United Group Programs offers a host of fully insured Preferred Provider Programs, Point of Service and Health Maintenance Organization options. Many of these programs may be adapted to different regions and areas of the country. UGP also offers a host of Short and Long Term Disability options, along with many lines of coverage including Life Insurance, such as Term Life, Whole Life, and Optional Life.

Dental Plans

UGP provides a single source solution for your dental insurance needs. We offer a nationwide network of fully insured and self-funded options to make your dental plan a success.

Self-Funded Health Plans, Dental, & Short Term Disability Plans

Self-Funding is a successful alternative for Employers to control rising health care costs. While flexibility in making key decisions on benefits, administration and funding, are attractive to most Employers, limiting liability can be problematic. Partial Self-Funding / Self-Insurance with Stop Loss Coverage is an attractive alternative for cost conscious Employers in choosing an Employee benefits plan.  

The goal of every insurance company in a fully insured program is to maximize the profit center which can reach up to 60%. Under a fully insured plan, the Employer pays a fixed premium regardless of the amount of claims paid by the insurance carrier. Annual rates are often increased based upon the industry standard, otherwise known as “trend”, and not based upon the Employer’s claims experience.

In a self-funded or partially self-funded program, everything provided in a conventional fully insured program is duplicated. All services provided by the insurance company in a fully insured plan are provided in the self-funded or partially self-funded program. The only difference is that the Employer retains the funds used to pay benefit claims.

How Does Self-Funding Work?
The Employer purchases reinsurance for protection, uses an administrator to administer the program, and pays a fraction of the conventional premium for these services. The remainder of the conventional funds (claim funds) is held by the Employer who then invests them, segregates them if desired, or uses them for general business purposes until they are needed for the funding of claims. When claims do not materialize, the Employer keeps the balance of the unused claim funds, hence making a profit. In this way, the payment of claims is directly correlated to the premiums paid and the Employer keeps the profit instead of the insurance carrier.

Advantages of Self-Funding

Flexibility in Benefits
The advantages of self-funding are numerous.
Most importantly, the Employer is able to develop the flexibility it desires in making key decisions on benefits, administration and funding. Control as to what will be covered and what will not, allows the Employer to exclude or limit certain vaccinations, drugs, and behavioral diseases such as obesity or alcoholism, or infertility. The key is the employer has the ability to tailor the plan to meet the specific needs and budget of the Employer.

Flexibility in Carriers
Another major advantage to self-funding is the flexibility in choosing a reinsurance carrier. Unlike fully insured plans, a shift from one carrier to another does not affect the network of providers, impose waiting periods, or require the issuance of new I.D. Cards and booklets.

Multiple Locations
In addition, for Employers with multiple locations, the same plan may be offered to everyone in every location with no administrative difficulty. By self-funding, an employer can utilize one national network or multiple local PPO networks with the same benefit plans.

Executive Class Plans
Self-funding provides the unique ability to class out the executives to provide 100% of all of their benefits where named executives and their families pay no co-pays, deductibles or coinsurance. Employers therefore can afford to provide ultimate benefit protection for executive personnel at a much lower cost. This is important in creating longevity for key employees in a competitive job market. This device may be used to attract and retain certain important employees.

The bottom line is that self-funding save money. In a good claims year, the best scenario would be that profit formerly enjoyed by the insurance carrier under a fully insured plan now is enjoyed by the employer who can choose to do what they wish to do with the surplus. But even in a bad claims year, maximum liability is in place to protect the employer. Even in a bad claim year, there is not a deficit carryover.