FAQ

Yes, we support this with Medicare Advantage, Medicaid, ACA, employer, and other health plan clients that we serve. We support a variety of restriction types, even within a singular benefit (e.g., within an OTC benefit, we can restrict in-store purchases at our high value retailer network to only specific items via our development of an AP, or approved profile).

Yes, we work with multiple fulfillment partners to provide members access to eligible OTC products to purchase online and by phone. Our solution meets the full scope of the plan’s needs and includes a service level agreement of two-day delivery for 97% of OTC catalog orders.

evermore produces a best-in-class OTC catalog that serves as a guide to help members shop to get the most out of their supplemental benefits. It is designed to be easy-to-understand, helpful, and vibrant. The goal is to make the shopping experience clear, no matter how they choose to shop – in store, online, or via phone.

Unlike other flex card providers, evermore directly integrates with our retail partners (as opposed to borrowing third party technology), which means(1) we can accurately and consistently restrict (i.e., “adjudicate”) transactions down to the item-level and (2) provide item-level reporting back to the plan.

Unlike other flex card providers, because evermore has direct integrations with retailers, we can consistently and accurately restrict transactions down to the item-level.

Unlike other flex card providers, because evermore has direct integrations with retailers, we can provide item-level reporting back to health plans. Our item-level reporting will verify that restricted items have not been purchased.

evermore’s approach to Smart Benefits enables us to support virtually any type of supplemental benefit that can be purchased with a Mastercard. Restriction capabilities are powered through evermore’s proprietary technology and can be mixed and matched to co-design locally and culturally relevant benefits that best meet the plan member needs. We can easily restrict the purchase of alcohol, tobacco, and firearms as required by Medicare regulations. We can support approved supplemental benefits by applying the following restriction types, from broadest to most narrow:

• Approved network: Spend anywhere Mastercard is accepted
• Approved merchant category: Spend at approved categories of merchants such as dental practices, utilities companies, or medical providers
• Approved merchant: Spend at a specific merchant such as a particular dental practice, utility company, or hospital
• Approved item category: Spend on item categories such as fruits, vegetables, oral care (available in our high-value retailer network)
• Approved item(s): Spend on specific items (SKUs) such as fresh apples but not candy apples, toothpaste but not mouthwash (available in our high-value retailer network)

Unlike other flexcard providers, evermore can consistently and reliably exclude purchases of alcohol, tobacco, firearms, and other non-eligible items and provide a monitoring and oversight program that verifies restricted items are not purchased.

Unlike other flex card providers, evermore can restrict purchases at the item level, which allows for nuanced approval profiles that may include healthy foods but not foods that are unhealthy.

Unlike other flex card providers, evermore can accommodate multiple purses on a single card and there is no limit or additional cost based on the number of purses. Additionally, benefit purses are entirely configurable to meet the needs of your program or specific populations. This includes eligibility, benefit amounts, approval criteria, expiration, and rollover rules.

evermore provides multiple full-time employees who are exclusively dedicated to the plan’s implementation. This includes a Benefits Designer lead (who will assist in confirming benefit packages and program design) and an Implementation Lead, who will be responsible for managing the day-to-day tasks required to implement the program on-time, along with all communications between evermore and the plan.

Our goal is to make implementation as easy as possible for our plan partners. We are consistently named our customer’s best implementation partner and have CSAT scores that validate our expertise and superiority for implementations.

Unlike other flex card providers, we currently meet these requirements with our existing California plans. The evermore platform was purpose built for compliance with all federal and state regulatory requirements for Medicare Advantage plans, including Special Needs Plans for Dual Eligibles. The platform’s data richness, full observability, and comprehensive reporting capabilities enable it to meet evolving regulatory requirements and client needs,ensuring ongoing compliance with current and future federal and California state regulations.

