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We'll consult with you and explain your options so you know which plan to choose.
Fully Insured Health Plans
Fully insured health plans are the traditional type of health insurance prevalent among small to midsize businesses.
Fully Insured Health Plans
- Employers pay premiums to an insurance carrier, and in return, the carrier assumes all financial risk for providing healthcare coverage to employees.
- Premiums are typically fixed and the insurance company keeps all of the premium at the end of the policy period regardless of loss ratio.
- The insurance company manages claims, handles administrative tasks, and sets the plan's terms and conditions.
Fully Insured Health Plans:
- Employers pay premiums to an insurance carrier, and in return, the carrier assumes all financial risk for providing healthcare coverage to employees.
- Premiums are typically fixed and the insurance company keeps all of the premium at the end of the policy period regardless of loss ratio.
- The insurance company manages claims, handles administrative tasks, and sets the plan's terms and conditions.
Level-Funded Plans
- Employers pay a fixed premium each month, similar to a fully insured plan, but a portion of this premium is used to cover expected claims, and the remaining funds go into a reserve or claims pool.
- If claims expenses are lower than expected, employers may receive a portion of the surplus as a refund or credit.
- Level-funded plans offer cost predictability and potential savings for employers while providing some risk-sharing features.
Group Captives
- Each participating employer pays stoploss premium which part of goes into a pool, which is used to cover healthcare claims for all members. Any surplus left at the end of the policy period gets returned to each participating employer.
- Employers have more control over plan design and claims management, potentially leading to cost savings and more tailored benefits.
- Group captives can be heterogeneous or homogeneous and to an employee looks exactly the same as a traditional fully insured plan.
Health Consortiums
- Consortiums can leverage their combined size to negotiate better rates and terms with insurance carriers.
- Members of a health consortium share the risks and benefits of their pooled insurance arrangement.
- Consortiums do not require any collateral, but any stoploss surplus is retained by the consortium.
Discover the Benefits of Group Health Insurance:
Self-Insured vs. Fully Insured Plans
Self-Insured Plans:
Self-Insured plans grant you full control over your healthcare program. Tailor your benefits to suit the unique needs of your employees while maintaining cost transparency.
Fully Insured Plans:
In a fully insured plan, the employer pays a fixed premium to an insurance carrier in exchange for coverage. This means that costs are predictable and stable, making budgeting easier for the employer.
Get a Free Consultation
Ready to explore your group health insurance options? Our expert team is here to help you find the perfect plan for your organization. Schedule a free consultation today and let us take the hassle out of insurance for you.