EverlyWell Home Tests Review

By: Lauren Browning
Last Updated: August 29, 2018
Everly Well Home Tests

EverlyWell was founded in 2015 in Austin, Texas, and has quickly grown into one of the best known at-home health testing companies around. Their extensive product list includes both biomarker and DNA-based tests covering many aspects of women’s/men’s health, weight, metabolism, and cardiovascular health, in addition to STD panels. Purchased kits are dispatched quickly and discretely to your address, so that you can take control of your health from the privacy of your own home for prices that won’t break the bank!

Review Summary

Pros

  • Large number of accurate at-home tests to choose from including STD tests, genetic tests, and general health tests
  • Discreet packaging and free two-way delivery
  • Free phone or video consult with a board-certified physician and prescriptions if you test positive for specific STDs (applies to 34 states)
  • CLIA certified lab facilities
  • Speedy results
  • Affordable prices (especially for STD panels)
  • Detailed, well written reports
  • HSA/FSA payments accepted

Cons

  • Currently you cannot purchase testing kits from EverlyWell if you are a resident of the states of New York, Maryland, New Jersey or Rhode Island due to state medical regulations
  • Some of the STD’s included in the STD panels are not available as individual tests
  • Not all of the tests can provide very actionable results, so be sure to do your research before buying

Bottom Line

EverlyWell provides huge variety of quality, accurate tests to suit a range of budgets and health concerns. If you spot a product that addresses one of your health concerns, you can expect a professional, confidential and expedient service. Don’t forget though, these tests are not diagnostic, and you should discuss anything that worries you with your doctor!

Pricing and Options

EverlyWell offers a huge range of products, with a huge range of prices to match. The least expensive kits typically only test for one or two biomarkers, such as the Testosterone test for $49, or the HbA1c test for $59. As you increase the number of components that make up a product, the prices understandably increase, all the way up to $399 for a woman’s health test that evaluates 11 different biomarkers. Two-way postage and any lab fees are included in the test prices.

There are a number of products that are made up of various combinations of individual tests, such as the Male and Female STD panels, which both cover all of the diseases offered as individual STD tests plus extra tests that aren’t available individually. These are convenient and economical choices for customers who want a one-stop comprehensive insight into their sexual health, but are less well suited to customers who are experiencing symptoms of a particular STD, but are confident that they do not need a full STD panel. Likewise the woman’s health test includes many of the hormonal biomarkers covered in more specific tests such as the peri- and postmenopause tests, and is more suited to a customer looking for a complete hormone evaluation than one with a specific goal corresponding to a specific stage in life or fertility question.

The EverlyWell/Helix genomic tests are in general more expensive than biomarker tests as a result of the technology involved; a biomarker food sensitivity test retails for $199, while a genetic food sensitivity test costs $289. In our opinion, you are more likely to receive accurate information regarding what foods you react badly to with a biomarker test than with a genetic one.

If you test positive for Chlamydia, Gonorrhoea, Trichomoniasis, or Herpes Type 2 using the EverlyWell service, you will be offered a free phone or video consultation with an EverlyWell physician affiliate. The doctor will attempt to reach you on the same day that you receive your positive results and accept the offer of a consult, and if you miss this call, they will try again in two consecutive business days. If you live in one of the 34 compatible states, during this consult you will also be evaluated for treatment, and the physician may be able to send a prescription to your chosen pharmacy straight away. For a list of the states in which prescription options are currently available, see “STD Prescription Availability By State” on the EverlyWell website.

EverlyWell runs a subscription program which is still in the early phases of development. This is aimed at customers who are interested in purchasing a particular product multiple times for repeat testing, for instance the cholesterol test to keep on top of your cardiovascular health, or an STD test for customers at high risk of contracting an infection. The way this service works is that you sign up for a subscription on one of the product pages, and you are charged at a ‘highly discounted rate’ at the interval you chose (monthly, quarterly, or bi- annually) and shipped a new testing kit. You cannot mix and match products within one subscription i.e. you cannot sign up to receive repeat cholesterol testing, and request a sleep and stress test instead of your regular delivery. You can cancel a subscription any time provided that you give the company 48 hours notice, and have payed for/received the minimum number of kits associated with your plan according to their requirements (monthly = 3 kits, quarterly and bi-annually = 2 kits). This policy is designed to stop customers from abusing the subscription service to gain discounted prices for one-off purchases.