Unlike other flex card providers, evermore maintains robust records to both support our customers’ audit requests and support customers through third-party/government audits. We have a customer compliance team that responds to customer compliance needs and requests. This team will support the plan, including gathering accurate responses and supporting documentation as requested by the plan’s compliance team to complete the process timely. We require similar record retention requirements from our subcontractors for the same purpose. Additionally, our personnel, including our subcontractors, can be made available to provide additional support to the plan for third-party/government audits.

evermore does NOT utilize any offshore resources.

Yes, we currently work with health plans that offer Special Supplemental Benefits for the Chronically Ill (SSBCI). Our Smart Benefits platform is designed to support the unique requirements of SSBCI programs by enabling highly personalized and condition-specific benefits. We allow plans to tailor benefits based on clinical criteria, such as chronic disease diagnoses or social needs assessments, and configure benefit eligibility, frequency, and expiration accordingly.

Benefits administration is designed to be easy and flexible to manage benefits by plan, population, or even down to the individual. The plan administrators can add, modify, or remove benefits at any time via SFTP file transfer, API, and/or an administrator portal.

Because evermore’s platform is purpose-built for healthcare, our platform enables real-time activation and member notification of benefits upon SSBCI qualification. We additionally offer benefit configuration options tailored to SSBCI such as our Expanding Combined benefit which allows Plans to change a benefit’s spending restrictions without modifying other configurations such as periodicity, rollover, and the member’s remaining balance at the time of qualification.

For example, let’s say a Plan offers a $50 per month base OTC benefit for all members and an additional SSBCI-qualified Food benefit that is filed under the same benefit amount as OTC.

Once a member qualifies for SSBCI, the member’s benefit would “expand” from an OTC-only benefit to a “combined” OTC + Food benefit. If the member had spent $26 of their $50 benefit prior to the conversion, their remaining balance of $24 would be available to spend for the new OTC + Food benefit for the remainder of the month. When the next month begins, $50 would be available to spend as an OTC + Food benefit.

evermore can support the plan with the administration of rewards and incentives, as a standalone service or as an addition to a larger, dynamic benefits package. For example, we can administer rewards on the same evermore Smart Benefits card that members are already using for their Medicare supplemental benefits or, for standalone rewards programs, we can send prospective “empty” evermore Smart Benefits cards at the start of a program (loaded with rewards once members complete defined healthy actions) or retrospective cards over the course of a program (sent once defined activities have been completed). Just as unspent benefit dollars are returned to the plan, unspent reward dollars are also returned to the plan after a defined expiration date. Rewards can be configured to reflect your desired level of restriction – OTC, healthy foods, gas, or simply general spend that excludes alcohol, tobacco, firearms, cash/gift cards, and lottery tickets.

Unlike other flex cards, we have clinical integrations within our retail network that provide us additional channels to engage locally with members in their communities and incentivize pharmacy assisted gap closure (e.g., flu shot, A1c screening, BP screening, etc.). We can reach members at integrated locations using in-store SMS prompts, outbound calls from their local pharmacist, as well as reminders at the pharmacy counter via prompts in the pharmacist workflow. After a member accomplishes a healthy action at an integrated retail location, evermore can unlock rewards to members within 48 hours (without having to wait on a claim or self-attestation).

We also enable direct gap closure through our survey and screening technology in the evermore Member Portal. The portal provides members with a space to view their benefits and rewards, and it can also host critical screenings, such as Health Risk Assessments and SNS-E, in a place that’s easy for members to find and complete. For example, as a member activates their new evermore Smart Benefits card and registers for the Member Portal, they might also see a prompt with an incentive to complete an HRA within the Portal while they are logged in. Completion of the HRA could automatically trigger a member reward, providing instant gratification for having engaged with their plan.

Rewards programs can be administered for population segments (e.g., Medicare care gap closure campaigns, Medicaid maternal health programs, etc.) and can be launched according to the plan goals throughout the year. evermore’s outreach for rewards and care gap closure programs can include mailers, email, SMS, outbound calls, and in-workflow prompts for integrated retail pharmacies.

