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    Funding Options
    Our funding options allow you to choose a more conservative arrangement or one with higher risk but potentially greater reward. All four large employer funding arrangements are available with any product.

    Traditional Fully Insured

    Employers are responsible to prepay premium, which includes expected claims and fixed costs (administrative fees and risk allocation). We pay for all covered claims as defined by the Group Health Insurance Contract. 

    Advantages:
         > Set monthly premium
         > No risk to the group

    Eligibility Requirements:
         > Minimum of 51 benefits-eligible employees

    Contingently Funding
    This provides the option to assume a limited amount of medical expense risk. Employers are billed for the established premium throughout the contract year, and a final settlement occurs during the 17th month. Employers are responsible for costs up to the maximum liability, and we are responsible for costs that exceed the maximum liability. If costs are lower than the established premium, the employer is refunded the difference down to the minimum liability.

    Advantages:
    > Set monthly premium
    > Lower fixed costs than the alternative and self-funding options
    > Low annual maximum liability — 105 or 110 percent of 
       established premiums
    > No need for specific stop loss reinsurance
    > Possibility of partial premium refund

    Eligibility Requirements:
    > Minimum of 100 enrolled employees

    Self Funding
    Self-funded plan administration is available for employers that want to assume financial risk for the medical claims of their employees. With self funding, employers are responsible for fixed costs (administration fees, specific, and aggregate reinsurance) and incurred claims up to a maximum liability (usually 120 to 125 percent of expected claims).
    We provide self-funded employers the same high-quality services our fully insured business receives (e.g., claims administration, customer service, disease management, pharmacy benefit management).

    Advantages:
         > Cash flow advantage superior to traditional fully insured or contingently funded plans
         > Employers benefit if they have low utilization
         > Aggregate and specific stop loss coverage are available at very competitive rates

    Eligibility Requirements:
         > Minimum of 200 enrolled employees

    Alternative Funding
    This fully insured funding arrangement provides greater cash flow advantages and lower risk exposure than self funding. Each month, the employer pays fixed costs (administrative fees and risk allocation) for the current month and claims expenses for the previous month.
    An annual maximum is established at either 105 or 110 percent of expected claims, and we cover claims expense exceeding this annual liability limit. The annual maximum is spread over 12 months, limiting exposure on a month-to-month basis.

    Advantages:
         > Low annual claims maximum at 105 or 110 percent of expected claims — may eliminate need
            for specific stop loss reinsurance
         > Monthly claims maximum — limits monthly claims exposure
         > Cash flow — claim payments are due following the month in which they occur
         > 12/24 maximum liability contract — claims maximum covers all claims incurred during the 
            12- month contract year

    Eligibility Requirements:
         > Minimum of 100 enrolled employees

     

    ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame a SelectHealth Advantage: 1-855-442-9900 (TTY: 711) / SelectHealth: 1-800-538-5038.


    Cerrar

    注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電SelectHealth Advantage: 1-855-442-9900 (TTY: 711) / SelectHealth: 1-800-538-5038. 。


    退出

    CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số SelectHealth Advantage: 1-855-442-9900 (TTY: 711) / SelectHealth: 1-800-538-5038.


    Thoát

    주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. SelectHealth Advantage: 1-855-442-9900 (TTY: 711) / SelectHealth: 1-800-538-5038. 번으로 전화해 주십시오.


    종료

    ध्यान दिनुहोस्: तपार्इंले नेपाली बोल्नुहुन्छ भने तपार्इंको निम्ति भाषा सहायता सेवाहरू निःशुल्क रूपमा उपलब्ध छ । SelectHealth Advantage: 1-855-442-9900 (TTY: 711)/ SelectHealth: 1-800-538-5038 मा फोन गर्नुहोस्।


    बाहिरनिस्कनुहोस्

    FAKATOKANGA’I: Kapau ‘oku ke lea fakatonga, ko e kau fakatonu lea te nau tokoni atu ta’etotongi, pea te ke lava ‘o ma’u ia. Telefoni ki he SelectHealth Advantage: 1-855-442-9900 (TTY: 711) / SelectHealth: 1-800-538-5038.


    Hū‘anga ki tu‘a

    ОБАВЕШТЕЊЕ: Ако говорите српски језик, услуге језичке помоћи доступне су вам бесплатно. Позовите Select Health Advantage: 1-855-442-9900 (TTY- Телефон за особе са отежаним говором или оштећеним слухом: 711)/Select Health: 1-800-538-5038.


    IZLAZ

    PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa SelectHealth Advantage: 1-855-442-9900 (TTY: 711) / SelectHealth: 1-800-538-5038.


    Isara

    ملحوظة: إذا كنت تتحدث العربية، فإن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل بشركة SelectHealth Advantage: 1-855-442-9900 (رقم هاتف الصم والبكم: 711) / SelectHealth: 1-800-538-5038.


    خروج

    ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: SelectHealth Advantage: 1-855-442-9900 (TTY: 711) / SelectHealth: 1-800-538-5038.


    Beenden

    ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги переводчика. Позвоните SelectHealth Advantage: 1-855-442-9900 (телетайп: 711) / SelectHealth: 1-800-538-5038.


    выйти

    សម្គាល់៖ បើសិនជាអ្នកនិយាយ ភាសាខ្មែរ សេវាជំនួយផ្នែកភាសា ដោយមិនគិតថ្លៃ គឺអាចមានសំរាប់ អ្នក។ សូមទូរស័ព្ទមក SelectHealth Advantage: 1-855-442-9900 (TTY: 711) / SelectHealth: 1-800-538-5038 ។


    ចាកចេញ

    注意事項:日本語を話される場合、無料の言語支援をご利用いただけます。SelectHealth Advantage: 1-855-442-9900 (TTY: 711) / SelectHealth: 1-800-538-5038. まで、お電話にてご連絡ください。


    終了

    ATTENTION : si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Contactez SelectHealth Advantage au 1-855-442-9900 (TTY: 711) / SelectHealth: 1-800-538-5038.


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