HSA, FSA and Health Insurance

As EverlyWell tests are authorized by physicians, you can submit your EverlyWell purchases for reimbursement through HSA/FSA benefits. To do this, email the company using the address provided on their website to request an itemized receipt, which should be provided to you within 24 hours. If you plan to pay using this method, it might be a good idea to check in with your HSA/FSA benefits coordinator to ask about any specific requirements and regulations regarding reimbursement that may affect your purchase. EverlyWell cannot provide you with itemized receipts for their bundled kits supplied in collaboration with helix.com (Food Sensitivity+, Metabolism+, and Breast Milk DHA+).

It is not possible to pay for EverlyWell products via health insurance. It is possible that specific health insurance plans may cover some tests, but it is down to you to find out if this applies to you, and to submit your test costs for reimbursement by your insurance provider (there is more information on how to do this on the EverlyWell website). The benefit of not going through health insurance is that your privacy is protected, as your test results and information won’t be shared with your insurance company and won’t appear on your medical records unless you choose to share them with your doctor.

Submitting your Sample

The process of submitting a swab, urine sample, or blood sample for testing with EverlyWell is simple, fast, and convenient. Once you have ordered your testing product, your kit will be despatched from the company warehouse within 2 business days, and should arrive at your door within 3-5 business days (5-7 business days during peak holiday season). Unfortunately due to state medical regulations, it is not possible to order testing products from EverlyWell if you are a resident of the states of New York, Maryland, Rhode Island, or New Jersey. Your test will arrive in discrete packaging with no company visuals or identifiers, and you do not need to sign for your package if you are receiving it at a residential address. To register your kit, enter the unique ID code displayed on the registration slip inside your kit into the secure registration page of your personal EverlyWell account.

There are a number of videos on the EverlyWell website explaining process of collecting a swab, small urine sample, or a few drops of blood, as well as detailed instructions inside the kit itself. All the equipment you will need is included in the kit, as well as a pre-paid return shipping package. Simply write your name, the collection date, and the time (if required) on your specimen and return the package to the Everlywell lab for analysis. Your results should be ready to be viewed within 5 business days from the date that the lab receives your sample. You will be notified via email when your results are ready to be viewed on your EverlyWell account. Subject to your consent, if you receive an abnormal result from specific tests (such as many of the STD tests) you will be contacted by a board-certified physician who will provide a medical consult, and may prescribe medication.

Reports and Features

Sexual Health

EverlyWell offers individual STD tests for Hepatitis C, HIV, Syphilis, Trichomoniasis, and chlamydia andgonorrhoea (which comes as a pair), as well as two STD testing panels - one for men and one for women.

Chlamydia and Gonorrhoea

Chlamydia and gonorrhoea are two of the most common sexually transmitted diseases in the US, and infection with either can have serious health consequences if not caught and treated early. The good news is both are easily curable in most cases, and early detection and intervention is the best way to prevent long-term damage. A large number of people infected with chlamydia and gonorrhoea don’t have any symptoms at all, so if you think you may be at risk of exposure, testing is a good idea!

Testing with EverlyWell involves the submission of a small urine sample. Unfortunately this test will not be able to tell you the specific area of your body that is infected (vaginal, anal, or oral infection), but this will only be relevant to some customers. If your test comes back positive, subject to your consent, a board-certified EverlyWell affiliated physician in your state will contact you free of charge to discuss your case, and prescribe medication if this is indicated. EverlyWell recommends that you wait a minimum of 1-6 days after a potential exposure before taking a chlamydia and gonorrhoea test, and if this test comes back positive, that you get re-tested 2 weeks after your treatment has been concluded to make sure the infection has completely cleared.

Hepatitis C

Hepatitis C is a serious infection of the liver caused by a virus. If left untreated, Hepatitis C can cause permanent and potentially life-threatening damage to your liver, but luckily it is now possible to treat or cure the infection in most cases. The infection is often asymptomatic for many years, with affected persons only realizing they have Hepatitis C when the liver has already been damaged, sometimes significantly. The virus is spread via blood-to-blood contact, and rarely can be contracted through unprotected sex. The CDC recommends that all adults born between 1945 and 1965 be tested for Hepatitis C, as well as people with specific medical conditions, and people who are part of particular high-risk groups such as current or former IV-drug users.

