Group Benefits
Group Health Insurance
The largest line on the benefits budget and the one employees judge you by. Worth getting the structure right, not just the price.
Ways to fund the plan
Fully insured. You pay a fixed monthly premium and the carrier takes the claims risk. Predictable, simple to administer, and the default for most small employers. If your group has a healthy year, the carrier keeps the difference.
Level funded. You pay a level monthly amount that covers expected claims, administration, and stop‑loss protection. If claims come in under expectation, some of the surplus may come back to you at year end. It usually requires medical underwriting up front, and a group with significant claims may not qualify or may be quoted higher.
Self funded. The employer pays claims directly with stop‑loss coverage above a threshold. More control and more reporting, and it generally suits larger or unusually stable groups.
Network types employees will ask about
- PPO — broad access, out of network covered at a higher cost, no referrals. The most flexible and usually the most expensive.
- HMO / EPO — a defined network, lower premium, and little or no out‑of‑network coverage except emergencies.
- High deductible with an HSA — lower premium, higher deductible, and a tax‑advantaged account employees can fund and keep.
The contribution decision
Carriers set a minimum the employer must contribute, commonly toward employee‑only coverage. What you do above that minimum — especially whether you contribute toward dependents — determines who actually enrolls. We will model a few splits with the payroll deduction shown per pay period, because that is the number your team will react to.
What we need to quote
- Census: date of birth, zip code, and coverage tier for each eligible employee
- Your current plan summary and current rates, if you have coverage now
- Eligibility rules — hours required and waiting period
- What the company contributes today
- Your renewal or target effective date
Want to see what the market would do with your group?
Tell us your headcount and renewal date and we will tell you honestly whether shopping it is worth the effort this year.
By calling this number, you will be connected with a licensed insurance agent who can answer questions about the plans we offer. There is no cost or obligation to talk. Or email Bill@imagineins.com.