Group Health Insurance Plans
Tailored Solutions for Diverse Needs
At Kalish Financial, we design tailored group benefits packages that help attract and retain talent while controlling costs. Whether you’re a small business or a large enterprise, we’ll guide you through Fully Insured, Level-Funded, and Self-Funded options to find the best fit for your organization.
Fully Insured Group Health Insurance Plans
With Fully Insured plans, your company pays a fixed premium each month to a carrier, and the insurer assumes all claims risk.
Key Features:
- Predictable Costs: Fixed monthly premiums simplify budgeting
- Carrier Administration: The insurer handles claims processing, compliance, and reporting
- Regulatory Protection: Insurer bears risk of high claims and must comply with state mandated benefits
Best For:
- Organizations seeking stable, predictable costs
- Employers without internal HR capacity for benefits administration
- Companies that prefer an all-in-one solution
Considerations:
- Premiums may rise annually based on the group’s claims experience
- Limited flexibility to tailor benefits beyond standard plan designs
- No access to surplus funds if claims run below premium revenue
Level-Funded Group Health Insurance Plans
Level-Funded plans blend aspects of Fully Insured and Self-Funded designs, offering budget predictability with potential for claims rebates.
Key Features:
- Level Monthly Payments: Similar to fully insured premiums, covering expected claims, administrative fees, and stop-loss coverage
- Claims Refund Potential: Unused claims dollars may be returned at year-end
- Stop-Loss Protection: Caps the employer’s maximum claims liability
Best For:
- Small to midsize employers looking to control costs and gain transparency
- Companies prepared to share in cost savings if claims are lower than expected
- Organizations wanting stop-loss security without full self-insurance risk
Considerations:
- Up-front stop-loss premiums can be higher than fully insured
- Potential for unexpected costs if claims exceed stop-loss thresholds
- Requires moderate administrative involvement (e.g., enrollment support, basic claims oversight)
Self-Funded Group Health Insurance Plans
Self-Funded plans place the claims risk squarely with the employer, offering the greatest flexibility and potential cost savings.
Key Features:
- Pay-As-You-Go Financing: You only fund actual claims and administrative costs
- Customized Plan Design: Tailor benefits to your workforce’s unique needs
- Cash Flow Advantage: Premiums stay with your company until claims are paid
Best For:
- Larger employers with stable workforces and strong cash reserves
- Businesses seeking maximum plan design flexibility
- Employers willing to invest in robust benefits administration infrastructure
Considerations:
- Exposure to higher-than-expected claims without adequate stop-loss coverage
- Requires dedicated resources for claims processing, compliance, and reporting
- Greater regulatory and administrative responsibilities
Why Choose Kalish Financial for Your Group Benefits?
- Expert Guidance: We analyze your workforce demographics and claims data to recommend the optimal funding strategy.
- Seamless Administration: From quoting and enrollment to ongoing compliance and renewals, we handle the heavy lifting.
- Cost Management: We negotiate with carriers, review proposals side by side, and implement cost-containment strategies.
- Employee Education: We provide easy-to-understand materials and enrollment support to maximize plan engagement.
We’d love to hear from you.
Take control of your future by contacting us today for a free consultation and let our expert team guide you through your insurance roadmap. Reach out now to schedule your personalized planning session and start building the secure future you deserve.