Large Group Medical
We offer a wide range of flexible funding options designed to accommodate each group’s specific needs or budget. For groups with 51 or more covered employees, the following fully insured and funding arrangements are available, subject to underwriting guidelines and product availability of the carriers we represent.
Experience Rating Agreement
In these products a partially insured contract is in place, but the carrier agrees to return unused premium to the group. Unused premium is collected premium that exceeds the sum of claims paid, needed reserves, expenses, taxes and other government obligations. The carriers Experience Rating agreement also may be available on a Retrospective Premium basis.
Stop Loss Insurance – Aggregate Only – “Spagregate”
These products sometimes called “Spagregate programs” combine the best features of traditional stop loss using specific and aggregate reinsurance but allow the employer the benefit of pricing at or near traditional fully insured levels. The employer’s liability is rolled into a fixed stable monthly payable. At no time will the employer be asked to fund more than the fixed monthly payable. Funds left at the contract end are the employers. The employer realizes the flexibility of an ERISA plan document and the efficiencies of a qualified third party administrator.
Pooled Medical and Dental Programs
Together with a partner insurance carrier we can provide a unique way of coming together and pooling employer health and dental benefits. Using a modified partially self-funded program this platform has been built to do the following for employer groups:
Underwritten as a Self-Funded Group
- Preferred industry with favorable underwriting factors
- Provides quarterly pool reports
- Significant cost and benefit design advantages in relation to current Health Care Reform requirements
- Limited Health Care Reform taxes and fees
Increasing Plan Performance Through Transparency
- Transparency means no more hidden data selectively shared by insurance companies
- Quarterly reporting will be provided to the contractor board to review claims utilization of the purchasing group
- Claims data can be reviewed to target and educate on high claims categories, thereby minimizing future claims costs and renewal trends, ensuring long-term competitive pricing within the pool
- Easier to budget
- Easier to predict increases and decreases
- Lower administrative costs
- Four tier composite rates
- Provides appropriate tiering for each group to keep pool strong
- Benefits all risk type groups
Exclusive Network with Excellent Access:
- Employer groups have the flexibility to choose between the prestigious Cigna PPO and Arizona Foundation networks
- Contractor Board meets quarterly
- Voting rights for renewal changes
Keeps Renewal Rates at a Minimum
- Historical renewal trends of other EMI Health purchasing groups average single digits
Stability and Long-Term Health Care Solutions
Integrated Wellness Program:
Onsite biometric screening, mobile mammograms, flu shot clinics and more- all included in the program at no extra cost
Based on experience of other AMI Health groups, employees engaged in 85% of key wellness categories can save up to $1,800 per year in claims cost.