Fully Insured Health Plans: Fully Insured Planning for Employers

What is a fully insured health insurance plan? A fully-insured or traditional product is a fixed cost program. It doesn’t matter how many claims an organization does or doesn't incur, the same monthly cost will apply. These plans include traditional plans through UnitedHealthCare, Blue Cross Blue Shields, Cigna, and Aetna. They are available to organizations with two or more qualifying employees. On the other hand, with a self-funded product, the organization pays the claims as they are incurred. In the years with "average" to "below average" claims, the organization reaps the savings. However, in the "bad" years the organizations are protected with stop loss and pay a comparable "fully insured" amount. Self-funded plans are available to organizations with 100 or more employees, and are available on a limited basis to organizations with 20-100 employees. Do you know what your risk threshold is? What types of claims is your organization making? Find a consultant that can show you the pros can cons when comparing self and fully insured planning for your company.