (you can build a plan that works far better than what large carriers offer off the shelf).

Stop-loss is just catastrophic-claim insurance. It kicks in once an individual's claims pass a threshold. For example, your plan pays the first $25,000 per person per year, and stop-loss covers the rest.

Who runs the plan day-to-day

A self-funded employer hires one of two types of administrator.

	ASO (carrier-owned)	Independent TPA
Network	The carrier's, no customization	Any network, including direct contracts
Rates & data	Confidential; carrier controls visibility	Full claims data, configurable rates
PBM	The carrier's PBM, typically required	Any PBM, including transparent pass-through

ASOs look simple. One company handles everything. But the carrier sets the rules, and you can't carve out direct contracts. Independent TPAs unbundle these services, and that separation is what makes direct contracting possible.

What you need to make this work

1. A self-funded plan (or a level-funded plan whose vendor will accommodate direct contracts).
2. An independent TPA, or an ASO willing to pay claims at published CPW rates.
3. Stop-loss coverage that recognizes CPW rates.

Fully-insured today? The first step is figuring out whether self-funding makes sense for your size and risk tolerance.

Here's how Mark Cuban Companies rebuilt its plan from scratch.

Why we rebuilt it

MCC ran into the same problems every self-funded employer hits. Opaque contracts. Runaway costs. A plan that paid more for hospital services than a walk-in patient with a credit card.

The defining moment came on a single ER claim. The carrier's network required MCC to pay over $45,000 for an emergency visit. The hospital's public price-transparency files showed the same carrier had negotiated $14,000 for the same services through its fully-insured book. Same hospital, same services, same carrier. Three times the price for the self-funded employer.

That's when we stopped trying to renegotiate the carrier contract and went straight to the providers. Those contracts became the foundation of Cost Plus Wellness, and they're now published in full for any other employer to use.

How the plan is structured

MCC's Summary Plan Document organizes providers into three tiers.

Tier	Providers	Member cost-share
Tier 1	Cost Plus Wellness providers	$0 out-of-pocket. Deductible waived. No copay. No coinsurance.
Tier 2	Wrap (PPO) network	Standard plan benefits
Tier 3	Out-of-network	Standard out-of-network terms

The $0 Tier 1 isn't a marketing flourish. It's the engine. When members are looking for a new provider, "free" is the easiest signal to remember and act on. Even with already-generous Tier 2 benefits, MCC's members reliably choose Tier 1 when they have the option.

A $0 Tier 1 isn't required to use these contracts. Plans can structure cost-share however they want, as long as the plan, not the provider, collects any member responsibility. Providers under a CPW contract never chase patients for money. That's what makes cash-like terms work end-to-end. The provider's billing experience stays the same regardless of how the plan's benefits are structured.

The vendor stack

We're a contracting framework, not an administrator. The vendors around the plan (TPA, repricer, stop-loss carrier, wrap network, PBM, care navigation) are what make the model work in practice.

Role	What it does	What MCC uses	What to look for
Independent TPA	Receives claims, identifies CPW providers, pays at published rates within 30 days, prints ID cards, reports on utilization.	Independent TPAs (no ASO arrangement); multiple groups across MCC entities are administered separately.	Owns its payer ID and prints it on member ID cards. Real-time eligibility through a major clearinghouse. Flat-fee or capped pricing, never "shared savings." Direct claims flow with no carrier intermediary. Willing to amend the SPD with direct contract terminology.
Repricing	Applies the contract's pricing rules to flagged claims and returns the allowed amount to the TPA.	Claimsbridge, centralized across all MCC groups.	A dedicated repricer scales better once a group has more than one TPA, or works with a TPA that has less experience with direct contracts.
Stop-loss	Covers individual catastrophic claims above a threshold.	Carriers that explicitly recognize CPW rates in the policy.	Comfort with transparent, published pricing, and pricing that reflects it. No requirement to route claims through a specific network before stop-loss recognition.
Wrap network	Provides nationwide access for services and geographies CPW hasn't reached yet.	A national PPO with a direct-contract carve-out, so wrap rates never override CPW rates.	Direct-contract carve-outs allowed without surcharges. Claims flow direct to your TPA, not through the wrap. No anti-steering or anti-tiering language.
PBM	Pharmacy claims, separate from the medical flow.	A transparent, pass-through PBM aligned with the Cost Plus Drugs approach.	Pass-through pricing, no spread, no rebate retention. ASO carriers usually require their own PBM; independent TPAs let you choose.
Care navigation	Helps members find CPW providers, schedule, confirm benefits, and resolve incorrect bills.	Internal team plus call/text-accessible navigation, with a dedicated employee who maintains the provider roster and member-facing directory month over month.	Reachable by call and text. Provider directory access with CPW providers flagged. Pre-visit advance work. Post-visit support for incorrect bills.