During their time building and scaling Walmart’s flex card program, our founders witnessed the failure of existing competitors in this space trying to retrofit legacy payment systems. It was clear the legacy systems could not adequately manage restricted spend and the evolving needs of health plans at scale. evermore was founded to create a modern platform built on direct integrations with retailers that provides the capabilities necessary to succeed in the market, keep members happy, and provide health plans with innovative ways to address the social drivers of health.

Our solution provides unique capabilities in the ways that we interact with members, support our health plan clients, and partner with our high-value retailer network, including:

Member Experience

• 99.8% accuracy rate on transaction rates when using our Smart Benefits card (compared to the industry standard of 90-95%) means satisfied members, reduced support calls, fewer complaints and grievances, and ultimately higher Star ratings and retention rates.
• Multiple ways for members to access their benefits and support—digital, telephonic, and physical—to meet members where they are, regardless of digital literacy or access.
• Multi-language communications and culturally sensitive outreach to ensure all members understand and can use their benefits.
• Exclusive SMS capabilities including instant transaction confirmations and decline reasons.

Health Plan Support

• Benefit administration portal (i.e., “Member Admin”) with dynamic ability to add or remove benefits down to the member level in seconds (rather than weeks) anytime throughout the year. evermore is the only vendor who can address updated CMS guidelines for SSBCI administration with the ability to combine purses or maintain separately on one card and flex up or down throughout the year.
• Easy to use but powerful market analytics, compliance reporting, and benefits optimization tools.
• Reporting portal with real-time operational dashboards that contain the required granularity to meet and exceed CMS requirements.
• Exclusive pharmacy integrations that enable seamless gap closure initiatives via custom messaging reminders for care and HRA administration (e.g., Kroger and Albertsons affiliated banners with more being added).
• Account manager led stewardship meetings provide actionable insights into program performance.

Retail Network Experience

• Direct, rather than third-party, integration of retailers means we can add new retailers in a fraction of the time versus other flex card providers. This helps us address the custom needs of our clients’ members by integrating local and culturally important retailers into the network quickly.
• Streamlined technology: our retailer point of sale integration spec is only 12 pages long, compared to the hundreds for legacy solutions, which means evermore is easy for partners to integrate and deploy.

Members have multiple options to access their benefits, including in-store or online with our retailers, or online or by phone through our catalog. Members can use their benefits online through our Member Portal to place OTC order online for home delivery.

We ship cards and catalogs together (when applicable) in our Welcome Package (complete with card, carrier, card holder agreement (CHA), OTC catalog, welcome letter). We deliver an exceptional member onboarding experience, because we know it is key to delivering value, mitigating complaints, driving enrollments, and enabling member satisfaction. We make successful onboarding seamless and painless with a human-centered experience designed with your members in mind.

For all materials, we use first-class or standard mail, based on the plan preference. evermore has implemented the USPS’ Intelligent Mail barcode (IMb) service to track mail along its journey and provides critical observability while cards are in transit to your members. Cards are mailed 3-5 business days after receiving an eligibility file and typically arrive in members’ hands 5-7 business days thereafter. We are also able to ship additional member communication (e.g., personalized letters, postcards, or other direct mail) within 48 hours.

Upon receiving their card, members have a variety of channels where they can activate their card (clear instructions are made available on the card carrier):

1. Dial the IVR (number printed on back of card)
2. Dial a live agent (number printed on back of card)
3. Text ACTIVATE to our SMS short code (if opted in)
4. Via the Member Portal during the registration process
5. Via the mobile app during the registration process

If a card is lost or stolen, members can request a replacement card by calling our contact center. Additionally, the plan-designated stakeholders will have access to our Member Admin tool, where they can order replacement cards on a member’s behalf.

