How It Works
With The Secure Plans: Simply
Keep claims savings or gift them to an Insurance Company.
The choice really is that simple.
Fully-Insured Coverage
Comprehensive medical coverage
Fixed costs each month
Employer is protected when claims are higher than expected
Insurers keep100% of the surplus when claims are less than expected
versus
Level-Premium Self-Funded
Comprehensive medical coverage
Fixed costs each month
Employer is protected when claims are higher than expected
Employers receive 100% of surplus when claims are less than expected
Traditional PPOs
Higher costs for out-of-network services.
Higher reimbursement rates mean higher premiums.
versus
Reference Based Pricing
No networks (but can be added as an option)
Lower health care spending means lower premiums
The Secure Plans Simplifies Savings
Self-funded health plans can be complicated, but they don’t have to be. The Secure Plans are straightforward: nine comprehensive standard plans, a standard contract period, proven administration, fair and experienced underwriting. 100% reimbursement of claims fund surplus — fees or renewal requirements gimmicks. Our Referenced Based Pricing reduces costs and delivers extensive employee education and advocacy to minimize and avoid balance billing. Employers can even add a physician-only PPO network or go full PPO if desired. It all comes together to make The Secure Plans the safe and simple way to transition from fully-insured to self-funded medical coverage and Reference Based Pricing.
Advantages and Responsibilities
The opportunity for refunds is the advantage of self-funded plans that gets most of the attention. But there are other benefits as well. For example, self-funded plans are governed by federal law so employers can offer the same plan in all the states in which they do business. And monthly payments are often comparable to those of traditional insurance.
Self-funding does entail some additional responsibilities for employers. They are responsible for paying eligible claims of employees and their dependents. That’s why companies self-funding coverage need to work with a dependable administrator, offer a cost-effective network, and have access to programs that manage risk. All of which the Secure Plans deliver.
This additional responsibility is also why most companies–especially those new to self-funding–use excess-loss coverage to cap their claims exposure. Again, that’s what the Secure Plans deliver with both specific stop-loss coverage (limiting employers’ exposure to claims from any one employee or dependent) and aggregate stop-loss coverage (capping exposure to claims from all of a company’s insureds).
Please see the “What to Know About Self-Funding” flyer on the “Collateral” page for more information.