Transcript Claim Fund - Oberlin Marketing
Allied™ Funding Advantage How Alternative Funding Works
Why Funding Advantage?
Do your group health clients want to receive a refund for being healthy?
YES!
Alternative Funding is the answer!
Fully Insured or Self Insured?
Fully Insured
Risk Bearer is the Insurance Company Premium covers all risks and costs
Self Insured
Risk Bearer is the Employer Claims are paid from Employer funds Employer pays for claims administration
Alternative Funding
Also called Partial Self-Funding
Employer is still the risk bearer
Employer purchases Stop Loss Insurance to protect against high claims
Stop Loss Insurance
Employer’s risk minimized
Specific Stop Loss
Claims paid by carrier when an individual’s claims exceed a set dollar amount
Aggregate Stop Loss
Claims paid by carrier when the group’s total claims exceed a set dollar amount
Why Consider Self Funding Sales?
55% of all companies are fully or partially self funded
Only 13% of employers with 200 or less employees are self or partially funded
Staying Power
Employers that self fund remain doing so on average of 3 to 5 years
Opportunity
Market is untapped for small group employers
Savings
Chance for employers to save and take control of their health plan
What is Allied Funding Advantage?
An alternative funding plan for groups of 10 to 99
Limits employer risk from self-funding
Allows employer to save significant dollars
Monthly costs may be less than fully-insured premiums Potential for refunds at end of plan year
The only risk is not getting a refund at the end of the year!
How Does it Work?
Monthly Costs
Employer makes monthly contributions for each of these three items:
Funding Advantage Monthly Costs
Admin & Sales
Allied claims paying and reporting expenses Agent & General Agent Sales Compensation
Stop Loss Insurance
Covers both Specific and Aggregate Coverage Costs vary with plan benefits selected Funding Advantage has set levels for Specific & Aggregate to keep sales process simple
Funding Advantage Monthly Costs
Claim Fund – Employer’s Money
Employer contributions used to fund expected claim costs
MAX funded plan
Employers’ MAXIMUM claim costs for the year Monthly contributions are 1/12 of this annual cost each month MAX funded - Employer will NEVER be charged more than this for claims Claims Fund money left over is the employers!
Funding Advantage Monthly Costs
Claim Fund Questions
Accommodation
When claims exceed money in claim fund Insurer loans employer money –
Reporting
Detailed monthly reporting showing claim fund activity
Plan Year and Claims Run Out
Plan year is 12 months Claims incurred during plan year are payable for 9 months past end of plan year At end of the 9-month run-out – all remaining claims funds belong to employer!
No hidden terminal liability costs
ERISA Plan
ERISA plan is the plan of benefits for the employee Funding Advantage Options
Premium Advantage Plans
Traditional PPO
HSA Qualified Plans Indemnity Freedom Plans
No networks – no penalties True freedom of provider choice No balance billing
Allied Funding Advantage
Advantages for Employer
Limits the risk of self funding Lowers monthly costs Healthy groups can receive LARGE refunds Won’t be subject to the ObamaCare “rate shocks” that will happen in 2014
Allied Funding Advantage
Advantages For Agents
Available for small groups 10 to 99 Not subject to MLR regulations
No restrictions on Compensation! Compensation paid on full monthly costs.
Take advantage of group trend toward self-funding with a simple, flexible plan
GET YOUR ADVANTAGE TODAY!
Phone: (888) 767-7133 Fax: (913) 945-4396 Quote E-mail: [email protected]
Web site: www.alliednational.com
The RIGHT Benefits. The RIGHT Price.