The EverlyWell Hepatitis C test involves the submission of a small blood sample. If your test comes back positive, you will be contacted by an associate from EverlyWell’s physician network who will provide you with any information you need, and discuss your options moving forward. EverlyWell recommends that you wait a minimum of 8-9 weeks after a potential exposure before taking a Hepatitis C test, and if this test comes back positive, that you get re-tested 3 months after your first test to confirm the positive result.

HIV

HIV (Human Immunodeficiency Virus) is the virus that causes AIDS (Acquired Immune Deficiency Syndrome). Once you become infected with HIV, you will always carry the virus, and so must continue antiretroviral treatment for life. A diagnosis of HIV would be devastating to many people, but it is important for customers to know that diagnosis with this virus is far from the death sentence it once was. Treatments have come along way over the past decade, and it is now possible to bring HIV infections under control, giving patient’s a life expectancy that is very close to that of the rest of the population. The CDC recommends that screening for HIV should be routinely performed for everyone aged 13-64, but testing is especially important for those who engage in unprotected sex, IV drug users, those who have come into contact with blood products, or persons who’s mothers were HIV positive when they were born.

The EverlyWell HIV test involves the collection of a tiny blood sample. If your test results are abnormal, you will be contacted by an associate from EverlyWell’s physician network who will provide you with any information you need, and discuss your options moving forward. EverlyWell recommends that you wait a minimum of 1-3 months after a potential exposure before taking an HIV test. There is no need to re-test, as once a person is HIV positive, they will always be positive.

Syphilis

Syphilis is an STD caused by a species of bacteria. It can cause serious and even life-threatening medical issues if left untreated, but affected persons will often have no symptoms in the early stages. Luckily, it can often be cured with a short course of antibiotics, so testing is a good idea if you have engaged in unprotected oral, vaginal, or anal sex with someone who may be infected, have come into contact with an infected sore, or are an IV drug user.

The test for syphilis involves the collection of a tiny blood sample. If your test result is positive, you will be contacted by an associate from EverlyWell’s physician network who will provide you with any information you need, and discuss your options moving forward. EverlyWell recommends that you wait a minimum of 3-6 weeks after a potential exposure before taking a syphilis test, and if this test comes back positive, that you get re-tested 3 months after your treatment has been concluded to make sure the infection has completely cleared.

Trichomoniasis

Trichomoniasis (“trich”), is another of the most common curable STDs in the United States, and over 70% of affected people never develop any symptoms. It is caused by a protozoan parasite called Trichomonas, and infection is more common in women than it is in men. Trich testing involves the submission of a small urine sample, and is very accurate for women, but slightly less accurate for men, who are more likely to receive false-positive or false-negative results. If you test positive for trich using an EverlyWell test, a board-certified physician based in your state will contact you for a consult, and it may be possible for a them to send you a prescription straight away, dependant upon your symptoms and state of residence.

STD Test Male

The male-oriented STD panel includes tests for 7 different infections; Chlamydia, Hepatitis C, Syphilis, Gonorrhoea, Herpes Type 2, HIV, and Trichomoniasis. The test requires both a urine and spot blood sample. If you test positive for any one of the conditions covered, a board-certified physician in your state will contact you to discuss your case, and to prescribe medication if appropriate.

STD Test Female

The female-oriented STD panel includes tests for the same 7 infections as the male panel; Chlamydia, Hepatitis C, Syphilis, Gonorrhoea, Herpes Type 2, HIV, and Trichomoniasis. The difference is that this test requires a blood spot sample and a vaginal swab. If you test positive for any one of the conditions covered, a board-certified physician in your state will contact you to discuss your case, and to prescribe medication if appropriate.

General Wellness

Food Sensitivity Test

The EverlyWell food sensitivity test measures your body’s IgG (immunoglobulin G) response to 96 different foods, and is designed to help you make better choices when it comes to your diet. This test does not tell you about food allergies, which can be very serious, and cannot diagnose Celiac disease. What it can do is help you identify elements of your diet that may be triggering a mild immune response and causing uncomfortable symptoms such as stomach pain, diarrhea, skin problems, or bloating. The test involves the submission of a small blood sample. Each food tested is rated on a class scale of 0 to 3, 0 being no/low reactivity, and 3 being high reactivity. It is important to note that if there are particular foods you are concerned about, it is recommended that you keep those foods as part of your diet for about 4 weeks in the run up to your test, to ensure that any antibodies can be picked up. The information you will gain from this kind of test can largely be worked out by yourself using an elimination diet, but this can take a long time to complete, so if you’re anxious to pinpoint your problem foods quickly and think it’s worth the money, a food sensitivity test can be a great way to jump start the process.

