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                                                             OVERVIEW 

At Jpappas, we find ways to offer Healthcare plans that fit the needs of our clients. In doing so, we also offer them Self Insured plans that have features that may be beneficial to some companies.
Definition of a Self-Insured (Self-Funded) Plan:

A self-insured, or self-funded, plan is one in which an employer (or organization) assumes the financial risk of providing insurance benefits to its employees. In this arrangement, the employer sets aside funds to cover the cost of claims, administrative expenses, and other related costs. Instead of paying premiums to an external insurance company, the employer directly pays for the healthcare services used by its employees. The employer may also purchase stop-loss insurance to limit the financial risk in case of unexpectedly high claims.
insurance plans and they are owned by the employer.
Here are the key differences between Self insured and  Fully insured Group Health Plans :

RISK ASSUMPTION

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  • In a self-insured (or self-funded) group health plan, the employer assumes the financial risk for providing healthcare benefits to its employees. Instead of paying fixed premiums to an insurance carrier, the employer directly covers the cost of claims and administrative expenses.

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AETNA

 Aetna Funding Advantage (AFA) is a self-funded option that provides all of the financial and plan design flexibility of a traditional arrangement with special features designed to help companies with as few as 2 employees achieve even greater savings on their health insurance. 

In a self-funded plan like Aetna Funding Advantage, the employer assumes the financial risk for providing healthcare benefits to its employees. Instead of paying fixed premiums to an insurance carrier, the employer pays for the actual healthcare expenses of its employees. Aetna serves as the administrator for the plan, helping with the management of claims and providing network access to healthcare providers.

This plan is competitive for companies that have more than 9 eligible employees. We quote this insurance with Frank Basile from Emerson Rogers Frank.Basile@emersonrogers.com

Benefits of AFA

  • Predictable monthly payments

  • Stop-loss protection

  • Refund opportunities

  • Access to Aetna’s broad network of healthcare providers

  • Wellness programs and resources to help employees stay healthy and prevent costly medical claims

AETNA AFA Brochures

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