California Attack on Self Insured Small Group Plans

[junkman]

You can do much better than that in TN. A 10k spec for a group of 100 (if it were even available) would be so expensive that it would not be worth it. You could do a risk-sharing captive or some other strategy that would be much less costly.

I'm aware of that and have gone behind to clean up enough self funding messes to not really believe in self funding until upwards of 1000 members, not employees. Claims are only ~ 65% credible even at 800 members.

(I don't care that carriers are willing to sell the plans or assign 100% credibility on smaller groups. The arithmetic deck is stacked in carrier's favor.)

 

[leevena]

I'm aware of that and have gone behind to clean up enough self funding messes to not really believe in self funding until upwards of 1000 members, not employees. Claims are only ~ 65% credible even at 800 members.

(I don't care that carriers are willing to sell the plans or assign 100% credibility on smaller groups. The arithmetic deck is stacked in carrier's favor.)

I don't necessarily disagree with your comments. But think about this for a small group, under-50. You shop the market for the usual BUCHA plans and for a level premium self-funded plan(s). If the group happens to be a good risk (meaning below the insured/community rates, your level premium self-funded plans will probably have a lower cost. Since these plans are rated as a "fully insured" cost the group will have a maximum cost that is less than the fully insured. If their claims are lower (as expected in most cases) they get a refund. If there claims are higher there is no request for addition $ because of the "fully insured" aspect of their costs.

If the group goes sideways in a bad way and the plan costs increase dramatically, you put them back into the GI small group market.

 

[ABC]

I am not 100% sold on the small group self funded market.

Assurant has self funded plan down to 25 EE that they have launched in Illinois.

They are suppose to launch in my state shortly.

Every other Partially or true self funded plan for small group does not make sense.
If you truly have a a healthy group the preferred best rates with a competitive carrier will be tough to beat. A rented network has little chance.

 

[junkman]

Here Assurant's network discounts are 10-15% smaller than those carriers that manage their own networks (BCBST, UHC, Cigna etc). Consequently Assurant controls claims by nitpicking underwriting and strip benefits or write the plan in such a way that is difficult for the layman to appreciate (akin to shrinking portion size while holding the price) They are generally not competitive or don't give good value when the price looks good,