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Medical Insurance Funding Options
Medical Insurance Funding Options | Funding Options |
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| Company / Group - Medical Insurance | ||
 Insurer’s state that the vast majority of claims are inevitably out-patient and under a £1,000 each claim; it is simply the sheer volume of claims which insurers are finding difficult to manage in some areas. Coupled with excessive overheads and administrative burdens, some insurers prefer to let the member to negotiate on their behalf and simply reimbursed the employee or company once the claim has been finalised. This approach is fine for some companies, but many employees do not want or need to be making arrangements when feeling ill.Other alternatives include Hospital Treatment Plans which provide a cash sum dependant on the severity of the operation required. Based upon national OPCS codes, they aim to provide enough 'cash' for the employee to either self-fund the operation and retain the balance or let the insurer make the arrangements up to the limits set. Should a claim exceed the benefit, the employee will either have to fun the remaining balance or do so in conjunction with their employer. An advantage of this approach is when an individual is prepared to venture further a field to secure competitive pricing, such as Holland, Belgium and France. Because the insurer’s risk is capped, they are able to manage the book of business more effectively, thereby reducing future increases substantially.
The larger employer could consider taking their healthcare out of insurance completely and use alternative methods to fund their employee healthcare needs. A growing market is emerging in providing employers with this facility, this idea is far from new and has been utilised extensively in the USA where healthcare costs are seen as spiralling out of control in some states.
The self-fund proposition is only as strong as the company administering the scheme and can prove problematic, especially where management is sloppy and uncontrolled. However, if a trust fund is managed well, it will provide a cost effective alternative for many years. |
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