Balanced Solutions®: An Innovative Health Plan
We know that small businesses have unique needs and traditional health plans aren’t a one-size-fits-all solution. Our level-funded product, Balanced Solutions®, is an alternative health insurance option that can put unused health insurance premiums back in employers’ pockets.
Create Your Plan
First, you select a benefit plan that works for you and your employees. Next, you select your specific stop-loss and aggregate stop-loss coverage levels. The last component of your Balanced Solutions plan is the employer claims fund. Medical Mutual assigns your employer fund based on your benefit and stop-loss coverage selections.
This is how Balanced Solutions stands out from traditional plans:
| Traditional Health Plans | Balanced Solutions |
|---|---|
| Your business pays Medical Mutual a fixed health insurance premium and then we pay for the cost of claims, in addition to administrative costs, sales commissions and taxes. If the claims are higher than expected, we cover them. But here’s the catch: if the claims are lower than expected, you don’t benefit or get money back. | With this level-funded plan, you pay a consistent monthly premium that mirrors the same fixed costs as a traditional plan. Medical Mutual packages a stop-loss policy with an employer fund to ensure that you have no financial liability beyond your monthly pre-determined premiums. Here’s the best part: if claims are lower than expected, you have the opportunity for a refund. |
On average, 65% of Balanced Solutions enrolled groups have received a refund1.
Who Qualifies for This Coverage?
- Groups with 10 to 50 employees (within a minimum of 10 enrolled).
- Additional requirements include enrolling 75% of net eligible employees and requiring them to complete health questionnaires.
What Else is Offered with Balanced Solutions?
Pharmacy Benefits
Prescription drug benefits are included with every Balanced Solutions plan. Medical Mutual partners with Express Scripts to offer your employees access to more than 70,000 pharmacies. We make sure your employees receive the care and attention they deserve while managing pharmacy costs.
Specialty Products
Offer your employees benefits beyond health insurance with Medical Mutual specialty products, including life, dental, vision and more. Providing benefits that help keep your employees healthy and financially protected can be a key factor in employee retention and satisfaction. It can also be an integral part of attracting new talent and growing your business.
Preventive Care and Wellness Features
To help employees achieve and maintain their best health, Medical Mutual offers many preventive care services and overall wellness benefits. This includes free flu shots, free biometric health screenings and preventive care at no cost to members. Also, digital and telehealth visits are alternate channels available to members for flexibility when it comes to receiving care and obtaining necessary services.
Other Tools and Resources
Nurse Line – Your plan includes access to Nurse Line, where a registered nurse is available to answer health-related questions 24 hours a day, 7 days a week. The Nurse Line is available by phone or through Medical Mutual's secure member portal, My Health Plan®.
Provider Search2 – Through our Provider Search you can find in-network doctors, hospitals and facilities, and other helpful information. Once enrolled, members can also use this tool to view approximate costs of care and treatments.
My Health Plan – Through My Health Plan, Medical Mutual's secure member portal, employees can check their benefits, view claims and deductible information, as well as access their health spending accounts.
Personal Wellness Platform – Employees enjoy access to their own wellness platform, which provides a personal health dashboard, healthy recipes, fun challenges, an online health university and other digital tools to help employees achieve health goals.
Ready to take advantage of potential savings? Let’s talk!
Talk to your broker or call 877-355-4596 today to learn more. You can also request a quote below.
1A group must renew to be eligible for a refund.
2Please verify your provider is in network before making an appointment.
The information and descriptions above are intended as general information and are not necessarily complete descriptions of all terms, exclusions, and conditions applicable to the products and services offered by Medical Mutual. All products may be subject to applicable laws and regulations.
Is Balanced Solutions the Right Plan Option for You?
We’ve compiled the following resources to educate you on this level-funded option: