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.

Compare all three plans to find which best fits your needs, or email Karl Sommers at karl.sommers@karlsommers.com to ask questions, seek advice, or get a quote.