Assure Elite: Small Employers' New Favorite Healthcare Program

Employers of multi-generational employees often fret about the delicate and difficult balance of offering health coverage. The typical generalization is that younger employees tend to cost less to insure, while older employees cost more. The truth is, not every young employee is going to require less health coverage because they are presumed to be young and healthy. Likewise, not all older employees are going to cost an arm and a leg to insure. With each employer comes unique employees, and therefore, there is a need to have options to benefit and reward small employers and their employees alike – enter the Assure Elite program. In this installment of CenterStage, Tonya Bahr, a Benefits Advisor at Hierl Insurance, has highlighted the game-changing aspects of this unique healthcare program.

What Exactly is Assure Elite?

Assure Elite is a small employer focused healthcare program aimed at offering the best options for small employers who want to take control of their healthcare spending. “As a partnership between Hierl Insurance, Network Health and Agnesian Healthcare (SSM Health), employers can have peace of mind knowing their healthcare options are backed by three local companies who know healthcare expenses are out of hand in our community,” explained Tonya. Through this partnership, Hierl creates unique plan designs with deep discounts reflected in the premium costs, placing money back in the pockets of employers and employees. 

What sets Assure Elite apart is actualization, not generalization. Among other issues facing the modern healthcare scene, age of employees plays a large factor in coverage pricing. The tendency is to believe older employees will cost an employer more to insure due to a greater prone to injury, sickness and other ailments. On the other hand, younger employees are in better shape and theoretically removed from any costly health issues.

However, not always is this the case. By working with a partnership established around the goal of providing the most cost-effective and honest coverage for small employers, Assure Elite bases pricing on the overall health of the employee. Taking age out of the equation and replacing it with health ensures the proper coverage is received.

How Does the Program Work?

Assure Elite is a level-funded program, meaning premium is based on actual healthcare utilization rather than age. Healthier overall groups will pay less than a group who is unhealthy (or high users of healthcare). Being a level funded program, Assure Elite is a hybrid between a traditional, fully-insured medical plan and a partially self-funded plan. With a fully-insured plan, employers are paying a fixed monthly premium for coverage, meaning the amount only fluctuates when the number of employees on the plan changes. Often, employers are unaware they are overpaying in premium due to claims paid out by the insurance carrier are less than the premium paid in by the employer. With a partially self-funded plan, an employer still faces fixed costs, (much lower than a fully-insured plan), but also pays for medical claims as the employees incur expenses. Therefore, groups don’t overpay like they do on fully-insured plans because the cost of the claim is what the group’s actual expense is. Cash flow fluctuation can arise from this, and many smaller employers do not prefer this risk. A level funded plan like Assure Elite offers the best of both worlds: providing the fixed monthly premium costs of a fully-insured plan, but at the end of the year, offering the employer 50% of the balance back if the amount paid in is less than the amount paid out by the carrier. Many different options are available to choose from; both EPO and POS, as well as traditional and HDHPs. Employers can dual choice up to 4 plan options. Adherence generic prescriptions are $0 copay and office visits are only $10. Low cost, convenient virtual visits are available, as well. All plan options come with a wellness component offered through Agnesian’s Know & Go program, which includes health risk assessment questionnaires, biometric screenings, coaching, and an employee portal with educational materials, food and exercise trackers, online workshops, a blog, a mobile site and more – all at no additional charge.

How Do I Go About Getting a Quote?

The application process is completely pain-free. Base rates for Assure Elite are released after a current census statement, billing statement and wage and tax statement are received. Employers wishing to move forward with the process would go through medical underwriting to obtain final rates. This includes the completion of a three-page application covering basic demographic information and a brief medical questionnaire. Some groups choose to go through underwriting immediately rather than receiving base rates first, but each decision is unique to each employer. Despite remaining largely competitive for groups having 2 to 49 employees, discounts are still acquirable for group sizes up to 100.

To begin your journey toward optimal employee healthcare coverage, speak with Tonya at Hierl Insurance, Inc. With a passion for educating employees who may not understand their insurance, misuse their coverage and spend more than they need, Tonya is ready to assist in discovering cost-effective care without any missteps. You can reach her at 920.921.5921 or at tbahr@hierl.com.


HRL - Office - Collaboration - Write - Paper

Level-funded plan uptake trickling down market

What are level-funded plans, and why are they becoming so popular? Allow this article to break down the facts for you.


A brighter light is being cast on level-funded group health plans as benefits decision-makers tackle open-enrollment season. Several industry observers say the trend is more pronounced given that the Affordable Care Act remains largely intact — for now.

There has been an ebb and flow to these self-insured underwritten plans over the past 18 months, says Michael Levin, CEO and co-founder of the healthcare data services firm Vericred. But with a fixed monthly rate for more predictability, he says they can drive 25% to 35% savings relative to fully-insured ACA plans that must comply with the medical loss ratio for a certain segment of the market.


Level funding typically leverages an aggregate and/or specific stop-loss product to cap exposure to catastrophic claims. These plans are offered by an independent third-party administrator or health insurance carrier through an administrative-services-only contract.

It’s best suited for companies with a very low risk profile comprised of young or healthy populations, according to Levin. And with low attachment, stop-loss coverage in most states, he explains that the plans have “very little downside risk from the group’s perspective.” Two exceptions are California and New York whose constraints on the stop-loss attachment point “essentially preclude level-funded plans from being offered” there, he adds.

The arrangement is trickling down market. “We’ve heard from carriers that will go down to seven employees, plus dependents, while others cut it off at 20 or 25,” he says.

David Reid, CEO of EaseCentral, sees a “resurgence of level funding” across more than 38,000 employers with less than 500 lives that his SaaS platform targets through about 6,000 health insurance brokers and 1,000 agencies. His average group is about 30 employees.

He’s also seeing more customers using individual-market plans rather than group coverage through Hixme’s digital healthcare benefits consulting platform. Under this approach, health plans are bundled with other specific types of insurance and financing as a line of credit to fill coverage gaps. Employer contributions are earmarked for individual-market plans, which are purchased through payroll deduction.

Read further.

Source:
Shutan B. (17 November 2017). "Level-funded plan uptake trickling down market" [Web Blog Post]. Retrieved from address https://www.employeebenefitadviser.com/news/level-funded-plan-uptake-trickling-down-market?feed=00000152-175e-d933-a573-ff5ef1df0000

SaveSave