Health Insurance

Health Insurance

Spetner can help your company choose a health plan that both incentivizes employees and works within your budget.

Conventional Plans

  • Open Access or Preferred Provider Plans

Give your employees a balance of cost savings and access to care with great freedom of choice.

  • Point-Of-Service Plans

Give your employees rich, network-based benefits with the flexibility to access in- or out-of-network providers.

  • Health Maintenance Organization Plans (HMO)

Give your employees a physician-driven plan that provides rich benefits and maximum cost savings.

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Consumer-Driven Plans

  • Health Reimbursement Arrangement (HRA)

A tax-favored account used to pay for medical care. Employers fund 100 percent of the HRA. Funds can be used to pay medical services covered under your high deductible health plan and some services that are not covered under your health plan – all with pre-tax dollars. Employees may accumulate unused funds and carry them over year to year to pay for future healthcare needs.

  • Medical Savings Account (MSA)

A tax-favored account used to pay for medical care, as well as to build up savings that may be used to pay future medical expenses. Employers or employees fund the MSA. The employee owns all monies contributed. Funds can be used to pay medical services covered under your high deductible health plan and some services that are not covered under your health plan. At retirement, an employee’s account balance becomes a retirement plan.

Flexible Funding Options

  • Traditional Funding

Allows employers to easily predict their cost by having a set monthly premium based upon the level of coverage selected. This type of funding may be referred to as “fully insured” because the risk is completely held by the insurance carrier.

  • Minimum Premium Funding

Allows employers to combine a fully insured, traditionally funded plan with some of the features of an Administrative Services Only (ASO) program. The employer pays a set monthly administrative fee (usually a per employee fee) to the insurance carrier. Then the employer funds the claims as they are incurred. The financial risk for this program is shared between the employer and the insurance carrier.

  • Administrative Services Only (ASO)/ Self-Funded or Self-Insured Program

Allows employers maximum flexibility in plan design. An ASO contract is not subject to most state laws or state premium taxes because there is not a true insurance contract in force. The employer pays a set monthly administrative fee to the administrator and also assumes full financial risk.

  • Stop Loss

Allows self-insured employers to limit their medical claim liability to a specified amount.

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