Kaiser Permanente offers a range of funding options to meet your clients’ needs. Regardless of which solution they choose, they’ll enjoy coordinated, cost-effective care that focuses on better health outcomes for their employees.
We can help your clients create a health care solution based on their needs and overall benefit strategy. Employers can choose from several options.
Predictable costs with less risk
With our fully insured plans, large groups get the financial security of a set monthly rate and Kaiser Permanente assumes the financial risk. The monthly premiums are established before each contract period and protect employers from unexpected claims costs. This makes financial planning easier, since they won’t need to cover large fluctuations in their health care costs.
Opportunity for surplus sharing
Kaiser Permanente’s risk sharing arrangements offer employers the opportunity to benefit from surplus sharing through lower health care use, plus the peace of mind that comes with a fully insured plan. Employers can benefit from favorable claims without taking on the full risk of their health care costs. Your clients will pay a predictable premium each month, while selecting the amount of financial risk they’re willing to take above and below that total monthly amount (their risk sharing corridor). At the end of the year, their total costs are reconciled against their total earned premium, based on the details of each employers’ arrangement. They may receive a surplus if their plan performance is better than expected. In the event of a deficit, the customer may owe Kaiser Permanente within the agreed upon shared risk.
For groups with fewer than 1,000 enrolled members, Kaiser Permanente offers a Surplus Only option. With this option, if your client’s total expenses for the year are less than their total premium, they may be eligible to share in a portion of the surplus.
Full responsibility for plan and costs
Improved cash flow and flexibility aren’t mutually exclusive. Self-funding makes it easy to create a benefits package that meets your client’s needs. With this option, your client assumes financial risk and has more flexibility around benefit design to control claims costs. This option also offers streamlined administration, the expertise of a knowledgeable third-party administrator, and transparent, in-depth reports that help your clients understand their employees’ health care costs.
Encourage your clients to ask for information about all the funding options we offer and what’s available to them. If you have more questions, please contact your Kaiser Permanente representative.
1Fully insured commercial coverage provided by or through Kaiser Foundation Health Plan, Inc., its regional health plan subsidiaries, Kaiser Permanente Insurance Company, or Kaiser Foundation Health Plan of Washington Options, Inc.
2Health benefits are self-insured by the employer, union, or plan sponsor. Kaiser Foundation Health Plan of Washington, Kaiser Foundation Health Plan of Washington Options, Inc., and Kaiser Permanente Insurance Company (KPIC) provide certain administrative services for the plan and are not insurers of the plan or financially liable for its health care benefits.
3Self-funding is not currently offered in the Hawaii region.
