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Getting Employers To Self-Fund In The PPACA Era - Keep Existing Clients Self-Funding... Get New Employers To Self-Fund...
Getting Employers To Self-Fund In The PPACA Era - Keep Existing Clients Self-Funding...  Get New Employers To Self-Fund...

As time passes and elements of PPACA are triggered, the cost of purchasing insurance has become too great.  Meanwhile, employers see an opportunity to drop coverage, pay a relatively small penalty, and exile employees to the exchanges.  The reasons to offer employment based benefit plans hasn’t changed.  For those that self-fund, they need to know why self-funding remains the best option for them.  For those leaving fully funded insurance, self-funding may be an option they haven’t considered.  Join The Phia Group’s CEO, Adam V. Russo, and Sr. VP, Ron E. Peck, as they discuss the many reasons to keep health benefits in-house, and how self-funding allows employers to “play” the game in a PPACA era!

 

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Stop-Loss Battle Expands to Four States
March 12, 2013 – Utah has become the fourth state that is considering legislation that would make it more difficult for employers to operate self-insured group health plans by restricting the availability of stop-loss insurance.

Known as the Small Employer Stop-Loss Insurer Act, HB 160 applies to groups with 50 or fewer employees. Unlike stop-loss legislation in California, Minnesota and Rhode Island, attachment point requirements in this bill are not onerous, but does contain a provision requiring stop-loss carriers to pay claims incurred but not reported if the plan terminates. The bill would also prohibit lasering.

Other provisions include:

  • Insurance Commissioner will create a standard stop loss application form for small groups
  • Policy must guarantee rates for 12 months – only exception is to price for a change in benefits of the Plan
  • Specific and aggregate coverage required
  • Requires the stop loss to provide gapless coverage
  • Minimum specific attachment point = $10,000
  • Minimum aggregate corridor = 90%
  • Contract basis no less favorable than 12/24
This is a developing story so please watch for further exclusive reporting from SIIA. The full text of HB 160, as well the other state stop-loss bills can be accessed on-line through the members’ only section of the association’s web site at www.siia.org. Please contact SIIA Chief Operating Officer Mike Ferguson at 800/851-7789, or via e-mail at  mferguson@siia.org should you have any questions or would be interested in helping to oppose the legislation in Utah.

February 2013 Newsletter

It’s only February and I’m already getting sick of the snow. Thankfully spring training is underway and for the first time in years, my beloved Indians have a chance to win! We here at The Phia Group want all of you to win new clients and increase your profitability and that’s why our services are catered to you.

The industry is going through much change and our expertise can and will guide you through the storms. Our recent webinar on cost plus offerings was the highest attended to date and we expect to beat that number with our next two on how to convince employers that self funding is right for them. Thanks for choosing us and happy reading.

 

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