Four ways to fund the same benefits.
The plan design your employees experience and the funding mechanism behind it are separate decisions. Most employers only ever get offered the first one. The funding choice is usually where the money is.
Fully insured
A fixed rate per enrolled employee. The carrier keeps the claims risk and any margin left at the end of the year.
Level-funded & self-funded
You fund claims, stop-loss caps the bad year, and a good year comes back to you instead of to the carrier. Workable well below the head-count most people assume.
ICHRA & non-group
Set a monthly amount, employees buy individual coverage, you reimburse tax-free. Budget certainty, and no renewal to negotiate.
Most employers are told they are too small to self-fund.
The number quoted is usually one hundred lives. In practice level-funded arrangements are routinely written at twenty-five, and sometimes lower with the right risk profile. If nobody has modelled it for you, it has not been ruled out — it has been skipped.
What we need to model it
- Current plan summary and rate sheet
- Census: age, sex, zip, coverage tier
- Renewal letter, if it has arrived
- Claims or large-claimant report, where the carrier will release it
- States your employees actually live in
That is enough for a funding comparison. It takes us a few days, and there is no charge for it.
Medical is the biggest line, not the only one.
Ancillary coverage
Dental, vision, group life, short and long-term disability, and the voluntary lines employees pay for themselves. Cheaper to negotiate as a package than one at a time.
Administration
Enrolment, carrier feeds, new hires and terminations in Employee Navigator, set up and maintained by us rather than sold to you separately.
Compliance
Wrap documents, §125, Form 5500, ACA reporting and COBRA. The obligations that follow from offering the plan at all.
Send the renewal, and we will tell you what we would change
No fee, and no obligation to move the business. Most employers who contact us are simply trying to work out whether the number in front of them is a fair one.
- (800) 779-4090
- info@waughagency.insure
- 22 Bateson Drive, Andover, MA 01810