Heavy Metals Test

This test will measure the levels of certain environmental toxins (heavy metals) in your body. Many of these elements are required in trace amounts for normal healthy bodily function, but can be irritating and highly detrimental in higher quantities. The substances assessed by this test include arsenic, mercury, cadmium, bromine, selenium, and iodine, with urinary creatinine used to normalise the test results. There is more info on each of these substances and their significance on the EverlyWell website. People for whom this test is particularly relevant include smokers, those potentially exposed to heavy meals at work (people involved in pesticide, car, glass, or pottery manufacturing, dentistry, battery plant work, welders, etc), or those with relevant pre-existing medical conditions, such as thyroid problems. The test involves the submission of a small urine sample, and your results will contain your levels of each element and an assessment of whether these are low, normal, or high. If you do receive any abnormal results from this test, it would be wise to discuss them with your physician.

Sleep and Stress Test

The sleep and stress test measures your levels of Cortisol, Cortisone, Melatonin, and Creatinine at four points in the day (morning, afternoon, evening, and night time). Each of these hormones has implications for sleep deprivation and stress - creatinine is a biomarker used to normalise your data. Testing involves the submission of a small urine sample. The results of this test can be interesting and may provide you with an explanation for a problem that has been bugging you, but most of the time any recommendations will likely be common sense; less light and less stress before bedtime. If you are experiencing chronic sleep disturbances but the results of this test are normal, it may be a good idea to get tested for Obstructive Sleep Apnea, which is a serious condition and cannot be diagnosed by this test.

Cholesterol and Lipids

This home test is great for anyone who is trying to keep on top of their cholesterol levels, and can help you asses your overall heart health. The health conditions linked to high levels of LDL-cholesterol and triglycerides are numerous; heart attack, stroke, peripheral artery disease and atherosclerosis, high blood pressure (hypertension), type II diabetes… the list goes on! This test involves the submission of a small blood-spot sample. The specific elements of a cholesterol test included in the EverlyWell test are total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), and triglycerides. Your results will also include some guidance on how to make modifications to your diet or exercise regime to help bring your cholesterol and lipids levels back into the health range (if necessary). Cholesterol and lipid levels are also evaluated as part of the more complete ‘Heart Health’ bundle.

HbA1c

Analysis of HbA1c (Hemoglobin A1C) in the blood is a simple way to evaluate whether your average blood sugar level over the past 90 days is within a health range. The test involves the submission of a blood-spot sample, and is particularly useful for those customers worried about the possibility of developing diabetes. HbA1c levels are also evaluated as part of the more complete ‘Heart Health’ bundle.

Heart Health

This test is aimed at customers who want a comprehensive insight into the overall health of their heart, and includes analysis of the biomarkers mentioned in the ‘Cholesterol and Lipids’ and ‘HbA1c’ tests, as well as of HDL (high-density lipoprotein), and hs-CRP. Each of these biomarkers has implications for the development of heart disease, and there is more info regarding each of them on the EverlyWell website. This test is of particular relevance to; people with family histories of high cholesterol, heart disease, or diabetes; people who are overweight, smoke, or do not exercise; and those who take cholesterol medication. This test involves the submission of a small blood-spot sample.

Omega-3 Basic and Plus Tests

Recent scientific papers have called intoquestion the validity of claims that Omega-3 supplements have a significant effect on heart health, but Omega-3 fatty acids still represent an essential part of a healthy balanced diet, and Omega-3 index testing can help you identify any dietary changes you could make to improve your overall heart and brain health. The EverlyWell Omega-3 Basic tests involves the analysis of two specific fatty acids, EPA and DHA, while the Plus test also includes your Omega-6:Omega-3 ratio, your AA:EPA ratio, and your Trans fat index (more info on each of these biomarkers is provided on the company website, and also with your results). Both tests require a blood spot sample.

