Providing healthcare benefits is a smart way to attract and retain loyal employees. As a small business owner, you may also need health insurance coverage for yourself and your dependents.

Whether you're just starting to research health insurance or are ready to get a quote, we can help. Use the information below and talk to your broker about what plan option is right for you.

Funding Types

There are two different funding types of health insurance plans:

  • Fully insured
  • Self-insured

Either funding option could work for you and your small business, depending on your comfort level with risk and the amount of premium you want to pay.

Let's compare the two types:

Fully insured

  • Employer pays a premium to the insurance carrier, which assumes the financial risk.
  • Premium rates are fixed for a year, based on the number of employees enrolled per month.
  • Monthly premium only changes during the year if the number of enrolled employees changes.
  • Insurance carrier collects the premiums and pays the healthcare claims based on the policy purchased.
  • Enrolled employees/covered dependents pay deductible amounts and/or copayments for covered services.

Self-insured

  • Employer assumes the financial risk for providing healthcare benefits to its employees and pays administrative fee to carrier for processing the claims.
  • Claims are paid by the employer as incurred instead of paying a fixed premium to the insurance carrier.
  • The two main costs are:
    • Fixed, such as administration costs of the plan and stop-loss premiums
    • Variable based on how much the health plan is used
  • To limit risk, employers can use stop-loss insurance, which reimburses the employer for claims that exceed a predetermined level. Stop-loss can cover:
    • Catastrophic claims
    • Claims that significantly exceed the expected level for the group

Plan Types

There are several options to consider when looking at plan types. The usual plans include the following:

  • Preferred Provider Organization (PPO)
  • Health Maintenance Organization (HMO)
  • Point-of-Service (POS)

There are advantages to each plan type and one may work better than another for you, your employees and your small business. Learn more about these different types of plans and contact your broker to determine which plan is best for your small business.

What Medical Mutual Can Offer You

Funding Types Offered By Medical Mutual

Medical Mutual offers a variety of health plan options to meet the needs of you, your employees, and your business, including fully insured and self-insured plan options. Our Affordable Care Act (ACA) Small Group plans offer a variety of plan options with competitive rates.  Our self-insured options, Balanced Solutions and the COSE MEWA, provide alternatives to traditional plans.

Additional Plans

Medical Mutual offers PPO and HMO options, as well as Health Savings Accounts (HSA) and Health Reimbursement Accounts (HRAs). We also offer dental, vision and life insurance coverage for small businesses.  Learn more about these types of plans.

Next Steps

If you already have a trusted broker, call him or her to discuss your options. If you don’t have a broker yet, we can help you find a reputable one through our broker network. Call us at (440) 878-5930 or request a group quote to get started.