MEDICAL SELF-INSURED PLAN HEALTH INSURANCE. FOR YOU. WHEREVER. WHENEVER.



Similar documents
As the costs associated. Captive Solutions for Medical Stop Loss: Take Your Self-Insurance Program to the Next Level by Allison Repke

MELTZER GROUP BENEFITS SELF-FUNDING MYTHS AND ADVANTAGES

Self-Insured Health Plans for Beginners. 2011, Coastal Management Services

WHEN YOU RE CONSIDERING SELF-FUNDING

Chapter 32a Medical Care Savings Account Act

Group Captive Insurance Programs for Property and Casualty Coverages

Partial Self Funding and Population Health Management. Facts, Concepts, and Strategies

Self Funding Terminology Cheat Sheet

Request for Comment #1 How common is the use of stop-loss insurance in connection with self-insured arrangements?

Employer stop loss is an insurance coverage offered to employers who self-fund their

Unhealthy Profits. The Three Ways Insurance Companies Make Money from Health Care. Observations and Recommendations

Private Insurance Fundamentals: Health Insurance Coverage, the Market, and Insurance Regulation. Bernadette Fernandez February 25, 2011

GUIDANCE NOTE COST OF DEATH AND DISABILITY BENEFITS - CERTIFICATES BY ACTUARIES UNDER SUB-SECTION 279(3) OF THE INCOME TAX ASSESSMENT ACT

ASO. BlueCross BlueShield of Oregon HOW AN ADMINISTRATIVE SERVICES ONLY (ASO) PLAN CAN WORK FOR YOU AN INTRODUCTION FOR GROUPS OF MT HOOD

Connecticut Health Insurance Exchange. June 2012 [SHOP BRIEFING] An overview of the Small Business Health Options Program (SHOP) Exchange

COMMERCIAL EXCESS LIABILITY COVERAGE FORM

GOLD LEVEL. PROPOSED LIST OF SERVICES AND PRICING AZNHA Members and Associate Members SERVICES

Self Funded Health Insurance To be or not to be?

1. How common is the use of stop loss in connection with self-insured arrangements?

Legislative Brief: 2015 COMPLIANCE CHECKLIST. Laurus Strategies

COMMERCIAL EXCESS LIABILITY POLICY DECLARATIONS

Affordable Care Act (ACA) Frequently Asked Questions

Stop Loss for Self-Funded Plans

State Employees' Group Health Self-Insurance Trust Fund

Health Reform Updates: Planning for 2013/2014 Compliance Discussion with Colorado AHU June 4, 2013

Health Care Reform /2017 Strategic Analysis

GUIDE TO THE TEXAS SCHOOL EMPLOYEES UNIFORM GROUP HEALTH COVERAGE ACT (HOUSE BILL 3343)

A Claims Adjuster s Guide to Excess Workers Compensation Insurance Presented by the Safety National Claims Department

GLOSSARY OF INSURANCE TERMINOLOGY

Minnesota Comprehensive Health Association (MCHA) - Frequently Asked Questions & Answers about Eligibility/Application

ZaneHRA Frequently Asked Questions

Protected Self Insurance Program of the Diocese of Rockville Centre

Table of Contents ARCHIVE

TO INSURE OR SELF INSURE THAT IS THE QUESTION CONSIDERATIONS

Health Care Reform Implications for Employers with Seasonal Employees

956 CMR: COMMONWEALTH HEALTH INSURANCE CONNECTOR AUTHORITY 956 CMR 5.00: MINIMUM CREDITABLE COVERAGE

1. This Reporting Standard is made under section 13 of the Financial Sector (Collection of Data) Act 2001.

City of Houston Long-Range Financial Management Task Force Healthcare Benefits Questions

Time to Take Another Look at Stop-Loss Insurance

Protect your ministry with GuideStone s self-funded health plans

The Basics of Self Funding

RULES OF TENNESSEE DEPARTMENT OF COMMERCE AND INSURANCE INSURANCE DIVISION

FICA WITHHOLDING & TAXATION OF DISABILITY BENEFITS. Information for Policyholders

North Carolina Department of Insurance

Wyoming Health Insurance Market Study Preliminary Results

FORC QUARTERLY JOURNAL OF INSURANCE LAW AND REGULATION

The Rent-A-Captive Alternative

PUBLIC UTILITIES BOARD AUTOMOBILE INSURANCE REVIEW BACKGROUNDER

RentersPLUS Move In Special

Medical Stop-Loss 101

DEPARTMENT OF LABOR AND EMPLOYMENT. Division of Workers Compensation 7 CCR

User Guide. COBRA Employer Manual

Side-by-Side Comparison of the Senate and House Mental Health Parity Bills Updated September 14, 2007

PRIVATE HEALTH SERVICES PLANS

Q&A from Assurex Global Webinar. Employer ACA Reporting Requirements. Q: Where will these forms come from? will the IRS provide them?

