Plans & Benefits - Funding Options

Find the right funding arrangements for your client.

We offer several funding options based on the client's group size and individual needs.

Community Rated - 50 and fewer eligible employees.

  • Fully insured
  • Rated are the same within the community pool of people.

Experience Rated - 51+ eligible employees

Prospective

  • Fully insured with with claims pooling protection.
  • Premiums based on the cost and use of plan benefits.

Minimum Premium

  • Fully insured with claims pooling protection
  • Clients reimburse us for paid medical expenses up to a set liability maximum.

Retrospective

  • Fully insured
  • Clients pay a fixed monthly premium and an annual credit or a deficit is applied at the end of the plan year.

Administrative Services Contract (ASC)

  • Fully insured
  • Clients pay claims expenses as they occur ("pay as you go") plus any applicable plan costs.
  • Client can add stop-loss coverage

Self-funded/Self-insured - Groups with 250+ contracts

Administrative Services Only (ASO) Contract

  • You self-insure the medical expense and pay to have us administer the plan\
  • You can add stop-loss coverage

Self-funded plans have the ability to design their own health plan benefits.

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