Self-Insured Health Insurance Plans: More Control, More Stability for your Bottom Line

Health insurance products traditionally known as “fully- insured” plans have long been the norm for most mid- sized businesses. Lesser known but still popular with larger companies is the “self-insured” model. With the impact of health insurance premiums hitting the bottom line of many mid-size businesses, employers have been searching for ways to control their health insurance costs without trimming employees’ benefit packages.

Chamber Health Options has introduced two new self-insured options exclusive to Metro Chamber members, offering more stability regarding health insurance premiums: Anthem Balanced Funding, through Anthem Blue Cross and Blue Shield, offers a Chamber member discount and is for smaller employers with 10-50 covered employees; and the Chamber Group Captive, administered by Roundstone, an independent insurance organization focused on developing and managing captive and alternative risk products. The group captive works best for groups of 50-500 employees, but employers may qualify with as few as 20 covered employees.

ANTHEM BALANCED FUNDING

With Anthem Balanced Funding, you can enjoy the advantages of both a fully insured and self-funded plan, along with integrated stop loss coverage so your risk is limited. You can experience the peace of mind of fully insured plans with:

  • Predictable, fixed monthly payments
  • No deficit carry-forward
  • Coverage for claims run-out (also known as terminal liability)
  • A cap on financial responsibility

You can also gain cost control and flexibility from the benefits of a self-funded plan:

  • Money-back savings potential when claims experience is better than expected
  • Standardized reports for a more comprehensive understanding of plan costs. Reports do not include Protected Health Information.
  • Savings on premium tax and future health care reform taxes
  • Plan design options

As an employer subscribing to Anthem Balanced Funding, you have the additional security of integrated stop loss coverage, which protects the plan from high individual claims, and aggregate stop loss, which provides additional protection when your plan has higher- than-expected claims, in aggregate, for all plan members in one calendar year.

CHAMBER GROUP CAPTIVE Roundstone built the country’s first medical group captive in 2005 and recently brought this option exclusively to Metro Chamber members in Clark County. A group captive is an insurance facility formed by companies joining together to reduce the cost of insurance and to control its own risk. Member companies maintain good loss histories and effective risk management programs. Here are some of the reasons many employers join the group captive self-insured option:

  • Proprietary medical insurance program developed by Roundstone to help control cost and save money Self-insured principles with fully insured stability
  • Major medical program only – ancillary lines (such as dental and vision) not included
  • Aggregate, or pooled, large claims to reduce volatility and minimize financial impact
  • Full access to claims data, allowing for customization of plan design
  • Turnkey, with everything you need to gain control and improve wellness Proven: 30% cost savings experienced by groups with 100% return of collateral contribution Control over plan design, service providers, and networks, as well
  • as access to data to streamline the premium calculation process Ability to purchase insurance in the same way as large employers Engagement in some form of wellness program
  • Financially strong and transparent

To find out more about your self- insured options, contact your Chamber member broker or Chamber Health Options at 702.586.3889.