On top of that, MCC uses SurgeonCheck and GAM for individual-provider outcomes and appropriateness data, to help members find high-performing providers within the network.

For employers without an existing TPA, Sage TPA is MCC's current implementation partner. More TPAs are being onboarded.

What members actually see

Start to finish:

• An ID card with the TPA's payer ID, the company's logo, the words "Tier 1 Network," and a phone number for member services.
• A vCard distributed during open enrollment, so the TPA's contact info lives in their phone.
• A member-facing provider directory, updated monthly.
• A call/text care-navigation team that helps schedule appointments, confirms benefits, and coordinates with provider offices.
• Pre-visit calls from the TPA when an appointment is on the books, so the provider's office knows what to expect.

When the model works, it's invisible. A member books an appointment, sees the doctor, and walks out without a bill. When it doesn't (usually because a provider's billing system defaults to wrap-network handling), members know to call the TPA, and the TPA is trained to fix it.

What we've learned

A few non-obvious lessons from running this:

• Adoption is a member-engagement problem, not a contracting problem. Once contracts exist, the work is communication. Simple, plain language messaging beats benefits jargon every time.
• Pre-visit advance work pays for itself. Calling provider offices before scheduled appointments takes time, but it kills almost all post-visit billing disputes.
• Provider front desks need a script. Most are familiar with major-carrier ID cards. They're not familiar with self-funded plans, independent TPAs, or direct contracts. Real-time eligibility feeds in the TPA's clearinghouse make CPW members look the same on screen as carrier members.
• Anti-steering and gag clauses kill the model. Every wrap network and stop-loss vendor needs to be checked for these terms upfront. They're common in legacy contracts and incompatible with a tiered plan.
• Centralized repricing scales better than per-TPA repricing. Once a plan has more than one group or more than one TPA, a dedicated repricer keeps pricing consistent.

Already self-funded with an independent TPA willing to amend its SPD? Then you've got everything you need.

1. Compare your current claims against published CPW rates. Even before launch, this benchmark tells you how much your current network is costing you.
2. Confirm with your TPA that they can pay published rates within 30 days, route claims directly, and update plan documents.
3. Confirm with your stop-loss carrier and wrap network that they recognize CPW rates and allow direct-contract carve-outs.

If you need help navigating all of this, we're happy to share our experience. Tell us a bit more about your plan here and someone from Cost Plus Wellness will reach out: https://costpluswellness.com/employers/inquire

If you're fully-insured, start by figuring out whether self-funding is right for your size and risk tolerance. If you're an ASO client, ask your carrier in writing whether they'll allow direct-contract carve-outs. Most won't, but the answer in writing is the start of any real conversation about switching.

A note on geography. Most published contracts cover Dallas–Fort Worth, where MCC is based. The network is expanding, and the contract templates work for any self-funded employer in the country, even before the published network reaches you.

Most benefits consultants get paid by the vendors they recommend. They don't have a fiduciary duty to your plan. You do. "My consultant said so" is not a legal defense.

If yours says this won't work, here are four questions worth asking before you accept that answer:

1. What are all the sources of revenue you or your firm earn, directly or indirectly, from any of our plan's current vendors?
2. Do we have a contractual right to all of our plan's claims data? If not, why not?
3. When you recommended our current vendors, what alternatives were considered, and why did the alternatives lose?
4. At our last renewal, did you try to unbundle the network, ASO, PBM, or stop-loss components? If not, why not?

The answers will tell you a lot about whose interests are actually being represented.

