Orange County Employee Benefits
From Solana Insurance Service Employee Benefits, Newport Beach
A partially “self-insured” group health insurance program is an approach that typically saves businesses on average between 20- 40% on their annual health care costs without lowering benefits or changing carriers. This is the way large businesses have been approaching group health care for the last 30 years.
It works because:
Based on multiple studies of employee group health plan utilization over the last 10 years (by Anthem as well as Kaiser Permanente), it is a fact that between 50 to 80% of employees within any group simply will not use their health plan, or will drastically under utilize it. Only 4-7% will exceed their deductible or max out of pocket. Most companies today pay premiums as if everyone in their group hits their deductible which simply does not happen.
A more efficient and less expensive way to look at group health insurance is to raise the deductible significantly, and then let a third party administrator manage the small amount of incidents within the employee base that actually do exceed their individual deductible. Again on average that will only be 4-7% of the employees.
The simple mechanics are as follows:
1. The company keeps the carrier (Anthem, Blue Shield, Kaiser, etc.) they already have, if content.
2. The company keeps the same plan design for their employees (same copays, deductibles and out of pocket max for them)
3. Solana and our Third Party Administrator enroll the company in a much higher deductible plan which instantly drops the premium.
4. When an employee exceeds their individual deductible, the employer pays the excess with funds set aside and managed by the TPA to cover the difference. Those funds are made available from the reduction of premium.
5. Our Third Party Administrator manages the funds between the employee’s deductible and the employer’s overall group deductible.
Normally there are instant savings to the company immediately through the lower premium as well as additional money that is returned to the company at the end of the year if there is less utilization than is predicted by the actuarial models.
Solana’s Third Party Administrator
Solana’s partner, a third party administrator (TPA) has been doing this for over 17 years, with over 3,600 companies and a 97% retention rate. They are one of the biggest in the country and are located here in California.
To get a quote
All we need to run a quote is a company census of all employees that are on the insurance plan, the plan design (copays, deductibles, etc.) and a copy of the last statement from the insurance carrier. That normally gives us enough info to run the numbers to see if significant money can be saved.
We do this at no charge and 80% of our clients have now switched to this kind of plan. 100% of companies we deal with give us the info for a quote once they understand the concept!
Call 949-285-7209 for more information or send your info to firstname.lastname@example.org
You can also visit www.EmployerDrivenHealthPlans.com for additional information.
Solana Insurance Services, Inc.
Orange County Employee Benefits
3700 Newport Boulevard, Newport Beach, CA 92663-3900