Self-funded Qualified Health Plan (QHP): An Alternative to Fully-Insured, High-Cost Employer Plans
Employers face the struggle of deciding what type of healthcare to offer their employees. Absorbing the high cost of premiums can mean that employees get offered lower coverage or have to pay for a portion of the premium in order to get the coverage they want. With Aliera’s self-funded qualified health plans, employers can offer coverage employees want at a cost employers can afford.
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What is a qualified health plan?
Aliera’s self-funded QHP is built on the same premise as traditional fully-insured plans, but puts the control of cost and management back into the employer’s hands. It is not traditional insurance, but is ACA compliant under the CMS, IRS and ERISA—meeting the requirements set forth by the government.
Acting much like a traditional insurance’s deductible, Aliera Healthcare’s MSRA must be paid by the member up-front before the healthcare benefits apply. Once the MSRA has been met, members will be responsible for only a percentage of the cost.
What self-funded qualified health plans cover
Aliera’s QHP is a low-cost, full spectrum group healthcare, designed to meet the employees’ full healthcare needs. Covering 60% to 90% of the actual healthcare costs of its members, Aliera’s quality health plans provide both preventive and emergency coverage and meet all the government mandates for employer healthcare, including hospitalization. Primary care physician (PCP) visits, telemedicine, urgent care, laboratory and diagnostic services, hospitalization, surgical coverage for in-patient and out-patient procedures, preventive care, and prescription discounts are all included in this type of coverage.
In addition to all of the traditional benefits employers and employees are accustomed to, an Aliera qualified health plan includes telemedicine. Telemedicine puts a U.S. board-certified physician just a phone call or video chat away, and is unlimited, completely covered by the plan, and extremely convenient for a busy employee’s life.
How a qualified health plan works
Aliera now offers self-funded QHPs to small employers that are also level-funded, so employers are never liable for more than the cost of the employee premiums. By using the self-funded platform, an employer can save on health coverage as compared to traditional fully-insured plan. Today, employers can enjoy a completely risk-free self-funded plan by choosing a level-funded plan from Aliera.
A level-funded plan means that the employer’s maximum exposure is the amount of the premium—just the same as a traditional fully-insured plan, but at a lower premium. Additionally, with Aliera’s qualified plan, if there is any savings in the anticipated spend, the employer will actually receive some of the premium back—saving him significant money and adding dollars directly to his bottom line.
QHPs qualify as Section 125 Plans. Premiums can be deducted from employee paychecks before taxes, thereby reducing the employee’s taxable income. They also cover penalties A and B.
The benefits to providing qualified health plans
With Aliera’s qualified health plans, employers can now offer comprehensive healthcare plans at a more affordable price to traditional fully-insured plans. Business owners can begin taking control of their employees’ healthcare, and even receive some of the premium back at the end of the year depending on the claims experience. As a result, employers can control cost better and may get to the point where premiums no longer increase at 10% per year—Aliera is here to help that happen.
Our plans offer unique Core 4 model of care which helps control and drive down the cost of claims. Every dollar we save, the employer receives a 50% savings in total cost—adding up to lower premiums for the next year. Healthy employees increase productivity and the overall atmosphere of the work environment. Providing for the employee’s everyday medical needs through a qualified health plan is a win-win solution for both employees and employers.
Other names for QHPs and their cost
Besides being called qualified health plans, they are also referred to as minimum value plans, low-cost healthcare, full comprehensive healthcare, ACA compliant employer benefits, self-funded health plans, level funded health plans, employer health plans, and employer coverage. Because Aliera Healthcare is not a traditional carrier, its plans come at a lower cost to the employers.
Regardless of whether a company is large or small, its employees need health coverage. Choosing excellent coverage to keep employees healthy doesn’t have to kill the bottom line any more. With Aliera’s qualified health plans, both employers and employees can be healthy and happy.