Allied™ Funding Advantage How Alternative Funding Works Why Funding Advantage? Do your group health clients want to receive a refund for being healthy? YES! Alternative Funding is the answer! Fully Insured or Self Insured? Fully Insured Risk Bearer is the Insurance Company Premium covers all risks and costs Self Insured Risk Bearer is the Employer Claims are paid from Employer funds Employer pays for claims administration Alternative Funding Also called Partial Self-Funding Employer is still the risk bearer Employer purchases Stop Loss Insurance to protect against high claims Stop Loss Insurance Employer’s risk minimized Specific Stop Loss Claims paid by carrier when an individual’s claims exceed a set dollar amount Aggregate Stop Loss Claims paid by carrier when the group’s total claims exceed a set dollar amount Why Consider Self Funding Sales? 55% of all companies are fully or partially self funded Only 13% of employers with 200 or less employees are self or partially funded Staying Power Employers that self fund remain doing so on average of 3 to 5 years Opportunity Market is untapped for small group employers Savings Chance for employers to save and take control of their health plan What is Allied Funding Advantage? An alternative funding plan for groups of 10 to 99 Limits employer risk from self-funding Allows employer to save significant dollars Monthly costs may be less than fully-insured premiums Potential for refunds at end of plan year The only risk is not getting a refund at the end of the year! How Does it Work? Monthly Costs Employer makes monthly contributions for each of these three items: Funding Advantage Monthly Costs Admin & Sales Allied claims paying and reporting expenses Agent & General Agent Sales Compensation Stop Loss Insurance Covers both Specific and Aggregate Coverage Costs vary with plan benefits selected Funding Advantage has set levels for Specific & Aggregate to keep sales process simple Funding Advantage Monthly Costs Claim Fund – Employer’s Money Employer contributions used to fund expected claim costs MAX funded plan Employers’ MAXIMUM claim costs for the year Monthly contributions are 1/12 of this annual cost each month MAX funded - Employer will NEVER be charged more than this for claims Claims Fund money left over is the employers! Funding Advantage Monthly Costs Claim Fund Questions Accommodation When claims exceed money in claim fund – Insurer loans employer money Reporting Detailed monthly reporting showing claim fund activity Plan Year and Claims Run Out Plan year is 12 months Claims incurred during plan year are payable for 9 months past end of plan year At end of the 9-month run-out – all remaining claims funds belong to employer! No hidden terminal liability costs ERISA Plan ERISA plan is the plan of benefits for the employee Funding Advantage Options Premium Advantage Plans Traditional PPO HSA Qualified Plans Indemnity Freedom Plans No networks – no penalties True freedom of provider choice No balance billing Allied Funding Advantage Advantages for Employer Limits the risk of self funding Lowers monthly costs Healthy groups can receive LARGE refunds Won’t be subject to the ObamaCare “rate shocks” that will happen in 2014 Allied Funding Advantage Advantages For Agents Available for small groups 10 to 99 Not subject to MLR regulations No restrictions on Compensation! Compensation paid on full monthly costs. Take advantage of group trend toward self-funding with a simple, flexible plan GET YOUR ADVANTAGE TODAY! Phone: (888) 767-7133 Fax: (913) 945-4396 Quote E-mail: [email protected] Web site: www.alliednational.com The RIGHT Benefits. The RIGHT Price.