From Solana Insurance Employee Benefits, Newport Beach
A partially "self-insured" group health insurance program is a method that typically saves businesses on average between 20- 40% on top of their once a year health care expenses without lowering benefits or changing carriers. This is the way big businesses have been approaching group health care for the previous 30 years.
It works because:
Based on multiple studies of employee group health plan utilization over the previous 10 years (by Anthem as well as Kaiser Permanente), it is a fact that between 50 to 80% of employees within any group merely will not use their health plan, or will drastically under make use of it. Only 4-7% will exceed their deductible or max out of pocket. Most corporations today pay premiums as if everybody in their cluster hits their deductible which simply does not happen.
A more well-organized and less expensive way to look at group health insurance is to raise the deductible significantly, and then let a third party administrator manage the minor amount of incidents within the employee base that actually do exceed their individual deductible. Again on average that will only be 4-7% of the employees.
The simple mechanics are as follows:
1. The company keeps the carrier (Anthem, Blue Shield, Kaiser, etc.) they already have, if content.
2. The company keeps the same plan design for their employees (same copays, deductibles and out of pocket max for them)
3. Solana and our Third Party Administrator enroll the company in a much higher deductible plan which instantly drops the premium.
4. When an employee exceeds their individual deductible, the employer pays the excess with funds set aside and managed by the TPA to cover the difference. Those funds are made available from the reduction of premium.
5. Our Third Party Administrator manages the funds between the employee's deductible and the employer's overall group deductible.
Normally there are instant savings to the company immediately through the lower premium as well as additional money that is returned to the company at the end of the year if there is less utilization than is predicted by the actuarial models.
Solana's Third Party Administrator
Solana's partner, a third party administrator (TPA) has been doing this for over 17 years, with over 3,600 businesses and a 97% retention rate. They are one of the biggest in the country and are located here in California.
To get a quote
All we need to run a quote is a company census of all employees that are on the insurance plan, the plan design (copays, deductibles, etc.) and a copy of the last statement from the insurance carrier. That normally gives us enough info to run the numbers to see if significant money can be saved.
We do this at no charge and 80% of our clients have now switch to this kind of plan. 100% of companies we deal with give us the info for a quote once they understand the concept!
You can also visit EmployerDrivenHealthPlans for additional information.
We're located in Newport Beach in the heart of Orange County and we service all of Southern California as well as many clients in Northern California. We provide comprehensive Employee Benefit Plans for small to Medium Sized businesses.
A partially "self-insured" group health insurance program is a method that typically saves businesses on average between 20- 40% on top of their once a year health care expenses without lowering benefits or changing carriers. This is the way big businesses have been approaching group health care for the previous 30 years.
It works because:
Based on multiple studies of employee group health plan utilization over the previous 10 years (by Anthem as well as Kaiser Permanente), it is a fact that between 50 to 80% of employees within any group merely will not use their health plan, or will drastically under make use of it. Only 4-7% will exceed their deductible or max out of pocket. Most corporations today pay premiums as if everybody in their cluster hits their deductible which simply does not happen.
A more well-organized and less expensive way to look at group health insurance is to raise the deductible significantly, and then let a third party administrator manage the minor amount of incidents within the employee base that actually do exceed their individual deductible. Again on average that will only be 4-7% of the employees.
The simple mechanics are as follows:
1. The company keeps the carrier (Anthem, Blue Shield, Kaiser, etc.) they already have, if content.
2. The company keeps the same plan design for their employees (same copays, deductibles and out of pocket max for them)
3. Solana and our Third Party Administrator enroll the company in a much higher deductible plan which instantly drops the premium.
4. When an employee exceeds their individual deductible, the employer pays the excess with funds set aside and managed by the TPA to cover the difference. Those funds are made available from the reduction of premium.
5. Our Third Party Administrator manages the funds between the employee's deductible and the employer's overall group deductible.
Normally there are instant savings to the company immediately through the lower premium as well as additional money that is returned to the company at the end of the year if there is less utilization than is predicted by the actuarial models.
Solana's Third Party Administrator
Solana's partner, a third party administrator (TPA) has been doing this for over 17 years, with over 3,600 businesses and a 97% retention rate. They are one of the biggest in the country and are located here in California.
To get a quote
All we need to run a quote is a company census of all employees that are on the insurance plan, the plan design (copays, deductibles, etc.) and a copy of the last statement from the insurance carrier. That normally gives us enough info to run the numbers to see if significant money can be saved.
We do this at no charge and 80% of our clients have now switch to this kind of plan. 100% of companies we deal with give us the info for a quote once they understand the concept!
You can also visit EmployerDrivenHealthPlans for additional information.
We're located in Newport Beach in the heart of Orange County and we service all of Southern California as well as many clients in Northern California. We provide comprehensive Employee Benefit Plans for small to Medium Sized businesses.
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