For other questions, members can call our contact center to speak with a live Customer Care Specialist.

evermore was built to solve the common problems our Founders saw members struggle with at Walmart, where they managed 45 million directed spend transactions administered by other flex card provider:

1. Rejected items at checkout: Members may encounter frustration when certain items are not covered or are rejected at the point of sale. To address this, evermore developed our solution from the ground up to integrate directly with retailers instead of utilizing third-party payment services. SKUS are updated daily to ensure accuracy. Through these direct integrations, we have an industry-leading accuracy rate on card transactions of 99.8%, compared to 90-95% with other flex card providers, leading to fewer complaints.
2. Limited network of preferred retailers: Members may find that their preferred retailers are not in the network, making it difficult for them to utilize their flex card. To address this, we created our own platform that integrates directly with retailers. This means we can add new retailers on our own when requested by our customers rather than needing to pass the request to a third party with its own priorities. evermore’s retailer point of sale integration technology specification is only 12 pages in length. When contrasting legacy competitor technology specifications of hundreds of pages, it is not surprising retailers are delighted to work and integrate with evermore. Our timeline for integrating new retailers is 8-12 weeks, compared to 8+ months for other players in this space.
3. Lack of real-time information: Members may not have instant access to information about which items are covered or the status of their transactions, leading to confusion and potential delays. To address this, we provide an item-scanner that correctly identifies eligible and ineligible items and provides real-time reporting on the status of transactions, so it is clear which items were covered by the benefit, and which were not. Our plan partners also receive this real-time information so they can meet CMS compliance requirements.

Additional evermore remedies/ differentiators that support these challenges include:

1. Exclusive SMS capabilities: Members receive instant retail transaction confirmations or reasons for declined transactions, helping them avoid frustration and confusion at the point of sale.
2. Integrated rewards experience: Members can earn rewards at integrated care locations, providing an incentive to use their flex card and helping them save money on healthcare expenses.
3. Member-facing App: The app includes an industry-leading product coverage scanner and location mapping to in-network retailers, allowing members to easily identify which items are covered and where they can use their flex card.

Health plan testimonial about our 1/1/25 implementation expressing gratitude for the evermore team and the positive impact evermore has had on their success:

“Reaching out to express my most sincere appreciation of your team. We are continually wowed by the level of support we’ve received. I mean this with all sincerity, your team could teach workshops on partnering with plans. Jordan, Mason, Ari, Casey, Seth, Kevin, and Desiree have all contributed significantly to our success and given us peace of mind going into 2025.”

Member testimonials:
“Wow, [agent] was extremely happy to help me, it was such a pleasure and a relief to see how she went above and beyond for me, she dug into the situation fast and did everything she needed to do and was so caring, it felt great, so I really felt cared about, so grateful, and this has been a repeated experience every time I call in for help, I sure hope [agent] is promoted :blush: thank you ma’am.”

“It is so refreshing to get to talk with people who know their job and do it well”

“The customer service representative that I spoke was absolutely wonderful. Very helpful, courteous, and knowledgeable. Thank you.”

“I was treated with respect and courtesy. I am 81 and far from tech savvy so her patience and kindness was deeply appreciated.”

“The best service I’ve had in a very long time from any company! She stayed on the phone with me and made 2 calls to different department and company to be sure my issue was corrected. Awesome! A person who really does her job…so hard to find these days! Thank you!”

“The customer representative was knowledgeable and friendly, they knew their stuff and they were able to answer all my questions.”

evermore excels at Customer Care. Our call center is staffed with 100% onshore resources.  Our Customer Care Specialists (CCSs) are located across the US and exclusively work from home, providing a resilient, distributed workforce that is highly available and unaffected by local factors. Standard hours of operation are 8am-8pm, local time.

We recognize that our contact center CCSs operate as an extension of the plan’s brand, and we make it our highest priority to onboard them with advanced training in providing expert, human-centered customer care.

