•Self
Funded Medical •Self Funded Dental •Self
Funded Vision
•Loss Self Funded Short Term
Disability •Stop Loss •Reinsurance
•Pharmaceutical Benefits Management •Section
125 Administration
•Section
132 Transportation Administration
•COBRA & HIPAA
Administration
Third
Party Administration Services Can Save 25% and More
What is Self-Funding? As
the name implies, self-funding is where an employer assumes
the responsibility for paying employee health care claims. Studies
have shown that self-funding can save Employers 25% and more.
Self-funded plans can be tailored to meet the individual
Employer's specific needs in enabling Employers to add or
reduce benefits where it is believed to be necessary. UGP
specializes in providing Employers with very successful alternatives
to control the increasingly high cost of providing health
care benefits to their Employees.
Reinsurance – Stop
Loss – Medical Stop Loss: United
Group Programs has 36 years of experience placing,
writing, and negotiating Reinsurance Stop Loss Insurance
plans for employers with 20 to 10,000 employees. UGP
works with brokers and clients to strategically place
Reinsurance with the most quality A-rated carriers
with the most competitive rates. In writing
directly with the major reinsurance carriers, all excess
costs are cut. Moreover, since all reinsurance
carriers are different, placing your stop loss with
the right reinsurance carrier is critical to the success
of your self-funded plan.
UGP
will work with the client to determine and negotiate the
proper Specific and Aggregate Insurance Contract that is
a fit for the client. Our relationships with the reinsurance
carriers and devoted attention to Employers’ individualized
needs results in your group receiving the proper rating based
upon demographics, location, industry, plan design and claims
experience.
Why
Self-Funding is Right for Many Employers: The
first thing to bear in mind regarding self-insurance
is that it is a concept, not a product. It’s
a long-term decision having to do with financing employee
health care benefits. The second thing is that, for
many employer's, it is a concept that has helped them
save thousands of dollars in health insurance premiums.
Insurance
companies are looking for a profit: Insurance
companies, offering fully-insured programs, try to
price their products in such a way that, in the long
run, will assure the high probability that they will
earn a profit. Therefore, the premiums
paid by most employers to insurance companies for group
health insurance far exceeds the actual claims and
administrative costs generated by their plan. At best,
employers are really just "trading dollars" with
the insurance company and, in fact, are already "paying
for their own claims." The most efficient means
of providing these benefits, therefore, is through
self-insurance.
Claims
are claims but service makes the difference: All
things being equal, the dollar amount of a claim under
a policy of insurance will be the same as the one presented
to an employer with a self-insured plan. If the plan
of benefits is identical, there should be little or
no difference in the expected claim level, regardless
of the method used. In fact, the experiences
of most plans show that employees are more reluctant
to file claims against their employers. Therefore,
the self-insured plan utilization, is normally less
than conventionally insured vehicles.
Reduced
administrative expenses: Risks
assumed can be reduced or eliminated through the purchase
of appropriate stop-loss insurance. Naturally, if claims
costs are favorable, the savings can be significant
and better yet, the savings are yours. Even if the
ultimate dollar amount of claims is the same under
a fully insured or self-insured plan, the advantage
of self-insurance, lies in the reduced administrative
expenses charged for services and the "use of
money" not paid in advance for premiums. For
example: State premium taxes are eliminated (2 to 4%).
Overhead and profit charges by the insurance company
are reduced or eliminated (8 to 18%). Contributions
to the insurance company's contingency reserves are
eliminated (1-3%).
Why
UGP is the right TPA for Employers: United
Group Programs, Inc. as your Third Party Administrator
(TPA), can provide excellent administration services
for less than insurance companies would charge. It
is our unlimited devotion to customer service that
distinguishes us from insurance companies and other
TPAs. If no one is available to answer an incoming
call, the call will be returned promptly.
Additional
benefits of Self-Funded Insurance: Self-Insurance
has some important "sub-benefits": Tailored
claims systems provide greater claims control. The
addition of second opinion clauses, managed care, subrogation,
discounts from hospitals for timely payment and aggressive
coordination of benefits allows for tremendous flexibility
in plan and benefit design. Perhaps the most
valuable benefit to self-insured plans is that they
enjoy qualified exemptions to state mandated insurance
requirements under ERISA. United Group Programs
specializes in designing the most efficient and cost-effective
plans for each Employer.
For Sales or Marketing questions please call
Marc A. Edelheit
at (800) 482-8770 x 215 or email at marce@ugpinc.com
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