FCFS in conjuction with several industry leading Health Insurance providers, utilizes partial self-funding in providing medical, dental, vision and
short-term disability insurance coverage. Partial self-funding allows for a
much lower employer base cost when compared to fully insured or HMO plans. The
employer then participates in claim costs up to an agreed-upon maximum
Advantages of Partial Self-Funding
• Allows for "favorable
risk" pricing
• Provides detailed claims information to aid in plan design and pricing
• Frequently provides significant cost savings over fully insured and HMO plans
• Claims reserves are under employee control
• Creates maximum flexibility and customization
Generally, the employer is provided
cost (risk) management in three ways, as follows:
1. Specific Stop-Loss Coverage
Specific insurance limits the
employer claim expense to a specific dollar amount, per year/per person. For
groups under 100 employees, the maximum cost is usually $10,000- $20,000, but a
much higher limit can be elected.
2. Aggregate Stop-Loss Coverage
Aggregate insurance limits the
employer cost for the total of all claims for all employees for the plan year.
Most often, this is a very manageable cost for the employer. Specific claims in
excess of the specific stop-loss (e.g., $10,000) are not calculated in the
aggregate total, as they are paid by the specific excess-loss coverage.
3. Monthly Aggregate Accommodation
(optional)
In
addition to the protection of the specific and aggregate stop-loss coverage,
the Monthly Aggregate Accommodation provides the employer with a monthly cap on
claims.
For a quote, no-cost no-obligation, let us lend our due diligence within a 3-yr or 5-year Health Insurance
feasibility study; ensuring the right plan is designed for your unique
needs email: JosephJr@FirstCapitalFin.com.