News and Blog

Monday, 11 September 2017
Level Funded Health Insurance - Solutions for group insurance

Level Funded health insurance for the small and mid-sized group market.

As rates, requirements and ACA taxes continue, the insurance carriers have created health plans to help employers find affordable options for their employees. One that has proven most successful is a level funding strategy blends the simplicity and protection of a fully insured plan with the flexibility, ACA avoidance and opportunity to share in claims experience gains of a self-insured health plan.  

The success of a plan like this for your company begins with underwriting, if you are a healthy group with good claims experience you may be able to save a lot of money. For groups with under 50 employees you are subject to community rating and ACAs limited plan designs. Community rating means everyone pays the same rates regardless of your group’s health, male/female ratios and type of industry. For larger groups, while you are underwritten on these factors, you are still pooled with many other groups and if you have a good claims year there are no refunds for overpaying for your coverage.

Level Funded health plans give you the protection of a fully insured premium meaning that is the most you can pay regardless of your claims experience. The big difference is premiums are broken into fixed costs (administration and reinsurance) and claims costs (money to pay your claims). The claims funding is where you can receive money back if your claims come in less than expected. In the event of a bad claims year you can expect an increase in rates just like you would in the fully insured world. The difference is, most of that increase will be going into the claims funding bucket and in the next year if claims return to normal, you will get some of that increase in premiums back.

Another big difference is the ability for small groups (under 50 employees) to have flexibility to build plan designs to meet their needs rather than to meet the ACAs rigid bronze, silver, gold & platinum requirements.

Sound too good to be true? For many it will be because you have to go through underwriting to qualify. If the carrier is going to give you money back in good claims years and eat the losses in bad years they want to make sure and work with healthy groups. Fortunately, it has gotten easier to get your employees through underwriting with the simplified Milliman Rx reporting. Carriers can now order data about your employee’s prescription usage and are making underwriting decisions based on that rather than having all your employees fill out health statements.

Who are these new plans designed for? We can now get quotes down to 10 enrolled employees. Not all carriers are going this low and most want 25 enrolled. Regardless, there are new options for you to consider and we would like to show you how it works and if this is a good fit for your company.

Please call David Moore at 615-724-1699 or email for more information and to get pricing options for your company.

Posted on 09/11/2017 10:24 AM by David Moore
Friday, 8 September 2017
Equifax data breech - were you affected? Find out here

Hello everyone,

As part of our ongoing efforts to help keep your personal information as safe as possible, we want to remind you to stay on the lookout for the many security threats making the rounds in cyberspace today.

Recently, we learned about a massive Equifax breach in which more than 143 million consumers may have had their information compromised, including:

  • Social security numbers
  • Dates of birth
  • Addresses
  • Driver’s license numbers
  • Credit card information (for approximately 209,000 consumers)

Due to the high potential impact of this breach, we recommend taking the following steps:

1) Determine whether you may have been affected. Through Equifax’s self-service portal, you can quickly determine whether your information may have been compromised. Enter your last name and the last six digits of your social security number, and you’ll find out whether Equifax believes you’ve been affected. This process takes only a couple of minutes.

2) Enroll in Equifax’s credit monitoring and identity theft protection. Equifax is now offering one free year of TrustedID Premier, its credit monitoring and identity theft protection product, to all U.S. consumers, even if you aren’t a victim.

Once you enter your information in Equifax’s self-service portal, you’ll be given the option to enroll in TrustedID Premier. Click Enroll, and you’ll be provided with an enrollment date. Be sure to write down this date and return to the site on or after that date.

3) Be wary of e-mails that come from Equifax. Because of the high number of victims, Equifax is notifying only the 209,000 consumers whose credit card information may have been affected via postal mail. Do not trust e-mails that appear to come from Equifax regarding the breach. Attackers are likely to take advantage of the situation and craft sophisticated phishing e-mails.

4) Monitor your accounts for suspicious activity. Equifax’s free TrustedID Premier service can help you monitor your credit—but be sure to monitor your other important accounts for any suspicious activity.

For more information, visit Equifax’s FAQs page regarding the incident.

Rest assured that we are always concerned about information security. 

Posted on 09/08/2017 3:58 PM by David Moore