Group Health Insurance Types

Fully Insured

A fully-insured health plan involves an employer or association purchasing health insurance from a commercial insurer. This coverage is extended to employees or members. Premiums are paid by the employer to the insurer, who assumes the financial risk for coverage and administration. In case of medical claims, the insurer handles payments. State regulations apply to fully-insured plans.

Level Funding

Level funding is a form of self-funding where all plan components are combined into a monthly premium paid by the employer. It resembles fully-insured plans, but any surplus claims at year-end can be returned to the employer. This option offers security and potential savings.

Small Business Health Options Program (SHOP)

SHOP helps businesses provide health coverage. It's for employers with 1-50 full-time employees. It offers flexible coverage options and tax credits for qualifying businesses.

ICHRA - Individual Coverage Health Reimbursement Arrangement

ICHRA lets employers reimburse employees for health insurance premiums and medical expenses. It provides flexibility, portability, and cost control in a changing healthcare landscape.

ICHRA - Individual Coverage Health Reimbursement Arrangement

Individual Coverage Health Reimbursement Arrangement (ICHRA) is a type of health insurance arrangement designed to assist people in paying their medical expenses. Employers often help employees to acquire insurance policies that cover these expenses and cover healthcare costs through this method.

Small Business Health Options Program (SHOP)

The Small Business Health Options Program, more commonly referred to by its acronym SHOP, is a government initiative in the US designed to aid small businesses provide health insurance for their employees at an affordable cost. Simply put, SHOP insurance gives small business owners an affordable way to offer coverage options to their workers. Let’s look at how it works:

Level Funding

Level funding combines elements of self-funding and traditional health insurance to form one comprehensive solution. To better comprehend it, let’s unpack its key concepts:

Fully Insured

Fully Insured Insurance (FII) is an agreement between an individual or entity (the policyholder) and an insurance company to provide financial coverage in case of certain events or risks outlined in a policy, such as medical costs associated with illness or accidents, damage to property (like your house or car) or accidental injury claims from others. Premiums paid each month promise this financial protection should anything come up, such as illness or accidents which require medical care coverage, damage caused to either property ( like your house or car), or liability coverage should you accidentally cause harm.

Full coverage insurance comes in many shapes and forms, each tailored specifically to a customer’s needs. Here are some popular forms:

Employee Benefits

Group Life Insurance
Group life insurance, often part of employment benefits, offers coverage for workers through employers or associations. It’s affordable and can cover various costs, although coverage may be limited.
Group Dental Insurance
Employer-sponsored dental insurance helps cover dental care costs, encouraging preventive care and making dental services more affordable.
Vision Insurance
Vision insurance covers eye care expenses, from regular checkups to eyewear and procedures. It promotes healthy eyesight and can save on costs.
Voluntary Benefits
Voluntary benefits are additional options employees can choose beyond standard offerings. They offer flexibility, gap coverage, and affordability, attracting and retaining top talent.
Group Disability Insurance
Group disability insurance replaces income if an employee can’t work due to illness or injury. It comes in short-term and long-term coverage, ensuring financial stability.
Group Accident Insurance
Group accident insurance covers medical expenses and financial losses from accidental injuries. It’s offered as an employee benefit and provides added protection.
Group Critical Illness Insurance

Group critical illness insurance provides a lump-sum benefit to help with unexpected life events, covering costs like childcare and medical expenses.

Health Savings Account (HSA)
HSAs are savings accounts for medical expenses, paired with high-deductible health plans. They offer tax advantages and control over healthcare spending.
Flexible Spending Account (FSA)
FSAs allow employees to set aside pre-tax income for qualified medical expenses. They offer tax savings, cost reductions, and convenience.
Health Reimbursement Account
HRAs are employer-funded plans reimbursing employees for medical expenses. They offer tax deductions, convenience, and cost control.
401(k) Retirement Plan
401(k) plans help employees save for retirement with tax advantages. They include traditional and Roth options, with employer matches and investment choices.

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