How It Works

With The Protect Plans: Simply

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Keep claims savings or gift them to an Insurance Company.

The choice really is that simple.

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Fully-Insured Coverage

Comprehensive medical coverage
Fixed costs each month
Employer is protected when claims are higher than expected
Insurer keeps surplus when claims are less than expected

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Fixed-Cost Self-Funded

Comprehensive medical coverage
Fixed costs each month
Employer is protected when claims are higher than expected
Employer gets surplus when claims are less than expected

The Protect Plans Keep it Simple

You can make fixed-cost self-funded plans complicated, but you don’t have to. With The Protect Plans we keep everything straightforward: seven comprehensive PPO plans, strong national networks, one contract period, one proven administrator, fair and experienced underwriting. And our Refund Assisters help employers seize the potential for refunds when claims are lower than expected.

It all comes together to make The Protect Plans the safe and simple way to transition from fully-insured to self-funded medical coverage.

Advantages and Responsibilities

The opportunity for refunds is the advantage of self-funded plans that gets most of the attention. But there are other benefits as well. For example, self-funded plans are governed by federal law so employers can offer the same plan in all the states in which they do business. And monthly payments are often comparable to those of traditional insurance.

Self-funding does entail some additional responsibilities for employers. They are responsible for paying eligible claims of employees and their dependents. That’s why companies self-funding coverage need to work with a dependable administrator, offer a cost-effective network, and have access to programs that manage risk. All of which The Protect Plans delivers.

This additional responsibility is also why most companies–especially those new to self-funding–use excess-loss coverage to cap their claims exposure. Again, that’s what The Protect Plans delivers with both specific stop-loss coverage (limiting employers’ exposure to claims from any one employee or dependent) and aggregate stop-loss coverage (capping exposure to claims from all of a company’s insureds).

Please see the “What to Know About Self-Funding” flyer on the “Collateral” page for more information.