The Level-Funded VAULT Health Plan is for employers with a good health experience who feel they are paying too much premium for too little in benefits. Do you receive money back from your insurer for being healthy? If the answer is NO, then VAULT Health Plan could be the right alternative for you.
The VAULT Health Plan saves you money by paying the claims of your employees with your dollars instead of insurance premiums. Money left in your account is your savings and not insurance company profits. You are protected with stop-loss insurance that provides coverage for large claims and caps your maximum exposure.
If you are currently covered under a fully insured plan, your monthly premium costs are locked in. Even if you are healthy and have no claims you do not share in the savings, which are kept by the insurance company.
Self funding allows you to keep the savings when your group is healthy while stop-loss insurance caps your exposure. Level monthly funding takes the guessing out of monthly costs. You pay one set monthly fee. After all of your claims are paid for the year the unused money in your claim fund is returned to you.
With our level funded your only risk is you will not receive money back at the end of the year. Each month, your payment helps to build up your claim fund. The unused dollars in your claim fund are yours after claims are paid for the plan year. Your costs are capped by stop-loss insurance.
Most of our clients find that they can see whatever Doctor they want. We use several different networks depending on the market area. The networks available in your area will dictate which doctors are available “in-network.” Most of our plans allow members to see whatever doctor they like with a little higher co-pay or co-insurance if the doctor is not in the network. We also have unrestricted plans which do not use networks. These plans monitor which doctors are being used by your group, and then work to get agreements for payment terms with them.
With level funding, you will never pay more than the maximum claims cost and known fixed expenses for the plan year. Each month you pay 1/12 of your MAXIMUM annual costs. After you have paid this amount each month there are no other charges for claim payments. If needed stop-loss insurance pays claims over your contracted maximum claim cost. Once all claims have been paid for the plan year any unused dollars are returned to you after a 9 month run-out period.
Each month, you will receive an accounting report on all claims paid during the month and the plan year-to-date. Each quarter, you will receive a detailed utilization report about claims paid. Reports are subject to federal and state privacy regulations.
Plan Year & Terminal Liability - Your plan year runs for 12 months from your effective date. Claims incurred during your plan year will be paid through a nine-month run-out period after the end of the plan year. Any remaining money in the claim fund at the end of the run-out period is refunded to you. Terminal Liability coverage is built into the plan by providing the nine-month run-out period.
These are the costs you pay for the administration of your group’s health plan. This includes underwriting, claims processing and monthly claim fund reporting. Compensation is also paid to your agent from these costs for their role in helping you tailor your plan, managing your plan enrollment and the ongoing servicing of your plan.
Covers employees’ health care claims
Protects employer from unexpected claims
Covers processing and reporting