Men's Health

There are two men’s health tests advertised by Everlywell; the testosterone only test, and the men’s health test, which also analyses testosterone levels in addition to estradiol, DHEA and cortisol, which are related to the development of male characteristics and stress responses. Women can also check their free testosterone levels using the testosterone test, as proper hormone balance is important for both sexes! Both tests involve the submission of a small saliva sample.

Women's Health

EverlyWell offers seven women’s health testing products.

Breast Milk DHA

This test is designed to help new mothers who are breastfeeding to ensure that they are consuming enough DHA in their diet to support the development of their newborns. Low levels of DHA are fairly common among American women as a result of their meat, egg, and poultry-heavy diets. There is conflicting scientific evidence regarding the benefits of DHA supplements in pregnant women to promote cognitive development of their babies, so your results may not be hugely actionable, but if you’re interested in taking a DHA test, all that’s required is a small sample of breast milk.

HPV Test

HPV (Human Papilloma Virus) is an incredibly common virus that often generates no symptoms in infected individuals. There are over 150 different types of HPV, some of which have been strongly implicated in the development of cervical cancer (HPV16 and HPV18), genital warts (HPV6 and HPV11), and other types of cancer. HPV strains are said to be high-risk if they may cause lesions and cancers, and low-risk if they commonly cause warts. The EverlyWell HPV test will check for 14 high-risk HPV genotypes giving you detailed insight into your risk of developing cervical cancer. This information can be extremely useful as it allows you to create an appropriate cervical screening plan with your physician, so if you test positive for a high-risk HPV strain, an associate from EverlyWell’s physician network will contact you to discuss your case and give you advice. This test is particularly relevant to women over the age of 30.

Ovarian Reserve

This novel home-test uses FSH (follicle stimulating hormone) levels to estimate a woman’s ovarian reserve (how many more times she is likely to ovulate/release an egg) compared to the average for her age. This does not tell you how likely it is that you may achieve a successful pregnancy from one of these eggs. Hormonal birth control and other hormone-based therapies may interfere with the results of this test, so Everlywell recommends being hormone-supplement free for at least 6 weeks before taking the test - although you should not discontinue any hormonal therapies without first consulting your physician. The test involves the collection of a blood-spot sample on the third day of your menstrual cycle.

Postmenopause Test

Many postmenopausal women wonder about their hormone levels and the implications they may have for their health, which are numerous. If you are experiencing symptoms and want to know if these are the result of hormonal changes, if you are considering hormone replacement therapy (HRT), or if you are already on HRT and want to check that you are not over-compensating, this test may well be for you. The EverlyWell postmenopausal test specifically evaluates levels of the hormones Estradiol and Progesterone.

Perimenopause Test

The perimenopause test is designed for customers who think that changes to their menstrual cycle or symptoms such as hot flashes and night sweats may be indicative of approaching menopause, and want some clarity about their situation. The biomarkers covered by this test are estradiol, LH (lutenizing hormone), and FSH (follicle stimulating hormone). The test involves collecting a few drops of blood on day 3 of your menstrual cycle.

Woman’s Fertility Test

There are a number of hormones that play important roles in regulating a woman’s fertility, and imbalances in there hormones can result in a variety of troublesome symptoms. The woman’s fertility test is generally aimed towards women who are considering starting families, who are concerned about their fertility, or who have experienced symptoms which may indicate a hormonal problem, such as changes to their menstrual cycle or unexplained weight changes. The hormones analysed in this test include estradiol, LH, FSH, total testosterone, and TSH. Small blood-drop samples must be collected on a few different specific days of your menstrual cycle - instructions as to when to collect you samples are provided in the kit.

Woman’s Health Test

The woman’s health test is EverlyWell’s most comprehensive hormone panel and is aimed at woman in all stages of life. It includes evaluation of all of the biomarkers covered by the woman’s fertility test, the postmenopause test, the perimenopause test, and the ovarian reserve test, as well as a number of additional hormones relating to thyroid function and stress response. The test requires a few drops of blood and a saliva sample, each collected at different times during your menstrual cycle according to the instructions included in the kit. If you are looking for a home-testing service to help you answer a specific question (such as ‘are these symptoms the result of my menopause’ or ‘are my hormones affecting my fertility’), you may not need a hormone panel as comprehensive as this, and could instead opt for one of the more specific hormone tests described above. However, if you want to get the fullest, most detailed picture that you can of your reproductive health (and don’t mind paying the higher price), the woman’s health test is the best option for you.

