Employee Benefits

The employer pays monthly premiums to the carrier, incurring no additional financial exposure, but may experience limited utilization transparency for groups with fewer than 100 participants.

• Employers have fixed premium costs, making budgeting and financial planning more predictable.
• Insurance carriers handle most administrative tasks, reducing the administrative burden on employers.
• The insurance carrier assumes the financial risk associated with paying claims, providing financial protection to the employer against unexpected healthcare costs.

Split-funded insurance can be an attractive option for employers seeking cost savings, flexibility, and greater control over their employee health benefits. However, it's essential for employers to carefully evaluate the financial implications and administrative requirements of a split-funded arrangement before making a decision.

• Employers can potentially save money compared to fully insured plans by avoiding some of the overhead costs associated with traditional insurance premiums.
• Split-funded plans offer more flexibility in plan design and administration, allowing employers to tailor benefits to the specific needs of their workforce.
• Stop-loss insurance provides financial protection against unexpectedly high claims, reducing the employer's exposure to financial risk.

Self-funded insurance allows employers to assume the financial risk for providing healthcare benefits to their employees. Instead of paying fixed premiums to an insurance carrier, employers pay for covered claims directly as they occur. This arrangement offers greater flexibility in plan design and potential cost savings compared to fully insured plans.

• Employers can potentially save money compared to fully insured plans by avoiding insurer profit margins and administrative fees.
• Self-funded plans offer more flexibility in plan design and administration, allowing employers to customize benefits and control costs.
• Employers have more control over cash flow since they only pay for claims as they occur, rather than in advance through fixed premiums.