Plan Options

Medical Expense Plan Options

Choose the plan that works best for your organization. 

MHS offers several options for members with 50 or more insurance-eligible employees, each requiring different capitalization:

Fully Pooled 
This plan operates much like a fully insured plan. The Employer pays a premium covering member risk, pooled risk, and reinsurance, plus specific administrative fees.

Cooperative
A cooperative is an attractive option for groups that want to practice mutual aid and share risk, without costly up-front capital requirements. The cooperative option offers stop-loss protection for expensive individual claims and total annual claims; low capita is required to be a member; groups with better-than-expected results help those experiencing a difficult year; and immediate savings can be realized through risk management.

Employer Self-Funded
Operating like a traditional self-funded plan, the Employer Self-Funded Plan has a specific and aggregate stop loss. Groups manage their own plan, with support from a third-party administrator and use of a reinsurance carrier for stop-loss coverage.

 

Whichever plan you choose, all members are encouraged to develop wellness strategies and create a culture of health and well-being. Our mandatory wellness program contains annual biometric screening and financial incentives, while care management programs provide intervention and support to avoid more costly care.

Email Karl Sommers at karl.sommers@karlsommers.com to ask questions, seek advice, or get a quote.