Group Insurance Programs
A majority of Americans participate in employer-sponsored group insurance plans. These plans usually feature multiple options for major medical insurance coverage, and many include life, dental, vision-care and disability insurance. Most plans sponsored by small and mid-sized employers are fully insured, meaning that the insurance company assumes all of the risk of loss in exchange for a stipulated premium. Increasingly, however, large and small employers are considering risk-sharing arrangements in exchange for smaller premium or funding requirements. TriCore can help you decide which option is best for your organization.
Fully Insured Plans
Small Group Plans: If your organization is considered a small group by your state, you will probably find that all insurance companies offer similar plans with similar premium structures, in which case your selection of a carrier may be based more on claims paying history or provider networks than on comparative benefits and costs. We can help you make the best choice, considering your employees’ demographics and claims history. If you are eligible to participate in the SHOP Marketplace, we can help you analyze and understand the plans available in your state(s).
Large Group Plans: If your organization qualifies as a large group in your state, there are almost limitless plan designs and costs available in a competitive marketplace. Using your claims history, employee census and coverage requirements, we will submit requests for proposals to all of the principal providers in your state(s). Then we will consolidate the proposals in a single spreadsheet for ease of comparison. And that’s just the beginning. Every year thereafter we will repeat the process well-before the open enrollment period, to ensure that you are always getting the best value currently available.
Whether you fall into the small group or large group category, there are options that will enable you to exercise some control over the cost of your group major medical plan. If your group presents a better-than-average medical risk profile, you may realize substantial savings through a self-insured or partially-self-insured plan. TriCore has developed relationships with leading actuaries and third party administrators who can advise you on the feasibility of any type of risk sharing plan for your group.
For more information on Group Insurance Plans, or to obtain a proposal:Contact Us