Group Health

MarketScout has specific carriers that offer Group Medical on a Fully Insured and Partially Self Insured basis. With the Healthcare Reform Act we are positioned to offer competitive coverage with various funding means. We know that employers are looking for a way to lower or stabilize their group medical coverage and cost. We strongly believe that employers will be increasing deductibles and out of pocket expenses for their employees. As a result, we are very experienced with designing a comprehensive group medical plan and replacing the employee's increased out of pocket exposure via a GAP plan. Our GAP plan coverage can be offered on an employer contribution basis or a voluntary basis. We'll design your plan where our GAP product is first dollar coverage for the employee which in essence improves an employee's coverage. We have several partially self insured plans that offer maximum funding to the employer. With this, the employer's maximum cost is capped and with good experience a refund of the premium can occur. Our Group partially self insured plans allow the employer to know their maximum liability and be rewarded a return of premium for good claims experience. Regardless of the Employer's appetite for risk assumption, we have the carriers, plan designs and knowledge to offer a unique and competitive comprehensive Group Medical plan to all employees

MARKET OVERVIEW

Coverage Parameters

Healthcare Reform dictates the limits of liability; most products are unlimited.

Insurer(s)

Various fully insured and self insured reinsurers depending on the geographic location and size of the group.

Commission Schedule

Generous commissions based on geographic location and size of the group. We can include a specific requested commission percentage for partial self insured opportunities.

Application Requirements

Not applicable.

Applications
No applications available.

FAQs

1How can a Partially Self Insured plan help an employer?
We build a plan where the monthly rate per employee classification is the maximum amount per employee. As long as the insured continues to pay these rates for the 12 month policy, they have funded their maximum liability for the plan. If claims experience is less than the claim fund, this surplus is return to the insured or carried forward to the new policy period.
2Besides the ability to receive a premium refund for good claims experience, what other features does a Partially Self Insured plan offer?
There are many advantages of a Partially Self Insured program. One of the key factors is the ability to obtain "claims information" which is not always available under a fully insured plan (state specific). When the Employer has access to claims information, this allows for better design of future plans to be offered as you know where your claims are occurring.
3If an Employer wants to remain fully insured can MarketScout help?
Yes. We can create many different plan options that will illustrate a reduction in cost and improvement in benefits with the integration of our GAP plan. We'll provide first dollar benefits for the employee thus when a claim is eligible for reimbursement, our GAP plan pays the employee for out of pocket expenses and these amounts still apply towards the Group medical deductible which is an added benefit for the employee.