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We offer different self-funded plans based on the number of enrolled subscribers — from 10 to more than 250. Find the plan that’s right for your company.
Options for smaller businesses – for companies with 10 – 99 enrolled subscribers
Our specific/aggregate level-funded product provides protection against unexpected claims and allows a small business like yours to enjoy the benefit of paying pre-set monthly payments, similar to a fully-insured plan. Clients can receive a refund of 50% of the surplus that may remain at the end of the plan year.
Monthly accommodation – for companies with 100 – 250 enrolled subscribers
This allows the business to pay its own claims. However, your business is capped at a monthly claims target. Any claims that exceed the target are immediately reimbursed by the stop-loss policy. Otherwise, your business simply pays claims under the targeted projection.
Traditional self-funded plans – for companies with 250+ enrolled subscribers
Traditional self-funded plans include third party administration and stop-loss protection.
Self-funded Administrative Service Option – for companies with 51+ enrolled subscribers. Better suited for companies with 100+ enrollees due to greater risk
The ASO model allows organizations to choose between an all-in product and a base model with the option to add needed services and solutions.
- Low-cost base medical fee: Will include essential core services such as enrollment, claims processing, customer service and standard reporting.
- Buy-ups: Will all be optional such as Teladoc, claims fiduciary, maternity management program, biometrics screenings and additional wellness services.
- Operational flexibility: Allow for carve-outs for Rx and stop-loss. Size restrictions and fees apply.
- Stop-loss option: Protects clients from the risk of high-cost catastrophic claims through stop-loss coverage.
- Expanded in-network coverage: Members can choose any Geisinger Health Plan or First Health Network provider, regardless of location, to receive care and claims will be covered in network.
- Proof of savings: Our new claims repricer tool takes your detailed claims file for the past year and reprices the claims as if we were the carrier to show how much you’ll save.
Why choose Geisinger Health Plan?
Tradition of excellence
- Providing quality, affordable health insurance since 1985
Providers and care locations
- More than 33,000 primary care and specialty physicians
- Over 120 hospitals
- Includes Geisinger hospitals, Hershey Medical Center, Johns Hopkins and Children’s Hospital of Philadelphia
- 130 urgent and convenience care locations
- Over 3,000 pharmacies
Health and wellness programsWellness programs are extremely important in promoting healthy lifestyles, especially when a company is paying for claims directly. We can assist by evaluating your population, making recommendations and offering solutions on programs best suited for your group.
Our self-funded options are available to companies located across the state of Pennsylvania.
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