Quick Compare Plans
|Fully insured insurance
Level-funded + risk protection insurance
Stop-loss for self-funded insurance
|Monthly premium||Yes||Yes||Yes, small||Yes|
|Who covers basic health care costs?||Insurance carrier||Insurance carrier||Your firm||Depends on plan purchased: dental, vision, life, disability, accident, critical illness or cancer insurance|
|Who covers catastrophic costs?||Insurance carrier||Insurance carrier||Insurance carrier||Depends on plan purchased: dental, vision, life, disability, accident, critical illness or cancer insurance|
|Who keeps any unused funds?||Insurance carrier||Your firm shares with insurance carrier||Your firm||Insurance carrier|
How Each Plan Works
This is a traditional insurance plan: you pay a premium to an insurance carrier, who takes on the risk covering even catastrophic health care costs. It’s the most common type of insurance plan. Ours is provided through UnitedHealthcare.
Level funding is an alternate funding model that allows smaller firms to enjoy the benefits of self-funding without the risk.
You’ll pay an affordable premium to Meritain Health, our third-party administrator (TPA), including a small fee to manage claims.
When it’s time for your renewal, if your employees have had fewer health care costs than expected, you’ll get 50% of the remaining funds back.
If your employees’ health care costs are higher than expected, you’re still covered by the Trust and Meritain Health.
This is for firms who self-fund their insurance – meaning they keep funds in a special account to cover their employees’ health care costs and pay a small fee to a TPA to handle claims. One huge benefit of this model is that if your health care costs are below what you expected at the end of the year, you get to keep those funds.
On the other hand, self-funded firms may have unexpected health care costs their accounts can’t cover. To protect themselves and their employees, these firms purchase “stop-loss” insurance like the Advantage Plan.
Stop-loss will require a smaller premium than a fully insured plan, and it only kicks in when there are catastrophic costs.
The Trust will partner with your existing TPA to offer the Advantage Plan.
This includes additional insurance types you may want to include in your benefits package or make available to your employees to purchase for themselves – such as dental, vision, life, disability, accident, critical illness and cancer insurance.