CORONAVIRUS BLOG CAREERS CONTACT US 1 (888) 892-7688 CLIENT LOGIN PROPERTY AND CASUALTY EMPLOYEE BENEFITS PERSONAL INSURANCE MEDICAL FUNDING STRATEGIES Types of Funding Strategies We work with different medical funding strategies allowing us to best manage a company’s tolerance for risk to meet their specific needs. Find out more about our medical funding strategies below. Fully-Insured Level Funding Self-Insured Reference-based Pricing Consortiums Captives Fully Insured Employers may offer either self-insured or fully insured plans to their employees. Under a fully insured plan, an employer pays a fixed monthly premium based on the number of employees enrolled each month to the insurance carrier for the plan year. The insurance carrier assumes the financial and legal risk of loss if claims exceed projections. Conversely, if the claims are lower than projections, the insurance carrier retains 100% of the claim surplus. Types of Fully Insured Plans Depending on the contracted insurance carrier, all types of plans (conventional indemnity, PPO, EPO, HMO, POS, and PHOs) are viable options for the employer. Claims Administration Fully-insured employers contract with insurance carriers for insurance services such as enrollment, claims processing, and provider networks. Plan Design Employers are generally limited by insurance carriers’ stock plan design options. The plan design must comply with state regulations and healthcare reform laws. Additional Funding Tools We also utilize the following tools in conjunction with the medical plan to lower the total medical spend while protecting the integrity of the plan and minimizing the potential out of pocket costs for a company’s employees. Health Reimbursement Arrangements Health Savings Accounts Flexible Spending Accounts GAP Plans Accident Plans Health Reimbursement Arrangement (HRA) A Health Reimbursement Arrangement (HRA) is funding promised by employers to help plan members pay for qualified medical expenses, which may include but are not limited to, a plan members deductible, copay or coinsurance. An employer contributes a specified amount to each plan members HRA with the reimbursement usually becoming available to them at the beginning of the deductible period. HRA’s are fully funded by and are 100% tax-deductible to the employer. An advantage of utilizing an HRA is the premium charged for the health insurance plan is generally less since the employer is purchasing a higher deductible plan. Using some of the plan savings allows an employer to protect the integrity of the plan by reimbursing a portion of the higher deductible to their plan members. HRA plans do not pertain to all plan members, as 2% or more shareholders and their immediate family members are most often ineligible to participate. When a plan member terminates coverage through an employer the money in the account does not transfer to the departing member, as the employer is in control of the HRA funds. In application, an example of a Health Reimbursement Arrangement is an employer “funds” $1,000 into the plan members account at the beginning of the deductible period. If they visit a doctor for an annual exam, which is 100% covered, no money from the HRA account is deducted. Over the course of a year costs of qualified medical expenses towards lab work, MRI, etc. are incurred totaling $450, leaving $550 left in the account. An employer may choose to allow all or a portion of the remaining $550 to rollover to the next deductible period, however most often the employer will choose to reset the next year at the same $1,000 funding level to maximize the potential plan savings from the members lower deductible utilization. Share this: Click to share on Facebook (Opens in new window) Click to share on Twitter (Opens in new window) Click to share on LinkedIn (Opens in new window) Click to print (Opens in new window) You can play an important role to help keep your passengers safer. Learn how and share these tips with your friends… @safegardgroup We came together to participate in a non-perishable food drive for one of our clients! All donations will benefit f… https://t.co/ISjhO7QAsZ by The Safegard Group November 24, 2021 Subscribe to our Newsletter By subscribing to our mailing list you will get the latest news from us. Email* Latest Posts Gambling in the Workplace DECEMBER 31, 2019 Return to Work Program DECEMBER 26, 2019 The Benefits of Upskilling DECEMBER 24, 2019 Contact The Safegard Group, Inc. 100 Granite Drive, Suite 205 Media, PA 19063 Phone: 1 (888) 892-7688 Fax: (610) 892-7695 eassistant@safegardgroup.com Follow Us © 2020 The Safegard Group, Inc.