Fully-insured employee benefit plans are most common. If this makes sense for your business, our underwriters will estimate your company’s risk level by analyzing census information. We will draw data including: employee & dependent ages, company zip code, tobacco use, and if available, prior claims. The census data determines the premium price and the employer receives a monthly invoice based on covered employees.  

A self-insured plan is one in which employers take on most or all of the costs of benefit claims. A third-party administrator manages the payments of claims; however, the employer is the one who pays the claims. Since self-funded plans are subject to less regulation, they may be more flexible than traditional fully insured plans. Stop Loss insurance can be added to limit exposure to very large claims. 

Captive Insurance gives larger businesses with 50+ employees an option to join together with other similar sized companies to pool their resources and share their risk. The goal of this type of funding is to balance out the highs and lows of all the claims within a year to give you a layer of control and transparency over medical spend. 

With Captive Insurance, companies join a pool of other employers who want to share risk with like-minded employers through an operating agreement with stop-loss insurance. Captives are available for employers with 50+ employees on their health plan. Captives enable employers to win in good claims years, provide stability in bad years, and provide a layer of control & transparency over medical spend.  

This funding mechanism is available for group with 11+ employees. It is a mix of fully-insured and self-insurance plans that provides the employer with a fixed monthly payment to the insurance company and the possibility of receiving a refund check if claims run better than expected at the end of the policy year.