Transition large employers from self-funded to fully-insured plans.

The Problem

Over the last decade, large employers have been shifting from fully-insured health plans to self-funded plans. In 1999, 56% of covered employees were enrolled in fully-insured health plans, as opposed to only 41% today. What’s so appealing about self-funding? It exempts large employers from state insurance laws and premium taxes, and allows for greater flexibility in plan design.

While insurers have adjusted to this trend by offering administrative services only, known as ASO, the revenue and profitability are far lower for ASO business than for fully-insured business.

The Solution

Our Private Exchange helps increase revenue from previously self-funded clients by:

• Offering all the benefits of a self-funded plan, with cost stability. Our Private Exchange separates the employer funding arrangement from the insurance chosen by employees. This way, the employer is only responsible for the defined contribution arrangement. Since it’s federally regulated like a self-funded health plan, the employer is not subject to state health insurance laws or premium taxes.
• Providing members with options. It also allows employers to provide employees with more healthcare choice, which is advantageous for members and attractive for their employers.
• Charging administrative fees and premiums. In ASO business, you only receive administration fees. Through our Private Exchange, you can collect premiums and administration fees on your fully-insured products.