716.688.5600

Insured Health Plans

Insured Health Plans

Premier Consulting Associates has more than 200 years of combined team experience in helping employers implement and manage fully insured group medical plans. We are able to work with any licensed carrier and have experience working with many of them.

Fully insured plans are ones in which the employer pays a monthly premium to an insurance carrier to assume all of the risk associated with the group insurance claims for their employees.

Funding Mechanisms for Health Plans

There are four types of funding mechanisms available for employers to manage their health plans.

• Community Rated: Claims are pooled for employers with less than 50 eligible employees.

• Experience Rated:  Fully insured, premiums are based on claims utilization, demographics, carrier trends, administration and state mandates. 

• Minimum Premium: Hybrid mechanism between Prospective Rating and Self-Funding; premium taxes apply as well as a risk charge for accessing carrier funds. 

• Self-Funding: Employer maintains financial control for funding claims and administrative expenses. Costs are based on employer claims, administrative expenses and stop loss premium. 

Community Rating

0-50 Employees

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Experience Rating

50-100 Employees

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Self Funding

100+ Employees

Click here to learn more about what Premier can do for you.

1416 Sweet Home Road
Suites 5 & 6
Amherst, NY 14228

716.688.5600

News & Views

Auditing Prescriptions and Medication Claims Can Save Your Plan Money

One of Premier’s Pharmacy Management Unit initiatives is auditing not only prescriptions filled through the pharmacy benefit but also medication claims billed through the medical plan to ensure that patients are prescribed medications that are both necessary and...