There are several arrangements that can be made to help your business fund group medical plans for your employees.
Fully Insured – this is the most traditional funding arrangement.
Level funding – includes level premiums, return of surplus, and access to data
Self Funding – with Self Funding the employer funds and takes on financial risk. Includes fees to the third party to administer claims, might include fees to stop-loss protection, and includes full access to all claims data.
Reference Based Pricing – provider reimbursement is based on a percentage of what Medicare pays (120 – 170 percent of Medicare reimbursement allowable). Most hospitals are billing roughly 350 percent of medicare to traditional PPO plans. There are pros and cons to this method but can be effective in cost savings.
Health Savings Accounts (HSA) – employer and/or employee-funded with pre-tax dollars
Flexible Spending Accounts (FSA) – employer and/or employee-funded with pre-tax dollars
Health Reimbursement Accounts (HRA) – employer-funded, allows flexibility
Dental – DHMO and PPO Plan Options, full or self-funded
Vision – PPO Options
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