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Assurant® Self-Funded Program

A health care financing solution that could save you an average of 20%.1
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Assurant® Self-Funded Program overview

Gain control over health care expenses, and lower your health care costs now and for years to come, by putting a self-funded health program to work for your small business. With self funding directly funding your group's own claims, you only pay for the health care services your group actually uses. If your group's claim expenses are relatively low, your overall savings can be significant.2

Program highlights:

  • Predictable costs: your maximum self-funding cost for the year is determined up front, and it's guaranteed, subject to enrollment and benefit changes.3
  • Refund potential: over 50% of our self-funding employers receive a refund.4 If your group’s overall claims for the plan year are less than your aggregate limit (equal to your total claim fund contributions for the plan year), the difference is refunded.
  • Day-to-day plan management: program management is handled by your third-party administrator, including claim payments, accounting and customer service — so you're free to focus on your business.
  • Asset protection: stop-loss insurances protect your business's assets, even if your group's claims become larger than projected.

Where is the Assurant Self-Funded Program available?

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Program details

With the Assurant® Self-Funded Program, your employees get health care benefits similar to what they might be accustomed to seeing with traditional fully insured plans.

Health benefit program features include:

  • Your plan pays 100% of preventive services recommended under the Affordable Care Act when an in-network doctor is used5
  • Diagnostic X-ray and laboratory services paid at 100% (optional)
  • Optional copays for visits to network doctor offices and urgent care facilities
  • No referrals necessary to see a specialist
  • Multiple plan designs and provider networks to accommodate different employee needs
  • Employee Choice Program, so you can meet varied needs by offering multiple plans and networks

Added tax-savings opportunities6

Consider additional ways to provide tax-savings benefits when you purchase a small business health plan. Options include:
  • A Section 125 Premium Only Plan (POP)
  • Health Savings Account (HSA)
  • Health Reimbursement Arrangement (HRA)

Learn more about these tax-saving opportunities

How the program works

With the Assurant® Self-Funded Program, your maximum cost for claim expenses is determined up front and guaranteed, subject to enrollment and benefit changes. If the actual expenses are lower than the balance in your claims fund, you are refunded the difference.
  • Your monthly payment includes a contribution to your claims fund. The group's claims are paid out of this fund.
  • Depending on how the program is set up, the employee may have cost-sharing requirements to satisfy, such as a deductible or coinsurance, before claims are paid from your claims fund. 
  • The program and the claims fund are owned by you, the small business employer, and you select the features and options that best fit your group.
  • There are hundreds of program design templates for you to choose from and customize, offering your employees options similar to what they might be accustomed to seeing with traditional small group fully insured plans.
  • All employer-established health benefit plans are minimum essential coverage under the Affordable Care Act.
  • Program template options meet minimum value.

What happens if claims are larger than expected?

Assurant Health stop-loss insurance protects your business's assets against larger-than-expected claims by covering you (through direct payments into your claims fund) if claims for the program year exceed pre-determined levels called stop-loss limits.

There are two types of stop-loss coverage:
  • The aggregate stop-loss: which protects you against higher-than-expected claims incurred by your group as a whole. The aggregate limit is equal to your total contribution to the claims fund for the program year.
  • The specific stop-loss: which protects against higher-than-expected claims by an individual group member, if an individual group member's claims exceed a pre-selected level called the specific limit.

Stop-loss insurance also advances money, via a deposit into your claims fund, if the claims for any given month exceed your claim fund's available balance.

Who manages the program?

Your program is managed and administered by our trusted third-party administrator, Allied Benefits Systems, Inc. (Allied). They have more than 30 years of experience in benefit management and administration services. Allied also:

  • Manages your claims payments, reporting, customer service and more.
  • Offers extensive online services and monthly reports that make it easy for you and your employees to access information about your program.
  • Takes care of the program administration for you — so you're free to focus on your business.
  • Simplifies your billing, too. One flat monthly payment3 covers everything — your claims fund contributions, stop-loss insurance premium and administrative services.

That bill is guaranteed not to change, subject to enrollment and benefit changes.

Get more with your plan

  • White Lock Icon

    24/7 access to online accounts

    Convenient online tools allow small business customers to manage their health plans online.

    Learn more
  • White Doctor Icon

    Broad networks

    Get convenient access to extensive networks of doctors and hospitals.

    Check network availability
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    Supplemental insurance

    Dental, Accident and Critical Illness plans provide additional protection against out-of-pocket expenses not covered by your plan.

    Learn more

Plan limitations and exclusions and additional information

These plans include limitations and exclusions

See the general summary of plan limitations and exclusions PDF Icon for more information. As you select a plan, please check the specific benefits, limitations and exclusions listed as these may vary by state. To learn more about these plans, request a quote or talk to your agent.

Additional information
  • Average savings based on the cost of the Assurant Self-Funded Program versus that of comparable fully insured metallic health plans from Assurant Health. Actual savings will vary among eligible groups.
  • The Assurant Self-Funded Program provides tools for small-business employers to establish a self-funded health benefit plan for their employees. The benefit plan is established by the employer and is not an insurance product. Stop-loss insurance for the self-funded plan is underwritten and issued by Time Insurance Company.
  • Employer may be responsible for additional applicable state or federally mandated fees.
  • Source: Assurant® Self-Funded Program customer experience as of 2013.
  • Preventive services recommended under the Affordable Care Act Diagonal Arrow are paid at 100% when using in-network doctors; some additional preventive services paid subject to deductible and coinsurance. Varies by state.
  • Assurant Health is not engaged in rendering tax advice. Please see a qualified tax professional for tax advice.

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