Focus Benefits Flash

Words of Wisdom: Self-funded Insurance

“It seems like there is another company entering the self-funded arena every week; companies that a few years ago wouldn’t even quote a group because it was too small or, it wasn’t “credible.” Now in order to maintain or to attain market share, they want you to sell level funded, self-funded plans down to 25 or maybe even 10 lives. It’s funny how these groups all of a sudden became credible. Probably something to do with $$$$.
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Is there a difference between being Skinny and Valuable?

When the ACA came out they designated four plans called “metal plans” as acceptable standards for insurance coverage. They were called metal plans because they were named Bronze, Silver, Gold and Platinum. Each plan provided more coverage as the metal value increased. Then the chaos began. Employers (and everybody else) found that these plans were really expensive. Clearly “Affordable” was only in some parallel universe based on a different income system. Some very bright insurance people, attorneys and CPAS found that if you read the ACA law carefully you could offer a medical insurance plan that did not include all that expensive coverage and still be in compliance.
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Skinny Plans and Minimum Value coverage

As the Affordable Care Act rolled out, employers began trying to avoid compliance in any way they could find. My advice has been to plan for implementation and do it right because it is coming and will not go away. Continue reading