Understanding Your. Dental Benefits

Mayor and City Council IV. E.

Cynthia G. Tudor, Ph.D., Director, Medicare Drug Benefit and C & D Data Group Cheri Rice, Director, Medicare Plan Payment Group

assureflex health spending account the evolution of health and dental care benefits

STAFF REPORT ACTION REQUIRED

Transcription:

MEDICAL SELF-INSURED PLAN HEALTH INSURANCE. FOR YOU. WHEREVER. WHENEVER.

MEDICAL SELF-INSURED PLAN THE ALTERNATIVE TO FULLY-INSURED SOLUTIONS A self insured plan may represent an effective long-term strategy to save money from insurance expenditures depending on your company s activities abroad, but also on external factors such as insurance regulations. Our Medical Self-Insured Plan - or Administrative Services Only (ASO) - is a specific plan in which your company elects to support the risk related to your employees health and thus pay for actual claims incurred. As your partner, MSH INTERNATIONAL handles claims administration and other elements including actuarial services, underwriting and benefits description, included within a flat, monthly administration fee. Many companies see ASO programs as a cost containment measure, avoiding or reducing the retention costs that are associated with a fully insured program, which include premiums, commissions, taxes, etc. The overall cost of your self funded plan (claims paid plus administration fees) result in possible business deductible expenses. An ASO plan also gives you total flexibility in plan design, much more than a fully insured plan. 1

SELF-INSURED PLAN POTENTIAL SAVINGS FOR YOUR COMPANY FULLY INSURED SELF INSURED Premium Taxes Profit Reserve SAVINGS Total annual non-refundable premium * Risk Charges Pooling Charges Province/ State Compliance Federal Compliance Administration fees Stop Loss program Federal compliance Administration fees Total annual premium Claims Claims * Excess funds remain with Insurance Carrier as profits MSH Self-Insured plan does not have to comply with state regulations and all mandates while being fully compliant with ERISA, COBRA and HIPAA. 2

b HOW TO FUND YOUR ASO PLAN? To provide coverage on an ASO basis, you must be prepared to assume the total potential risk of the benefit, even if the likelihood of this occurring is slim. To do this, you would need to calculate the maximum risk involved and determine whether your company is able to assume this risk. At MSH INTERNATIONAL, we use our expertise in Self-Insured plans to help you estimate this maximum claim liability. Comprehensive reporting of the Self-Insured fund will be provided on a quarterly basis, detailing funds received and total claims paid per month. 3

SELF-INSURED PLAN RESERVE FUNDS To ensure our ability to process medical claims without delay, it is recommended that reserve funds are submitted to MSH INTERNATIONAL for claims reimbursement. The following options are available: Floats: A deposit sum is calculated based on claim projections and historical data. Additional lump sum payments would be made when the account reaches a set threshold amount. Budgeted Deposits: A monthly deposit is charged per member. The collected deposits are then allocated into the self-insured account and used to pay claims. This ensures a consistent flow of funds into the account. Any company can choose a self funded solution, whether it is a small business or a mutinational company, provided that it has the financial ability to accept a certain amount of risk. 4

STOP LOSS PROGRAM b A Stop Loss coverage, as an additional plan within a Self- Insured program, protects you from catastrophic expenses resulting from large and/or unexpected claims. As it reduces the risk associated to self funding, even the small and medium size companies can benefit from this program and limit their employee benefits expenses. Without this coverage, your Self-Insured program could cost you more than a fully insured program, in a worst case scenario. Thus, a Stop Loss policy protects you from important losses by setting a ceiling on the maximum amount your company would be liable for. Thresholds are available in two formats: A Specific Stop Loss (also called Individual) threshold will be implemented on a per certificate level. Therefore, you would be responsible for a specified amount of claims per family per year. This protects you against catastrophic claims. An Aggregate Stop Loss threshold will be implemented on a policy basis. Therefore, you would be responsible for a maximum percentage of the overall expected claims that we determine with you. This protects you against numerous claims. 5

SELF-INSURED PLAN MSH INTERNATIONAL offers both ASO claims administration and Stop Loss insurance. Having a single entity to administer the ASO program and manage the Stop Loss Insurance is a significant advantage for you as it makes your plan more consistent and flexible. 6

MSH INTERNATIONAL AMERICAS Regional Head Office Calgary Suite 300, 999-8th Street S.W. Calgary, Alberta T2R 1N7 CANADA Phone: 1 (403) 232-8545 CONTACT OUR SALES & DISTRIBUTION REPRESENTATIVES sales@americas.msh-intl.com Toll free: 1 (800) 672-6089 Fax: 1 (403) 265-9425 USA Phone: (832) 792-5912 Toll free: 1 (866) 423-5455 Visit us online at: www.msh-intl.com/americas