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Published byEileen Singleton Modified over 9 years ago
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How Self-funding Works
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Fully Insured 100% Non-refundable Premium Partial Self-funding Administration Stop Loss Premiums Potential Claims (Opportunity to Save)
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Claims treated as expenses Potential for savings Most premium taxes avoided Avoid certain coverage levels We manage self-funding Specific stop loss Aggregate stop loss
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Stop Loss limits your liability Specific stop loss limit = $40,000 Individual catastrophic claims = $50,000 Amount paid by insurer = $10,000
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Stop Loss limits your liability $400,000 x 125% = $500,000 $500,000 = Attachment Point
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Maximum funding recommended Maximum Cost = Total of all premiums paid Fully Insured 100% Non-refundable Premium
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Maximum funding recommended Partial Self-funding Administration Stop Loss Premiums Potential Claims (Opportunity to Save) Administrative Expenses Stop Loss Premiums Maximum Claims
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Example 100% Non-refundable Premium = $450,000 Administration = $20,000 Stop Loss Premiums = $130,000 Actual Aggregate Claims = $170,000 Actual Savings = $130,000 Covered Employees: 65 Annual Premiums: $450,000 Monthly Payment: $37,500 Claim Payments: $170,000 Annual Premiums: $450,000 Claim Payments: -$170,000 Carrier Profit: $280,000 Claim Reserve: $60,000
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Example 100% Non-refundable Premium = $450,000 Administration = $20,000 Stop Loss Premiums = $130,000 Actual Aggregate Claims = $170,000 Actual Savings = $130,000 $ 20,000 + $130,000 $150,000 $12,500 per month Claims paid: $170,000 Savings: $130,000
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In Summary Funds belong to your company Flexible plan design Compare at no cost or obligation Accurate claim settlement Greater financial control Access plan information 24/7 Decision making Monthly management reports Plan for the future Adapt to change Meet employee needs
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