Self-insured for Small Business
A self-insured group health plan is one in which the employer assumes the financial risk for providing health care benefits to its
employees. Thru monthly premiums to an insurance carrier a "claims bucket" is created to pay for future employee medical claims. Insurance is purchased in the event claims exceed the
funded "claims bucket". If funds are not depleted during the year, then the employer has an opportunity for a "return of premium", which can really help control costs.
There are many benefits to a self-insured or level-funded plan also known as reference based pricing models. These plans have no networks so employees have the freedom of choice with any doctor or hosptial. Plan benfefits are flextible and can be customized to your liking or budget. Furthermore, employers can expect predictable monthly premiums.
Get your self-insured plan options for your small business.
Products in our portfolio include
-Traditional Level Funded Plans: often 20-50%+ savings vs. fully insured option
-Advantage Plans: Access to National Networks with In Network Benefits only – 5-7% savings vs. traditional
-Core Value Plans: Reference Based Pricing. Our most aggressive option in the market (no strict network!) – often 20% savings vs. our traditional level funded options
-Dental is now available as an add-on to any medical plan with 3+ enrolled
What is Aetna Funding Advantage? Aetna Funding Advantage is Aetna’s fastest growing small business product. It
offers a suite of 54 health benefit plan options, robust health and wellness programs, digital benefits administration and both broad and enhanced local network options. Aetna Funding Advantage is a
self-funded product built specifically for small businesses. It has one stable monthly payment, the opportunity to get money back when claims are lower than expected and the protection of stop-loss
insurance when claims are higher than expected.
How can an organization get an Aetna Funding Advantage quote? Organizations can either work with their current broker or
visit discoveraetna.com/afa to request a quote. In order to
have the discount applied to the quote, please enter ABN’s discount code: E222 in the Affinity Organization section of the quote form. You and your broker can also work with the local Aetna
representative to learn more about Aetna Funding Advantage and Tennessee Chambers Health: Luke Orren, Aetna, (865) 438-0111.
What discount does Tennessee Chambers Health offer on Aetna Funding Advantage? On average, member organizations save
$144 per enrolled employee annually through the exclusive Tennessee Chambers Health discount. For a small business with 15 employees, that’s $2,160 off the annual cost of Aetna Funding Advantage. The
discount is subtracted from the administrative fee portion of the monthly invoice. Note, if the administrative fee is not large enough to cover the full discount, the discount will be the amount of
what the administrative fee allows.
Who is eligible for the discount? Any organization that is an active member of the Alliance for Better Nonprofits is
eligible for the discount on Aetna Funding Advantage. Please note that Aetna Funding Advantage is available to organizations with 2 enrolled to 100 eligible employees.
Does Aetna Funding Advantage have participation & contribution minimums? Yes. Employers must contribute 50% to the total cost of coverage of the lowest cost plan option or 50% of employee only contributions for the cost of coverage of the lowest cost plan option. Depending on the number of eligible employees your organizations has, Aetna requires a certain number of those employees to enroll in an Aetna Funding Advantage plan. Once you have 10 eligible employees, a minimum of 50% of eligible employees (rounding down) must enroll in the plan.
Christopher S. Kudryk
KBenefits provides insurance solutions for small business owners and individuals in NJ & NY. Contact KBenefits today and see how we can benefit you.
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