Our CCSs have access to a robust knowledge base of 300+ articles developed in-house by evermore subject matter experts to best address any member concerns. Our professional training development team is on-hand to develop any custom knowledge base articles and trainings needed to support the plan’s unique business needs. We complete warm hand-offs with members over to health plan teams when needed to maintain a positive Care experience. Knowing that many health plans have been perennially frustrated by lack of industry adherence to contact center service level agreements, we are proud that evermore has positively exceeded all contact center service level agreements for our clients. We also perform extensive Q/A processes on each agent weekly, which helps ensure the quality of every interaction.

We can accommodate English and Spanish; we can support the plan’s threshold languages via our language line (interpreter line).

We perform extensive quality assurance processes on each Customer Care Specialist weekly, which helps ensure the quality of every interaction. Our CCSs receive weekly call audits and coaching sessions for improvements. evermore hosts weekly quality calibration sessions to ensure alignment on call handling and agent behaviors. evermore also conducts weekly call listening for calls from the previous week. Our attrition rate is nearly half that of the industry average.

At evermore we have significantly mitigated the risk of covered items being declined at the point of purchase, evidenced by our industry-leading accuracy rate on transactions of 99.8%. We dynamically configure item eligibility and receive daily item assortment updates from our retail partners to ensure accuracy in item-level approvals/denials for your members. The approved products (APs) evolve throughout the year as we incorporate new items offered by retailers that align with the approval requirements provided by the plan.

This daily assortment file processing is one of the primary differentiators of the evermore Smart Benefits platform. An assortment file is the list of all the SKUs that a retailer has in-store. Other flex card providers only process files on a monthly, quarterly, or even yearly basis, which leads to greater inaccuracy when members are paying at checkout (i.e., 90-95% industry accuracy rate standard), resulting in member frustration and complaints. At the time of assortment ingestion, evermore proactively checks for high-shopped categories such as OTC and food and run metrics on completeness of categorization. If not up to our accuracy standard, we will categorize remaining items as needed to reach the standard. Monitoring continues post ingestion and we are alerted if items are not categorized at the time of member swipe which we action on same-day.

We have more than 16,000,000 unique SKUs categorized in our system and this number continues to grow each day. This provides our customers with nearly 100% confidence that members swiping at the point of purchase for covered items will correctly and accurately swipe.

evermore closely tracks current and proposed regulations to ensure we meet or exceed regulatory requirements for EDS and 837 reporting as mandated by CMS. During plan design, we assist clients with supplemental benefit design recommendations that adhere to evolving CMS requirements. Our standard reporting package enables clients to satisfy recent CMS guidance regarding Part C reporting and submissions of encounter data records (EDRs) for supplemental benefits into the Encounter Data System (EDS). We can report on spending at the PBP category level for combined benefits offered on the card.

Plans will have access to evermore’s rich data reporting and analysis tools that provide a comprehensive view of all program information that can be filtered on many different data categories. Using this data, we have already begun implementing the new CMS requirement for a mid-year notification of unused benefits for our clients.

Unlike other flex card providers, evermore uses an implementation plan that minimizes the level of effort required of the plan resources to ensure an on-time launch of a supplemental benefits program. Required the plan responsibilities include:

• Contract finalization in collaboration with evermore’s legal team.
• Submitting required forms for bank KYB and due diligence processes.
• Providing an excerpt of the PBP package, or otherwise sharing information about the benefits and rewards evermore cards will be expected to administer.
• Providing the plan logos and brand guidance and approving member materials.
• Providing sample eligibility data, setting up SFTP connections for file/data exchange, and conducting pre-launch eligibility testing.
• Providing production eligibility data for launch.
•  Providing program funds for launch.

