Does just hearing the words "Group Health" send negative thoughts through your mind. We understand! The fact of the matter is that a Group Health plan is the foundation of a comprehensive Group Benefits Program for your business. The problem is that most businesses feel like they have lost control of these programs and that they do not realize the benefit that they should provide.
It is true that the cost of these coverages have significantly increased since the inception of the Affordable Care Act (ACA), and many insurance agents have taken the path of least resistance in simply increasing deductibles and lowering benefits to keep premiums down, which simply disgusts their clients when they look at the value they are receiving from their plan. This, coupled with the fact that many carriers have reduced, or eliminated their offerings for this type of coverage. To many business owners, they feel stuck with dealing with the same old companies and the same old plans that just keep increasing in cost. This can be deflating, especially when it seems outside the scope of their business.
There ARE alternatives, even though your current broker might not have known about them. There are options in the fully insured, level-funded and even in the self-funded spaces. While the Self-funded alternative can be good for some entities, it is usually best for large employers and institutions due to the administrative costs associated with Third Party Administration (TPA).
For smaller businesses, the fully insured or level-funded routes are typically better. While most people understand the basics of fully insured plans, few understand the Level-funded world. As seen in the picture below, level-funded plans allow for the premiums to be split into an additional category, a claims account, in addition to admin costs and reinsurance. Basically, this allows for a portion of the premium to go directly to the first line of insuring people, and allow for the reinsurance component to be directed for potentially large claims. The benefit for the business owner is that they can receive a refund of a portion of the claims account if the usage on the plan is low to moderate, while at the same time, being able to cover the potential large claims that could arise for any specific individual on your payroll.

With both fully insured plans and level funded plans, we have the tools to help design a plan that works specifically for you. We also specialize in carving out groups based on their needs. For example, if you have a significant portion of your workforce that is Medicare Eligible, they can be on a group health plan separate from the other portion of your workforce. This means that we can utilize plans that take advantage of their Medicare Status giving them more benefits at a lower cost to the business. Contact us to learn more about your Group Health Options.