EMPLOYEE BENEFITS SOLUTIONS

Core Benefits

Customized health benefits for a thriving workforce.

Employee health benefits are critical to the health and financial wellness of your employees. Some health benefits are even legally required, depending on your industry sector. Core benefits can include:

  • Health Insurance: medical, dental and vision — and sometimes prescription drugs, mental health and wellness programs.
  • Retirement plans, paid time off, life and disability insurance

Our health benefits consultants will work with you to provide options for the diverse needs of your workforce, from preventive wellness and health management programs to cost-reduction strategies. This includes reviewing health plan options based on your state regulations, your size, cash flow, the age and health makeup of your employees, plan flexibility and your organization’s risk tolerance.

Types of Employee Health Plans.

Here are a few options:

You pay for your employees’ claims out of pocket when they occur.

  • Pros – Flexible, easily designed, removes insurance premium costs.
  • Cons – Increased claims processing administration and risks. Note that we can assist with risk mitigation through stop-loss insurance to potentially reduce your liability in cases such as single excessive claims. Plan design could also include our Third-Party Administration (TPA) services.

You pay fixed premiums to an insurance company that assumes all the financial risk for your employee healthcare costs.

  • Pros – predictable costs, less administrative burden. Compliance falls on the insurance company.
  • Cons – higher costs compared to self-funded plans due to insurance premiums

Combines elements of self-funded and fully insured plans. You pay a fixed monthly amount to an insurance carrier or TPA to cover estimated claims for the year, stop-loss coverage and plan administration expenses.

  • Pros – greater cost predictability and more risk mitigation compared to self-funded plans. You may also receive refunds and credit if claim costs are lower than estimated.
  • Cons – You pay for employee claims, so careful plan administration is required, including detailed monitoring of utilization data. Like self-funded plans, administration and compliance responsibilities fall on you.

Which is right for you? It depends on your needs. 

  • Fully insured plans combine simplicity and predictability.
  • Self-insuring is a challenging option if you don’t have regular cash flow or access to cash reserves.
  • Small-to-medium size businesses with a relatively young and healthy workforce may benefit from level funded plans to manage healthcare costs.

Daybright can help. Our employee health benefits consulting services include:

  • Consulting and plan design
  • Claims and underwriting
  • Helping you seamlessly switch between plan types
  • Vendor review and management
  • Education, communications, and enrollment
  • Administration
  • HSA, FSA and HRA options
  • Other healthcare options
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