Plans have a dedicated evermore Implementation Lead to manage the overall implementation and serve as your single point of contact throughout the project. Behind the scenes, the Implementation Lead coordinates across evermore specialists to ensure the program is a success. These specialists are always available for direct consultation and support throughout the project:

• Implementation lead
• Legal / Administrative lead (for contracting and KYB/banking regulatory processes)
• Benefits designer
• Experience and communications lead
• Technology/engineering lead
• Customer Service lead.

evermore’s goal is to make administering supplemental benefits programs as simple and streamlined as possible. For day-to-day escalations (e.g., portal issues, card issues, transaction support), designated the plan stakeholders will have access to evermore’s Partner Help Center—our internal ticketing system for triage and resolution. In addition, evermore will assign a dedicated Customer Success resource to oversee issue tracking and resolution, escalating when necessary. Customer Success includes dedicated roles across both teams to ensure the plan has consistent communication, strategic guidance, and the support needed to maintain program excellence.

In short, while we equip the plan staff with the tools and support needed to manage the program, our ultimate goal is to make the experience as low-touch and efficient as possible. To confirm the effectiveness of our approach, it is worth noting that every single one of evermore’s customers is a reference client.

Yes. Members may access their current balance and recent transactions in real-time on our member portal, mobile app, via IVR, or contact center. Additionally, members are able to access balance information simply by texting BALANCE to our SMS short code.

Unlike other flex card providers, the member portal shows card balance and transaction data in real-time. Real-time balance and transaction information is also available via IVR, SMS, app, and call center.

Yes, evermore is able to exchange eligibility and reporting data in a variety of preferred and HIPAA-compliant formats.

evermore can receive and process eligibility files automatically and as frequently as you would like to send them. We have a standard format for eligibility files, or we can customize to your file format. Our file format specification is quite detailed because it is highly customizable. It can be used as a guide, but your Implementation lead will walk your team through the process to ensure that it is easily adapted to your needs. Ultimately, the plan is our customer, and it is our responsibility to make the implementation and eligibility file and data interchange as easy as possible for them.

evermore provides a combination of standard reporting, data extracts, and custom reporting. Our standard reports and data include more than 40 data elements covering active balances, transactions, approved items, card statuses, funding account running balance, and declined transactions. For transactions within our high-value retailer network, our reports and data enable our clients to satisfy CMS guidance regarding Part C Reporting and submissions of encounter data records (EDRs) for supplemental benefits into the Encounter Data System (EDS) via EDI file.

In addition, the plan has access to the evermore Hub for dashboards and additional reporting. evermore can also support machine-to-machine interface through SFTP for automation of data intake to your systems. This provides the plan flexibility to incorporate the data into your own native reporting tools and with other data assets.

evermore currently tracks age, gender, language, and Medicare Advantage plan. For 2026 plans, we will also track race, ethnicity, and income data as third-party demographic data to enhance member level insights for our customers, both for in-year impact and for future year product planning.

The plan will have a designated account team (inclusive of an Account Manager and Customer Success Manager) that will work cross-functionally within evermore to prepare and conduct regular stewardship reporting in addition to managing the suite of tools available to your team for programmatic insights and member support. These reports and the available tools cover a variety of topics including but not limited to membership, cards, benefits, utilization, swipe activity, engagement metrics, customer care metrics, and more, with much of the data export-ready for your team at any time. Live stewardship reporting read-outs are typically held quarterly, with electronic reports shared monthly to review operational performance, maintain stakeholder engagement, and drive continuous program improvement.

Reporting is provided in real-time and can be produced down to the SKU/ item level on a member-by-member and merchant basis.

evermore is both SOC 2 Type 2 and HITRUST certified.

All data is encrypted in transit and at rest, evermore does not store card numbers.

evermore does not utilize offshore resources. All member and transaction data is stored within the United States.

evermore is well versed in CMS and CA Medicaid (Medi-Cal) requirements and guidelines. We have an established compliance program and compliance team.

evermore maintains both internal and external resources to ensure a robust regulatory compliance program. This includes our internal Legal and Compliance team, our Privacy Officer, our Security Officer, external compliance consultants with decades of experiences, and highly regarded law firms with government-contracted health care expertise, such as McDermott, Will, & Emery. These resources work seamlessly together with each function of the company, to maintain a strong compliance environment consistent with CMS, Medi-Cal, and other health care regulatory standards. Our Legal and Compliance team monitors regulatory updates and directs internal stakeholders accordingly to facilitate updates to our products, services, and internal operations as needed. In addition, we partner with our health plan customers to ensure our application of regulatory changes meet the needs and expectations of our customers.

