What will the Affordable Care Act Mean To
My CompanyThe Health Insurance Exchange may allow
you to access guaranteed coverage plans providing additional choices regarding your health insurance
decisions. By potentially lowering your costs or finding information about Tax Credits that may be available.
Employers are not required to utilize the Health Insurance Exchange. It is an option that is made available
to individuals & businesses. This site can provide information to help you make an informed
decision. This Wisconsin Exchange site provided by Valley Benefits of Eau Claire can offer you valuable
information and links to important topics to consider. The Wisconsin Exchange site was developed to
promote consumerism and choice among companies considering the SHOP or the
What are employers doing
about health care reform?
The time has never been better to
seek out alternative solutions to controlling healthcare costs. With industry changes and rising costs, it’s
important to take the time to find out what insurance options are available. Among these
alternatives are self-funded plan designs with stop-loss insurance for groups of 5 or more
members. Until recently, self-funded plan designs with
stop-loss insurance were primarily attractive to larger groups. But because of recent innovations and
approaches, now smaller groups can take advantage of the savings these plans may offer.
Self-funded plan designs provide
employers with flexible plan alternatives that are similar to the traditional coverage that they may have today,
but can offer lower costs and the opportunity for a refund of their maximum liability funding at the end of the
contract period. Most of the small group self-funded plan designs being offered today are considered maximum funded
plans (pre-funded), meaning the employer is funding their maximum liability on a monthly basis. And, with stop-loss
insurance, employers are protected from the financial impact of big claims.
Another key consideration that
self-funded plans with stop-loss insurance provide is the transparency and opportunity to control costs through
claim data and utilization reporting. The information from these can provide useful insight in determining
cost-effective plan designs in subsequent contract periods.
A growing number of organizations
see such plans as low-cost alternatives to conventional coverage, given that they’re exempt from PPACA requirements
such as insurance taxes and specified benefits.
And if significant numbers of
small firms with healthy, young workers self-insure, this could have far-reaching implications including
potentially increasing health care premiums for companies that choose to remain in the regulated (fully insured)
The key to self-funding is the
stop-loss policy. While that type of coverage has been around for some time, PPACA contributed to an environment
where stop-loss insurers could offer the coverage to organizations with fewer and fewer
“Historically, there have never
really been stop-loss policies that were well-suited for a smaller market. The dynamics of the marketplace have
created opportunities for employers with 5 or more employees. There are a lot of employers that wanted to self-fund
but couldn’t do it because stop-loss policies were developed for employers with 50 or more employees. And now
they’re down to 5 employees.
today and have us quote your group health insurance in addition to helping you calculate
the fee’s and tax’s your “fully insured” plan may make you liable for. You may be surprise at what you find
out! Thank you for visiting the Wisconsin Exchange web site.
Valley Benefits can help you navigate these
changes and help you consider your options. Call Today (715) 598-4412.
This website is a privately owned health exchange and is not
endorsed, affiliated, or associated with any Federal, State or Local