Program Overview

An alternative approach to affordable health coverage for small to mid-size employers.

offers small to mid-size employers an opportunity to gain the benefits of self-funding without taking on the complexities and uncapped risk of traditional self-funded programs. delivers comprehensive benefits, professional administration, and excess loss insurance protection– for one predictable monthly payment, and if claims experience is favorable, employers can receive money back.

SafeGuard is Simple SafeGuard offers the benefits of self-funding without the complications The employer makes only a few key decisions in building a plan to meet the group's unique needs– simply selecting benefit design, deductible level and member share percentage. The plan document, major provider network memberships, excess loss insurance coverage, and professional administration are already in place

SafeGuard is Seamless SafeGuard is turnkey, and results are seamless: All aspects of the plan are handled under one roof, from billing to claims adjudication, member support to network coordination, compliance review to excess loss insurance claim and payment processing Employers make one monthly payment, and USHL handles the rest– the employer is not required to submit bills, track paperwork, or pre-pay high dollar claims and await reimbursement

SafeGuard is Same-Source SafeGuard offers the significant advantage of same-source excess loss insurance and benefit administration Because USHL provides both administration and excess loss insurance, there are no coverage gaps in the SafeGuard program– anxiety and processing delays are eliminated for the member, liability issues and financial impact are lessened for the employer

The Best of Both Worlds SafeGuard combines the best aspects of insured and traditional self-funded coverage– Easy to understand and popular benefit designs, one monthly payment, no administrative burden on the employer’s staff, and protection against unexpected high-dollar claims.

SafeGuard Mechanics The employer selects desired benefit design(s) – medical and prescription drug coverage Final rates for the group – based on medical underwriting – are issued at the time of implementation; rates are specified for single, couple, single with children and family, and will remain unchanged for the plan year unless the group census changes Participants receive a SafeGuard member identification card which they present to providers, pharmacists, etc.; claims and questions are directed to USHL staff The monthly payment– consisting of a pre-funded claims reserve account payment, an administrative fee, and an excess loss insurance premium payment – is the only financial obligation the employer has for covered medical claims

SafeGuard Mechanics Claims that exceed the annual total of the pre-funded claims reserve account are covered by the excess loss insurance Funds remaining in the pre-funded claims reserve account after settlement are returned to the employer SafeGuard operates on a twelve-month incurred contract; groups may elect to re-contract for additional twelve month periods

Monthly Payment Components SafeGuard plans offer one level monthly payment consisting of an amount to be reserved for claims (the pre-funded claims account), monthly administration fees and excess loss insurance premium. The employer will not owe more for covered claims beyond this monthly amount– and may receive pre-funded claims dollars back at the time of settlement.

Any Additional Costs or Fees? Assuming no census changes, the monthly billed amount for SafeGuard remains the same for the duration of the contract– and this amount covers the employer’s total financial liability for covered claims Any taxes or fees imposed by government or state agencies, including the PCORI Fee and Transitional Reinsurance Fee, must be paid by the employer– USHL Client Services assists in the calculation of these fees and offers remittance advice

What Can an Employer Expect During a Typical Plan Year? Regardless of how claims run during the contracted twelve-month period, fixed costs and excess loss insurance premiums are equal, and the employer will owe no more than the monthly payment for covered, eligible claims During a moderate-cost claims year, the employer will receive unused pre-funded claims dollars after settlement. During a high-cost claims year, there will be no employer pre-funded claims dollars available for return

What Can an Employer Expect During a Typical Plan Year?

What Can an Employer Expect During a Typical Plan Year?

For additional information on SafeGuard, select an option below: Speak with a Sales Representative Contact USHL Sales Support at (844) 828-5968 or send an email to SalesSupport@ushealthandlife.com Learn more about SafeGuard http://www.ushealthandlife.com/Find-a-Plan/Medical/SafeGuard Review SafeGuard Benefit Summaries http://www.ushealthandlife.com/Find-a-Plan/Medical/SafeGuard/Benefit-Summaries Review Frequently Asked Questions http://www.ushealthandlife.com/Portals/0/Documents/SafeGuard/SafeGuard_FAQs.pdf Obtain a Quote http://www.ushealthandlife.com/Find-a-Plan/Quotes-from-USHL/Get-a-Quote#SafeGuardQ Excess loss insurance policies and PPO insurance plans underwritten by US Health and Life Insurance Company, Inc.  SafeGuard plans administered by US Health and Life Insurance Company, Inc. © 2017 US Health and Life Insurance Company, Inc. All rights reserved.

Program Overview