Employer, Self-Funded member profile...
"As an employer, I feel my business is ready to offer our own health insurance plans to employees. I need a reputable company to help with the paperwork and to make sure that we comply with all regulatory requirements."

Employer Self-Funded Plan (Administrative Services Only)

Self-funded plans are health plans developed and managed by your company. Preferred Care offers administrative services to support your company's plan.

Under the self-insured arrangement, the employer chooses to retain the risk associated with its employee benefit plan claim liability rather than pass it on to an insurance company or Health Management Organization (HMO). Both the employer and employees may make monetary contributions to fund the plan, as with a traditional health insurance program. However, without "stop loss" insurance, the employer's liability for all claim and administrative expenses is no longer capped, as with traditional insurance.

In addition, except for administrative expenses, the monthly cash flow (i.e., claim cost) associated with the funding of the employee benefit program is not as predictable as traditional insurance.

Preferred Administrative Services

Preferred Care offers several levels of administrative services through its wholly owned subsidiary Preferred Administrative Services (PAS). Administrative fees will vary based on the level of purchased services.

Eligibility

In order to provide economies of scale on administrative fees, a reasonable spread of risk on claim cost, and ensure that the employer is positioned to take on the responsibility of self-insuring, PAS typically requires that a self-insured employee benefit plan meets the following criteria:

• Employer has minimum of 500 eligible employees
• Contractual arrangement with PAS is on an exclusive basis
• Contract period is multi-year
• Employer is financially sound

For more information about Self-Funded plans, please contact a Preferred Care sales representative.

Disclaimer:
This summary of benefits is only an overview of plan provisions. While every effort has been made to ensure that this summary accurately reflects the provisions of each plan, it is the plan contract that governs the operations of individual plans and payment of all benefits. Please check with your company's plan administrator for a more detailed plan description.

Last updated: December 20, 2006