You have funding options for your healthcare plan with us.

Healthcare Funding Options

Controlling healthcare costs has long been a top priority for employers nationwide. Many businesses want to keep providing valuable health benefits to their current employees, and they want those benefits to help them attract and retain quality workers. They must, however, consider the cost-effectiveness of those benefits in an era when rate hikes are the norm.

At James Campbell & Associates (JCA), we offer various funding options for employer-sponsored healthcare so that businesses can maximize their plans – both in the coverage they offer and the insurance cost. Our staff will work with you to determine your needs and which funding approach best suits your needs.

Fully-Funded Plans

A fully-funded employer-sponsored plan is one where your business pays a premium to the insurance carrier. These premium rates are fixed for a year. The insurance company collects premiums and then pays medical claims based on the type of coverage benefits specified in the policy. Your employees and their dependents are responsible for any deductibles or co-payments in a fully-funded model.`

Self-Funded Plans

A self-insured health plan is one in which an employer bears the financial risk of providing health insurance to its employees. Instead of paying fixed premiums to an insurance company, which assumes the financial risk of paying claims, the employer pays for medical claims as they arise.

Employers who use a self-insured health plan operate their own rather than purchasing a fully-insured plan from an insurance carrier. Employers may self-insure to save the profit margin that an insurance company adds to the premium for a fully insured plan. There are risks to self-insurance if claims are higher than anticipated.

Level-Funded Plans

Employers can choose a level-funded benefit plan, in which you pay a monthly fee to cover administrative costs, claims, and stop-loss coverage. Level-funded plans combine the flexibility and cost savings of a self-funded plan (such as a captive) with a fully-funded plan’s financial security and predictability.

The level-funding carrier or third-party administrator (TPA) pays your employees’ claims throughout the year. If your payments exceeded claims at the end of the year, you would be refunded the difference in monthly claim allotments. If the claims exceed the amount you paid into the program, your stop-loss insurance will usually cover the difference.

We’re Ready
to Help You

Our commitment is to provide clients with the tools, resources, and strategies to make fully informed decisions regarding benefit plans – for the protection and well-being of their most critical asset: their employees, and families.

For more information about how we can make a difference for your business and employees, give us a call at (850) 561-8700.