How is Cost Plus Wellness different from Cost Plus Drugs?

Both are Mark Cuban-backed projects aimed at lowering healthcare costs through transparency. Cost Plus Drugs is a pharmacy that sells prescription drugs at published, transparent prices. Cost Plus Wellness is a contracting framework that helps self-funded employers contract directly and transparently with medical providers.

How does Cost Plus Wellness make money?

Right now? It doesn't. We're an open-source project, not a business. We're not charging employers, providers, or vendors. We might charge for specific services someday, but the point right now is getting prices into the open.

Who can use these contracts?

Self-funded employers (and some level-funded plans whose vendors will accommodate the model). They're explicitly not available to insurance carriers, or anyone acting on behalf of one. By accessing the resources, you're confirming you're not.

What pricing methodology do the contracts use?

Most use a percentage of Medicare. Where Medicare pricing is a poor fit, contracts use fixed fees per case or custom rate schedules. For pediatric vaccines, for example, we use the CDC's published cost per dose. See Contract Basics, Terms & Pricing Methodology for the full breakdown.

Why fee-for-service instead of value-based?

Fee-for-service is simpler to administer and harder to game. Value-based formulas often hide incentives that benefit the contracting party more than the patient or the plan.

What are Community Contracts?

Contracts submitted by providers outside Dallas–Fort Worth using Medicare-based rates. They're published alongside our negotiated contracts, but they're not part of the standard employer network requirement. Employers can adopt them separately if they want to.

How do you handle credentialing?

Every contract requires the provider to maintain all licenses, accreditations, certifications, and training required by law, and to verify those credentials for any personnel before they treat patients under the contract. Providers must be able to produce evidence of compliance on request.

How do you factor in provider quality?

Mark Cuban Companies licenses individual provider outcomes data from SurgeonCheck and uses it to help members find high-performing providers. We also license provider appropriateness data from GAM. Plans implementing Cost Plus Wellness can use SurgeonCheck or any other quality data source they trust.

How do you avoid runaway utilization without prior authorization?

We use retrospective review instead of prospective gates. Data vendors compare each provider's practice patterns to specialty norms. Outlier claims still get paid, but the provider gets a request for justification. Repeated unjustified outliers result in removal from the network.

Implementation

What TPAs work with Cost Plus Wellness?

Sage TPA is the current implementation partner for employers who don't already have an independent TPA. More TPAs are being onboarded. If you want to use a specific TPA, contact us.

How do MRFs work for Cost Plus Wellness rates?

Self-funded plans must publish Machine-Readable Files under the Transparency in Coverage rule. Cost Plus Wellness rates need to be in your MRFs. Most existing MRF vendors and repricing companies can fold them in. Confirm capability before launch.

What about HSAs and first-dollar coverage?

These contracts work with HSA-qualified plans, but IRS rules prohibit first-dollar coverage on most services in HSA plans. The plan still has to pay 100% of the negotiated rate to the provider, then collect the deductible from the member afterward. Plans that can't bill members for deductibles aren't a fit.

What about Direct Primary Care (DPC)?

Cost Plus Wellness pairs naturally with DPC. A strong primary-care relationship plus a transparently priced specialist and facility network is a powerful combination. We're actively exploring tighter integrations with DPC providers, so they can refer to in-network specialists and facilities at $0 cost to members.

How does Cost Plus Wellness work with Reference-Based Pricing (RBP)?

Plans using RBP for non-contracted providers can layer Cost Plus Wellness on top, giving members a clear, in-network path for the providers we cover. RBP and CPW are complements, not alternatives.

For providers

How do providers get paid under Cost Plus Wellness?

Plans pay 100% of the negotiated rate within 30 days of receiving a clean claim. Providers don't collect from patients.

Are providers required to accept all employers using these contracts?

No. Providers opt in to each new employer individually. Once a provider opts in, we connect the employer and provider so they can complete signatures on their copy of the contract.

What if my practice is outside Dallas–Fort Worth?

You can still publish a contract. Contracts from providers outside DFW with Medicare-based rates are published as Community Contracts and visible to all employers. To start, head to the providers page.

Still have questions?

Reach out at info@costpluswellness.com.