Additionally, we take a proactive and consultative approach to supporting clients in meeting state regulatory requirements, beginning with the plan design and working closely with clients’ compliance functions. We help clients design benefits and quality programs that adhere to evolving CMS and state Medicaid requirements. We develop our beneficiary marketing and informational materials with regulations in mind, so the materials are ready in a timely manner for state agency review and typically accepted without issue. Our reporting is data rich, which allows us to customize our reporting to meet state regulatory requirements and client needs. We are nimble and our products and services are broadly customizable, proactively making implementation of regulatory changes easier for our clients.

evermore is well versed in CMS and HIPAA requirements and guidelines. We have an established compliance program, compliance team, and security team.

evermore maintains both internal and external resources to ensure a robust regulatory and security compliance program. This includes our internal Legal and Compliance team, our Privacy Officer, our Security Officer, external compliance and security consultants with decades of experiences, and highly regarded law firms with government-contracted health care expertise, such as McDermott, Will, & Emery. These resources work seamlessly together with each function of the company, to maintain a strong compliance environment consistent with CMS and HIPAA regulatory standards. Our Legal and Compliance team monitors regulatory updates and directs internal stakeholders accordingly to facilitate updates to our products, services, and internal operations as needed. In addition, our security team monitors changes in security standards and industry updates for best practices, as well as emerging threats.

Unlike other flex card providers, we have never had any Medicare sanctions, suspensions, or Corrective Action Plans (CAPs) related to our operations.

Everything we do at evermore, from the reason we founded evermore, to our technology design, is in service to ensuring supplemental benefits deliver value to members and health plans. The future of supplemental benefits is not about adding more dollars to benefits, rather it will be about making sure benefits can be customized to meet member needs at the right time, without inefficiently using limited health plan dollars.

The evermore Smart Benefits card bears the member trusted Mastercard logo and can be co-branded with the plan as desired. Smart Benefits cards don’t “scan”, they “swipe” like typical consumer payment cards, providing members with an intuitive and consumer grade experience. evermore can manage several restriction levels to support many types of carded benefits in discreet purses, including OTC, Healthy Food, Rewards, and other benefits co-designed with the plan (e.g., fitness networks, transportation, or diabetic supports). Benefit amounts can be loaded with the same or different benefit amounts and expiration dates, with no additional charges for the number of benefit purses offered. If the plan prefers a “super-purse” with a single, blended benefit load, evermore can support that configuration as well. We built our Smart Benefits platform to enable personalized benefits, which means at any moment during the year as a members healthcare and life needs evolve, we can seamlessly turn on new benefits made available by the plan.

Ultimately, evermore was built to be the only organization dedicated to meeting the needs of health plans but built with a detailed understanding of consumers and retailers. Serving all three stakeholders with our operating model is what unlocks a differentiated value proposition to all stakeholders.

Our Smart Benefits solution uses modern financial technology infrastructure, powered by Mastercard and backed by a leading financial institution to offer the plan and your members reliability, security, and ease of use. Our solution also features tight integration with our high-value network of retailers that provides us with item level control over transactions to ensure accurate and reliable processing of eligible member purchases. Other differentiators of our solution include:

evermore offers:

