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Allied™ Funding Advantage How Alternative Funding Works.

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Presentation on theme: "Allied™ Funding Advantage How Alternative Funding Works."— Presentation transcript:

1 Allied™ Funding Advantage How Alternative Funding Works

2 Does your group want to receive a refund for being healthy? YES! Alternative Funding is the answer!

3  Fully Insured  Risk Bearer is the Insurance Company  Premium covers all risks, costs and administration  Self Insured  Risk Bearer is the Employer  Claims are paid from Employer funds  Employer pays for claims administration

4  Also called Partial Self-Funding  Employer is still the risk bearer  Employer purchases Stop Loss Insurance to protect against high claims

5  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 Employer’s risk minimized

6  55% of all companies are fully or partially self funded  Only 13% of employers with 200 or less employees are self or partially funded  Savings  Chance for employers to save and take control of their health plan  Now available for smaller employers

7  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!

8  Monthly Costs  Employer makes monthly contributions for each of these three items:

9  Stop Loss Insurance  Covers both Specific and Aggregate Coverage  Costs vary with plan benefits selected  Funding Advantage has set levels for Specific & Aggregate insurance to keep the plan simple.  Admin & Sales  Allied administration, claims paying and reporting expenses  Broker or Benefit Consultant Compensation

10  Claim Fund – Employer’s Money  Employer contributions used to fund expected claim costs  MAX funded plan  Employer pays 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 – even in a bad year  Claims Fund money left over is the employer’s!

11  Claim Fund Questions  Accommodation  When claims exceed money in claim fund – Insurer loans employer money. Since plan is max funded - regular monthly contributions will pay off the accommodation loan  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 Funding Advantage Monthly Costs

12  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

13  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  Take control of health plan usage and costs

14 www.alliednational.com The RIGHT Benefits. The RIGHT Price. GET YOUR ADVANTAGE TODAY!


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