Insured Plans – Insurance Company Takes 100% of the Risk
5 to 9 Employees:
- 16 – 28 month rate guaranteed on all lines of benefits including Extended Health and Dental
- Cap increases on the Extended Health Care & Dental on the 1st and 2nd renewal
- Provider’s rate stability
10 + Employees:
- No pre-existing conditions on Long-Term Disability benefit
- 16 – 28 month rate guaranteed on all lines of benefits including Extended Health & Dental
- Cap increases on the 1st and 2nd renewal
- Provider’s rate stability
Employers (with 2 plus employees) can offer a complete Group Employee Benefit Plan which can include Extended Health, Dental, Life Insurance, Accidental Death, Long-Term Disability, Short- Term Disability, Critical Illness, Employee Assistance Plan, Best Doctors/Second Opinion and Virtual Doctors as an effective way to attract and retain high-value employees.
With a fully insured plan, the employer has the stability of fixed premiums, varying with the chosen insurance provider, from 16 to 28 months on the initial guaranteed premiums rate for the pool benefits and 16 to 28 months on the initial experience benefits which are the Extended Health Care and Dental. After the initial premium rate guarantee, the premium rates are renewed every 12 months for all lines of benefits.
Pooled benefits premiums are reviewed for Life Insurance, Accidental Death and Dismemberment, Weekly Indemnity, Long-Term Disability, Critical Illness, and age, based on the make-up of employees (male versus female), occupation and claims experience.
Experience-rated benefits, including Weekly Income, Extended Health and Dental, are reviewed by the insurance underwriters at the renewal date and the rates are adjusted based on the premiums paid versus claims paid , generally speaking, there four components on the calculation, target loss ratio, credibility, trend factors and IBNR (Incurred but not reported reserves) charges.
A couple of insurance providers do not include the IBNRs in their renewal process, which benefits the policyholder.