• Dynamic ability to add or remove benefits for individual members in seconds (rather than weeks) throughout the year.
• The ability to add new retailers to our high value network roughly four times faster than our competitors.
• Superior member experience
• Highly configurable, virtually unlimited benefits and rewards on a single card platform that allows the plan to utilize the types of benefits that maximize ROI and direct money to members who need it most.
• Ability to modify member benefits on an individual level if their eligibility changes while retaining and applying prior spend from previous eligibility.
• An industry-leading accuracy rate of 99.8% for transactions (approving eligible items and denying ineligible items), enabled by our direct integrations with retailers
• SSBCI qualification enabling embedded benefit unlocking (without adding new allowance, rather converting OTC allowance into OTC+Food allowance, while maintaining balance tracking to date)
• Best-in-class market analytics and benefits optimization tools.
• Reporting portal with real-time operational dashboard and downloadable reports with the required granularity of information to meet the latest CMS requirements.
• Rich data collection allows the plan to understand utilization and track purchasing behavior
• Account manager led stewardship meetings will provide the plan with extensive insights into program performance.
• Member Administration Portal for designated the plan administrators to manage individual member benefits.
• Exclusive, performance-based gap closure capabilities with the evermore retail network pharmacies.
• Tight integration with our retail network provides item level detail on transactions (including Walmart), and results in an industry leading accuracy rates for approved versus ineligible items of 99.8%.
• Bibliography and benefit description support for SSBCI benefit bid submissions.
• Medicare and Medicaid benefit coordination for D-SNP card-based benefits.
• Ability to rapidly administer rollover benefits from a prior year’s vendor on new cards if desired.
• Market leading pricing for OTC catalog items. Unlike most competitors, we do not use the catalog items as a profit center, allowing your members to maximize the value of their benefits.

Members benefit the most from a seamless experience at the point of sale and a member engagement platform that removes complexity from what has historically been an overly complex system. What this looks like practically is that members are empowered to utilize their benefits because they know that the evermore smart benefits card will work as expected every single time. Unlike other flex card providers, there aren’t any embarrassing moments at checkout due to a flex card that is not working correctly and no frustration at the plan from a suboptimal partner lacking timely and accurate reporting.

Our rich data reporting through direct integration with our network enables us to support evolving CMS reporting standards for flexible benefits.

Our vendor-agnostic approach to flex benefits means that the plan can choose the vendors that will provide your members with the best value and quality rather than locking into proprietary solutions like some competing solutions.

At the end of the day, evermore is a trusted partner to our health plan customers. We lead with honesty and integrity. We will tell you what is and is not possible. We will be clear where there may be a compliance risk, and evermore acts as eyes and ears for all things supplemental benefits…we are the partner plans expect and deserve.

No. evermore serves numerous geographies, hard to reach, Dual and/or low-income, ethnically diverse, and I-SNP members with diverse mobility and support needs. We do this by maintaining a broad network of shopping destinations for both OTC and other supplemental benefits, including a mix of national, local, and ethnically relevant retailers as well as online retailers that offer home delivery nationwide.

evermore views supplemental benefits and Smart Benefits cards as an under-utilized mechanism to assist our customers in meeting their long-term business goals. evermore has built analytics and insight platform features to assist in maximizing benefit ROI. We believe shorter-term ROI calculations can be derived from these key inputs:

1. Optimizing member enrollment/acquisition costs: The first way that we drive benefit ROI is by working with our partner to provide actionable recommendations in creating smarter designed benefits
2. Benefit utilization and member retention: Utilization data and retention propensity are gathered through benefit delivery and fed into our analytics platform, allowing for benefit ROI optimization throughout the course of a program. As an example of some of our member retention efforts, with two clients on our platform we worked with them to analyze enrollment and retention data across different segments of their population based on user activity, member attributes, geography, competitor plan options, etc. We identified segments that were more likely to disenroll in the plan in the first 90 days, noting some of these segments were up to 21x more likely to disenroll. We then assisted the customer in taking action to retain members through engagement steps on our platform.
3. Pharmacy assisted gap closures: through our innovative partnerships and integrations with the likes of Meijer and Kroger, evermore is able to support plans to close care gaps at retail pharmacies by meeting members where they already are, at the grocery store. The average senior is visiting the grocery store 80+ times a year, with evermore the plan will be able to turn those points of sale into points of care; by recommending via SMS post transaction at checkout, the member is reminded of screenings or vaccines that can be completed in store.