As the cost of healthcare continues to escalate, more and more brokers are looking for alternative solutions for their clients. We partner with GBS (an AmWINS Group Company) to bring you a powerful, practical alternative to traditional insurance. GBS' HealthyAdvantage gives your employer clients the ability to directly fund their actual claim costs while limiting their risk with the purchase of stop-loss insurance.
With a traditional fully insured plan, the insurance company pays for most of the benefits and offers members small out of pocket expenses in the form of deductibles, copays and coinsurance but keeps the profits when the claims are lower than expected. With HealthyAdvantage, the employer pays the benefits up to a higher deductible, but purchases stop-loss insurance to reimburse the plan if the deductible is met.
Stop-loss insurance protects the plan against individual catastrophic claims (specific stop-loss) or their total claim expenses (aggregate stop-loss) exceeding their annual budget. Employers hire TPAs such as GBS to process, manage, and pay the claims on behalf of the employer.
HealthyAdvantage is a Level Funded Health Plan. Level Funded Health plans allow employers to pay a preset level premium equivalent which includes fixed costs and maximum claims fund. Because the employer is pre-paying the claims, 100% of the unused funds at the end of the contract period will be returned to the employer as savings!
With this funding arrangement, clients get the benefit of an unbundled approach to assembling a health plan. GBS helps employers contain costs by paying claims directly to the providers while allowing the client to customize the benefit design. HealthyAdvantage rewards your clients for good claims experience in a way that makes sense for them.
Click here to review the HealthyAdvantage Broker Product Guide.
Harvard Pilgrim Self-Funding
Plans designed for mid-sized employers; More Control, More Flexibility & More Savings
We empower you and your clients by partnering with other AmWINS operating companies.
Group Benefit Services (GBS)
Efficient administration, advanced technology, cost containment strategies and creative benefit designs.
Stop Loss Insurance Services (SLIS)
Unmatched stop loss expertise, access to the industry's top-rated stop loss carriers and highly competitive premium rates.
Independent, nationally licensed provider of infrastructure and service solutions, specializing in customized healthcare benefits administration.