Consumer-directed Plans and Self-funding

Ooh, I like this topic as I believe in them both as long as the liabilities are fenced appropriately with specific stop-loss (think of that as a CAP on a specific employee or family's claims) and aggregate stop-loss (CAP on your entire company's spend)....and doing this with a health reimbursement arrangement owned by the company or employer. This is Shangri La for a guy like me but here is the catch, it requires experts like us guiding, coaching and analyzing for our clients as this is pretty complex stuff that requires expertize. And if done correctly can really be a better way than just giving health insurance carriers the premium dollars to make the margin (PROFIT) they want on your case. I liken this to a fully insured company of say 400 employees that DOES NOT self-fund but wants the power of a health reimbursement arrangement (it is the tool that can pay deductibles for employees and be written off as a business expense as well)...well here is the catch, the greedy underwriters at insurance companies will push for a certain amount of premium regardless of the plan design selected (with pricing matrices they will push the plan they want as they MUST get the premium they want regardless....they know they will have X in claims, then administrative costs, plus profit...so they corner clients).

So it is more of a challenge to fit an HRA in to a fully insured case where carriers have claims data they use "against" you, as well as manual rates (your age, gender, marital status, home zip code) that they blend....so they have 2 "shells" they use on the table and benefit from whichever one they want to use against you to fit you in to their profit box.

This topic I could go on and on, but in general if you shop with a competent broker like Health Insurance Geeks and Nexus, and drive their commissions (when was the last time you reviewed what your broker charge, versus what they delivered in PRICE?...forget all the B.S. services they say they provide, I am talking about premium coming DOWN rather than your broker selling you on the INCREASE!)....

Shady, greedy, self-serving brokers make us crazy here....we work our tails off for our clients on less commissions as we are not reporting to shareholders or dummy boards, hmm-hmm ooops let's call them unnecessary executives in the game of price....

I feel companies who are less than let's say 1,000 employees, should ALWAYS be with a boutique, otherwise they are paying for nonsense.

visit www.healthinsurancegeeks.com or www.nexusbenefits.com for more of our ideas.