When it comes to Group insurance, there are two different categories: Small and Large. A group is considered a Small group if it consists of 50 or fewer employees.
Large groups, those consisting of 51 or more employees, enjoy the benefits of more flexibility in plan design, more potential carriers in the market, flexibility of premiums (as these plans are underwritten), and methods of funding those premiums.
Many employer-sponsored plans—especially for smaller groups—have fully insured health plans. In other words, the employer pays the entire premium and any underwriting losses are borne by the insurance company; sometimes employees share this cost, but not always.
Cost is based on the advice of actuaries who price the products to cover the potential underwriting losses, and provide for profitable business. This is a very straight–forward approach and the simplest to understand.
Other funding mechanisms include ASO (Administrative Services Only), Level Funding (a type of ASO), and self-insured plans. These plans, as opposed to fully insured plans, leave some of the risk of exposure to the employer. However, there is the possibility of large cost savings with these types of plans. Some of these plans will require the services of a TPA.
We work with almost all major carriers in 48 states, including but not limited to:
We also work with stop-loss carriers for self-funded plans—this limits the amount of risk exposure for the employer—and TPAs for the administrative functions of these plans. Remember, the cost savings can more than make up for the costs of these services. Our relationships allow us to receive very competitive pricing.
Please allow us to illustrate which plan may make the most sense for your organization.