Energy and Weight

Thyroid Test

One of the company’s most popular offerings, this test evaluates thyroid function via analysis of 4 hormones; thyroid stimulating hormone (TSH), TPO, T3, and T4. There is a full list of the potential symptoms of hypo- and hyperthyroidism on the EverlyWell website, and if one of these lists matches up with symptoms you have been experiencing, this test may be the first step in the diagnosis of a thyroid condition. The test requires a small blood-spot sample, and any abnormal results should be discussed with your physician.

Metabolism Test

Another hugely popular product, the EverlyWell metabolism test evaluates the levels of three hormones in your blood that contribute to the regulation of metabolism; cortisol, free testosterone, and thyroid-stimulating hormone. If you have experienced symptoms such as unexplained weight loss or gain, decreased energy or a change in body composition, a metabolism test may help you pinpoint the cause of your troubles, so that you can take appropriate action. As well as a small blood-spot sample, this test also requires a saliva sample.

Vitamin D/Vitamin D and Inflammation

Vitamin D deficiency is reasonably common among Americans, and can contribute to a number of health issues, including an overall pre-disposition to inflammatory responses, which can then increase your likelihood of developing more severe diseases. The Vitamin D test measures only the level of vitamin D itself in your blood, while the Vitamin D and Inflammation test also evaluates the level of C-reactive protein (CRP) in the blood, which indicates inflammation in the body if elevated. CRP levels can also be temporarily increased as a result of a recent infection or trauma, so if your results indicate abnormally high CRP, it may be necessary to get tested again after a month or so has passed, or consult with your physician to determine if the inflammation if chronic or acute. Luckily, if your results indicate that you are suffering from vitamin D deficiency, this can in most cases be rectified by increasing your time in the sun, your dietary consumption of vitamin D, or by taking supplements.

Genomics Tests

EverlyWell provides three genomics tests as part of a partnership with Helix (see our Helix DNA review?); Food Sensitivity+, Metabolism+ and Breast Milk DHA+. There’s more information on the various genes covered by each test on the company website, but in our opinion the most important section of each product page to consider is the ‘The Science’ section near the bottom, specifically the ‘Impact’ factor. This will tell you to what extent the characteristic studied by the test is governed by genetics, as opposed to being controlled by a person’s environment. For example, diet has a far bigger impact on breast milk DHA levels than genetics, so while a genetic test might be moderately helpful if it identifies that you have a slight issue metabolising omega fatty acids to DHA, you could certainly save the money and instead ensure you are eating a balanced diet rich in DHA. Similarly, although it might be nice to know how genetics affects your weight and body composition, any recommendations you receive as a result of your genetic profile will almost invariably be the same; eat healthily and exercise.

One notable plus to purchasing a genetic test via EverlyWell/Helix is that once you have submitted your first DNA sample (in the form of saliva), Helix will store your genetic data (subject to your approval), allowing you to access their other genetic testing products without having to get tested again. More information on how the EverlyWell/Helix partnership will affect your order is available at https://www.everlywell.com/everlywell-and-helix/.

Other Considerations

Privacy

EverlyWell state that they are highly committed to protecting your privacy and data, and seem to back this up with numerous security measures, although it is currently not possible to access a full privacy policy via the EverlyWell website. Bank-level encryption and security protocols are used to safeguard your health information, and your data is stored on a HIPAA compliant platform. Test results are only accessible to you, although you can choose to share them with whomever you wish, and you are encouraged to share worrisome results with your doctor. Your records are stored permanently by EverlyWell unless you request that they be deleted.

You may wish to consider that in certain states, mandatory reporting to health departments is in effect for some diseases. For example if you test positive for Chlamydia, Gonorrhoea, Syphilis, HIV, or Hepatitis C, EverlyWell is legally required to report the result to state health departments. This data is simply collected to track the prevalence of new infections and for public health and is completely private - family members, spouses or employers cannot access it. This requirement is exactly the same if you go to your doctor, although if you do access these same tests through a healthcare professional and you use your health insurance to pay, your test results will be recorded in the Medical Information Bureau (MIB) database, that is accessible to all U.S. insurance providers.

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