Carey Williams

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Self-Funded Health Plans

Self-Funded Health Plans could be for you if you have at least 50 employees and are:

  • Tired of paying high premiums for benefits you seldom use
  • Looking for a way to get something back for what you pay into your health plan
  • Ready to take control over health care costs now and for years to come

Self funding is an approach many large corporations use to control health care costs. Self-Funded Health Plans are within reach for your small business. We’ve done all the work of setting up a complete self-funding program, making it easy to establish and fund your own health benefit plan.

 

You just pay a monthly bill and get:

  • A complete package of self-funding products and services including premier health care benefits and insurance that protects your business from larger-than-expected claims
  • A cost that is determined up front and won’t change for a full year
  • All plan administration details managed for you so you can focus on running your business

With a Self Funded Health Plan, you could see immediate monthly savings, overall costs that stay lower year to year and the chance each year to get back the funds you don’t use.

 

A Self-Funded Health Plan combines a self-funded employee health benefit plan with plan administration and employer stop-loss coverage, all of which are regulated by federal law. The employer stop-loss coverage is an insurance product that is also regulated by the state in which the coverage is issued.

 



How Does Self Funding Work?

 

With self funding, you assume direct responsibility for funding your business’ health benefit plan.

 

With a Self-Funded Health Plan, your maximum cost for claim expenses is determined up front and guaranteed, subject to enrollment and benefit changes. If the actual expenses are less, you get the unused funds back.

If claims expenses exceed the amount expected, stop-loss insurance covers the excess.

  • Aggregate Stop-Loss Insurance protects against high claims incurred by the group as a whole.
  • Specific Stop-Loss Insurance protects against high claims incurred by an individual group member.

All plan administration details are managed for you so you can focus on running your business. You simply pay a monthly bill. This includes the stop-loss insurance premium, the plan administration fee and one-twelfth of the plan's annual claim funding cost. Claims will vary by month, but your bill won't change — because we advance funds as needed.

 

Claims are processed by a third-party administrator. The administrator processes claims, provides customer service, and manages your plan accounting.

 

 

Is This Plan Right For YOUR Group?

 

WFI Benefit Solutions will work with you to help you determine if Assurant Self-Funded Health Plans are right for your group. They carefully evaluate groups and issue coverage to those who are likely to benefit from a self-funded plan.

 

Self funding offers great advantages for many, especially those groups whose members have relatively few ongoing, high-cost medical needs.

 

But self funding is not the best choice for all. If your group includes members with serious, ongoing health conditions, you’re less likely to benefit from self funding.

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