Partially Self-Funded Health Plan
With a partially self-funded health plan, an extremely small portion of the claim risk is shifted from the insurance company to the employer in exchange for potential significant savings. The company enrolls in a High Deductible Group Health Plan, which instantly drops the premium drastically. A small amount of the funds saved by the reduction in premium are set aside to cover employees who exceed their max out of pocket. A Third Party Administrator (or TPA) is used to manage those funds, administer the medical plan, process and adjudicate claims and act as a service center and resource for employees.
Other great aspects of creating a partially self-funded health plan are greater efficiencies in plan administration and greater freedom to design a health plan that best suits the company’s culture and the needs of the employees. This approach gives the Employer more information in a timely manner about the group’s claims utilization so as to be proactive in making intelligent adjustments in Plan coverage, from one plan year to the next.
Plan utilization studies over the last 10 years show that 50-80% of employees do not exceed their max out of pocket. Because of this well documented fact, partially self-funded health plans make a lot of sense for most groups, but not all. On average, companies save about 30% on their annual group health insurance costs.
Call us today to find out if this revolutionary approach is right for your company.
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 info or email us at firstname.lastname@example.org