Balance Plans

If you are looking for more control over healthcare costs, but don’t want to lose skilled support, Balance plans can give you the best of both worlds.

What Is a Balance Plan?

They’re level-funded plans, which means your costs will never exceed a predetermined amount. This allows you to budget effectively. Balance plans also combine our experienced staff and administration for traditional self-funded plans with the safety net of shared risk.

And we’ve already built the network, pharmacy coverage, and wellness benefits for you from our most popular plans, so choosing the right plan is easier than ever.

What Are the Benefits of a Balance Plan?

Balance plans:

  • Coordinate services like claims administration, medical management, and pharmacy benefits.
  • Aren’t subject to most taxes and fees that apply to traditional insured plans.
  • Can save you money if claims are lower than expected.
  • Never exceed the predetermined cost, no matter what.
  • Protect your business with stop-loss coverage that lets you set a yearly maximum cost.
  • Follow federal ERISA rules and aren’t subject to most state mandates, like bariatic surgery. If your plan isn’t governed by ERISA, some state mandates may apply.

Who Should Think About a Balance Plan?

Employers with 25-150 employees that:

  • Changed from a large group to a small group in 2016, especially small groups with 51-100 employees.
  • Are large employer groups (101-150 employees) looking for an alternative to traditional self-funded or fully insured plans.
  • Are currently on an insured transition plan.
  • Want to take advantage of the opportunity for low claims.

Learn more in our Balance brochure.

Call your client consultant for more information.

We don't currently offer Balance Plans in your area.