Employee Benefits Plan Design

Employee Benefits Plan Design

Employee benefits are expensive and complicated, so everything we do is to help our clients regain control of spending and improve the experience of their people.

A successful employee benefits plan is designed with the employer and employee's needs in mind. We help you determine the right level of risk and can provide numerous coverage options to protect your plan.

Health Care
Financing Options

Group health insurance is a great way for your business to provide coverage for employees, but it can also be a bit of a financial challenge.

Fortunately, there are many ways to finance group health insurance. You can choose from fully insured plans to self-insured or coalition plans depending on what works best for your company.

Fully-Insured

Who is it for: Employers with 2+ employees
How it works: The company pays a premium to the insurance carrier, who in turn pays the health care claims based on the coverage benefits outlined in the policy. This is the traditional way to structure an employer-sponsored health plan.
Pros: The carrier assumes the financial risk, the employer knows the costs ahead of time.
Cons: Costs are unlikely to decrease even with low utilization, potential for rate hikes, higher taxes.

Fully-Insured + HRA

Who is it for: Employers with 2+ employees
How it works: This combines the traditional employer-sponsored health plan with a Health Reimbursement Arrangement (HRA). HRAs are employer-funded group health plans that employees are reimbursed tax-free for qualified medical expenses.
Pros: The carrier assumes the financial risk, the employer knows the costs ahead of time, tax-free HRA plan for employees.
Cons: Costs are unlikely to decrease even with low utilization, subject to state rules and regulations.

Level-Funded

Who is it for: Employers with 2+ employees
How it works: Employers pay a set amount each month to a carrier. This amount typically includes the cost of administrative fees, the max amount of expected claims based on projections, and an embedded stop-loss insurance.
Pros: No community premiums, money back if low claims lead to surplus, better utilization reporting.
Cons: Potentially higher admin fees, out-of-pocket claims costs, contractual impact.

Self-Insured

Who is it for: Employers with 25+ employees
How it works: Employer sets aside some of its funds to pay for employees' medical expenses. Employees then contribute to the plan rather than pay traditional premiums.
Pros: Turn-key solution from fully-insured to self-insured, no gaps between the plan's coverage and stop-loss coverage, plans generally see net savings over a 3-5 year span.
Cons: Bundling of plan document, stop-loss, and network agreements limit plan customization, limited flexibility to reduce spending.

Coalition Model

Who is it for: Employers with 25+ employees
How it works: Similar to the self-insurance model, the employer sets aside some of its funds to pay for employees' medical expenses. Employees then contribute to the plan rather than pay traditional premiums. However, in the coalition model, we can select best-in-class vendors that meet the specific needs of the plan participants.
Pros: Pick and choose partners and providers to meet your specific usage needs, complete access to claims data to design your plan accordingly, plans generally see net savings over a 3-5 year span.
Cons: Failure to educate employees can impact how much the employer spends on health care, unbundled plans can create more administration.

VAST Health Coalition Model

VAST Health
Learn More

Get Peace of Mind, Work with One Agency

Having one agency handling all of your insurance needs allows you to gain both convenience and peace of mind in knowing your insurance is being managed effectively.

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174 Center St.
Winona, MN 55987
(800) 657-4448

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7616 Currell Blvd., Suite 290
Woodbury, MN 55125
(800) 657-4448

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205 N. Chestnut St., Suite 101
La Crescent, MN 55974
(800) 657-4448

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