Medical Plans

We work with our member groups to choose the benefits and insurance funding arrangement that best fits their needs, in an effort to maximize the potential return and minimize the potential risk. Our members have the option to self-fund, fully insure or a hybrid combination of the two.

Self-Funded

A self-funded plan is one in which the employer / plan sponsor assumes the financial risk associated with medical claims for the healthcare benefits provided to its employees. Employers who self-fund their medical plan, pay for actual claims as they are presented, as opposed to fully-insured plans where the employer pays a set insurance premium rate each month, based on the number of enrolled employees and their dependents.

Advantages of Self-Funding

1
Flexibility

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Customize plans to meet the risk tolerance and specific needs of your workforce.

2
Improve and maintain control of cashflow

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No more pre-paying for coverage.

3
Transparency

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Transparency of all costs associated with the plan.

Fully-Insured

A fully-insured plan is one in which the financial risk associated with the medical claims are transferred to the insurance company in exchange for set premiums paid each month. All premiums paid to the insurance carrier are kept by the insurance carrier at the end of the year.

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Advantages of Fully-Insured

1
Predictable costs

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Costs are fixed by the insurance carrier and the employer only pays premium per enrollee monthly.

2
Less risk

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The insurance company assumes all of the risks for the set premiums paid.

3
Less administrative burden

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All claims are managed by the insurance carrier.