| On July 1, 2009, a new plan design-the partially | | | | Claims will still happen and in fact, one of the |
| self-funded plan-became available in Massachusetts | | | | biggest concerns small and medium sized |
| by two new carriers. It's an alternative to | | | | organizations have when considering partially |
| traditional health insurance that can cut group | | | | self-funded plans is fear of large claims losses. |
| healthcare costs 5-50% and allows you to | | | | With a more complete understanding of partially |
| establish and fund your own health benefit plan. | | | | self-funded plans, this fear can be alleviated. |
| Since 2002, small-to-mid size employers in other | | | | What partially self-insured actually means is that |
| states have drastically cut their health insurance | | | | you don't necessarily pay all of your company's |
| costs and preserved savings into the future with | | | | claims, just the smaller ones up to a pre-set dollar |
| these plans. Here's how they work. | | | | amount. For your company's unexpected and |
| Pay for what you use (and nothing more): | | | | costly claims, you partner with an insurer and |
| Self-funded plans let you pay for the amount of | | | | stop-loss insurance kicks in. |
| health care your group actually uses and nothing | | | | Partially self-funded plans feature two unique stop |
| more. What happens is this, the employer | | | | loss benefits. Specific stop-loss benefits protect |
| assumes financial risk for funding health benefits | | | | employees on the individual level from the crippling |
| and makes monthly payments that cover actual | | | | costs of unexpected, catastrophic claim expenses. |
| claims incurred, third-party administration fees and | | | | Aggregate stop-loss benefits protect small |
| stop loss insurance to protect against unexpected | | | | business owners from the total costs of many |
| high claims. This is in direct contrast to the fixed | | | | smaller claims if that sum total exceeds a pre-set |
| premium amounts they'd pay to the carriers in a | | | | dollar amount. With specific and aggregate |
| typical fully-funded insurance plan. | | | | stop-loss insurance, small and medium sized |
| With traditional fully-funded health insurance plans, | | | | organizations now can have Fortune 500 level |
| whenever your company incurs less than the | | | | protection from higher than anticipated claim |
| expected annual claims amount, they carriers are | | | | costs. |
| the ones that benefit financially because they | | | | Two carriers in Massachusetts began selling |
| keep your unused claims dollars as profits. With | | | | partially self-funded plans effective 7/1 and all |
| self-funded and partially-self funded plans, you | | | | plans meet the state's minimum credible coverage |
| often get the excess claim dollars back at the | | | | (MCC) requirements. |
| end of the plan year as a refund. Now physical | | | | We'd love the opportunity to discuss these plans |
| well-being equates to fiscal well being for your | | | | with your company and see what we can save |
| employees. | | | | you. So give us a call at 617-859-1777 and we'll |
| Premier health protection is for more than just | | | | work together to set a date and time. |
| the "big guys" now: | | | | |