Skip to main content

Assure Level-Funded Plans

Enjoy the best of both worlds—the security of a fully insured plan with the advantages of a self-insured plan.

Available to employers with 2-100 enrolled employees


What is Level-Funding?

Instead of monthly premiums, your company will be responsible for a specified level of monthly funding, which includes claim liability, stop-loss coverage and administrative services fees. The consistent monthly fees eliminate the normal volatility of self-insured plans.

Assure Advantages

  • Eliminate the financial risk and funding fluctuations common with a traditional self-insured plan.
  • Benefit from predictable, set monthly rates similar to a fully insured plan.
  • Save on health care costs.
  • Chance to earn back 100 percent of surplus claim funds at the end of the policy year.

Standard Assure Plans

Standard Assure plans include the following. 

  • $0 copayment for virtual visits (after deductible for HSA-qualified plans)
  • $25 copayment for preferred insulin (all plan participants are eligible before meeting their deductible)
  • When using In-Network Providers, $0 labs for condition management of chronic conditions.  Other diagnostic testing only a $30 copayment. (For all HSA plans, deductible applies.)
  • Affordable copayments for personal doctor visits (and still no cost for annual wellness visits and other preventive services)

You can find links to detailed plan benefits here.

Assure Value Plans

Network Health's Assure value plans offer employers a plan with a lower monthly premium in exchange for higher cost-sharing and out-of-pocket limits. These plans are a great option for businesses that want to offer Network Health's high-quality coverage for a lower cost. You can find links to detailed plan benefits here.

For more information or to receive an Assure quote for your company, contact your agent.

Don't have an agent? Call us and we'll be happy to help.

Call 920-720-1250
Network Health Assure graph

The Security of a Fully Insured Plan With the Advantages of a Self-insured Plan

Level-funding is a cost-effective health plan funding solution that allows companies to pay a predictable, fixed monthly rate like a fully insured plan to eliminate the funding fluctuations associated with self-insured plans. Instead of using the premium to pay expected claims and administrative fees, our Assure level-funded plans use that money to fund maximum claim liability, pay administrative fees and pay a stop-loss insurance premium. This eliminates the financial risk of self-insured plans.

The money that is set to fund maximum claim liability is used to pay the claims that occur throughout the year. If a company’s claims are less than the amount they funded at the end of the policy year, the company has the opportunity to earn back 100 percent of the funding surplus. Payments are calculated after the 24-month claim liability period has expired (12 months after the end of the policy year).

If claims go over the funded amount, the company is protected by stop-loss coverage.Stop-loss insurance protects employers by covering the cost of claims that have gone over the funded amount, which is based on maximum claim liability. Stop-loss insurance limits the company’s risk exposure and protects from catastrophic claims. An advance funding feature allows the payment of claims even when the funding level is less than the claim payments. This feature ensures that the company never pays more than their maximum claim funding amount for any month of the year.

Why choose Network Health and Assure for your insurance needs?

There are many reasons to consider Network Health's Assure health insurance plan for your insurance needs. Far too many to list them all. But we did narrow it down some.

  1. A Great Overall Value
  2. Outstanding Reputation
  3. Account Support at Your Fingertips
  4. We Are Good at What We Do (But don’t take our word for it)
  5. High-Quality Providers

    And more ...
Get more details and view the entire list
Top 11 Reasons to Choose Network Health

Out-of-Area Coverage Solutions

If your organization has employees living outside the Network Health service area, you may qualify to use Network Extend wrap plan as part of your Network Health Assure plan. The Network Extend wrap plan allows out-of-area members to use participating health care facilities in their area at an in-network benefit level. To find a participating provider, go to myfirsthealth.com and enter your zip code to get started. The Network Extend wrap plan requires the following.

  • A minimum of 80 percent of enrolled employees must reside in Network Health’s service area.
  • A minimum of 90 percent of enrolled employees must reside in Wisconsin.
  •  A maximum of 5 percent of enrolled employees may reside in a single state other than Wisconsin.

Network Extend requires approval for participation. Talk to your agent for more information. If you don’t have an agent, call 920-720-1250.

 

Want more information?

Download our Assure plan guide by completing the form below.

Loading...