ISO 9401:2018 certified company
+1 (904) 994-9255
English
ISO 9401:2018 certified company
+1 (904) 994-9255
English
Group Health-Employee Benefits
Solutions Focused on Enhancing Employee Benefit Programs and Managing Costs
Comprehensive Group-Employee Benefit Solutions
We recognize the importance of offering extensive insurance coverage to businesses in order to attract and keep top talent. That is why we provide a range of Group Benefit services designed to cater to the various needs of your employees. Our additional benefits go above and beyond the essentials, providing protection for your team against the uncertainties of life.
Coverage options
Choosing the right health insurance for your team is a big task for any business, big or small. But figuring out the differences between fully insured and level funded plans can feel especially tricky. These two choices offer different ways to handle healthcare costs and risks. Each has its own benefits and things to think about. In this guide, we’ll break down the basics of fully insured vs level funded health plans. We want to make sure you have all the information you need to pick the best option for your company’s needs and budget. Let’s dive in and learn more about these two types of health insurance plans.
Fully-Insured Health Plan
A fully-insured health plan refers to a group health plan in which the employer or association purchases health insurance from a commercial insurer in order to provide coverage for its employees or association members.
The employer pays premiums to the insurer (some of which are passed on to the employees via payroll deduction) in trade for the insurer taking on the financial risk associated with providing coverage and administering the plan. If an employee has a medical claim, the insurer – not the employer – is responsible for paying the bills (as opposed to a self-insured health plan, in which the employer is responsible for paying the bills).
Fully-insured health plans are subject to state insurance regulations, whereas self-insured health plans are not – they’re regulated at the federal level instead, under ERISA.
Most small group plans are fully-insured, although the percentage of self-insured small groups is rising (some are fully self-insured while others opt to purchase stop-loss insurance from a commercial insurer – to cover catastrophic losses – to supplement the self-insured plan). As groups get larger, they’re more likely to self-insure.
Level Funded Health Options
Level-funded health insurance is a hybrid form of health insurance that combines the advantages of traditional fully-insured plans with the cost-saving potential of self-funded plans.
It is a popular option for businesses looking for alternatives to traditional health insurance plans. In a level-funded health insurance plan, the employer pays a fixed premium each month to an insurance carrier. This premium is calculated based on the expected healthcare expenses of the employees, as well as an administrative fee.
The insurance carrier then handles the claims and administration of the plan.What sets level-funded health insurance apart is the concept of a “claims fund” or “stop-loss” agreement. This mechanism allows businesses to have more control over their healthcare costs. The claims fund is funded by a portion of the monthly premium. It acts as a reserve to cover expected claims.
If the actual claims are lower than anticipated, the excess funds in the claims fund can be returned to the employer or used to offset future premiums.Overall, level-funded health insurance provides businesses with the opportunity to have more control over their healthcare costs while still benefiting from the stability and coverage provided by an insurance carrier. By understanding the intricacies of level-funded health insurance, businesses can make an informed decision about whether it’s the right fit for their organization.
Ancillary benefits
Enhance your health insurance coverage with valuable ancillary benefits tailored to your needs.
Ancillary benefits
Enhance your health insurance coverage with valuable ancillary benefits tailored to your needs.
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About Company
Our team helps clients identify suitable insurance plans that meet their specific needs. Our team conducts in-depth meetings with individuals and businesses to provide the education needed to navigate through the complexity of today’s healthcare.
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