Tired of increasing Benefit cost even in low claim years? There are options out there.

1. ADMINISTRATIVE TRADITIONAL PLANS
SERVICES ONLY
Employee Claims
$2,000.00
$1,500.00
$1,000.00
$500.00
E1 E2 E3 E4 E5
The employer selects the plan design.
The employer submits deposits which go into a
trust/reserve account. These deposits are always the
property of the employer.
HEALTH SPENDING Deposits are used to pay claims and to purchase
stop loss insurance which covers the employees for
catastrophic claims.
ACCOUNT Stop loss insurance limits are set by the employer.
The employer selects the plan design.
They can range from $1,000-$5,000. The employer pays premiums to the insurance
carrier. These premiums are the property of the
Claims below the stop loss limit are paid from the insurance carrier.
There is no plan design. deposits at an administrative cost of claims plus
The employer always controls budget dollars. 10%. Premiums are used to pay claims. Administrative
costs are 25%-30% above claim payments.
There is no renewal. Claims above the stop loss limit are paid by the
insurance carrier. This protects the employer from Employees are covered for catastrophic health
Employees are empowered. They choose where to paying for catastrophic health claims. claims.
spend their benefit dollars.
Any unused deposits are the property of the There is a plan renewal each year to determine
Once the annual claim dollar maximum per employer. the new premiums. If claims experience is poor,
employee has been reached, the employer’s double digit increases should be expected. If
obligation ends. claims experience is favorable, there is still a rate
Money not spent by the employee is carried RICK MACHTINGER BBA, MBA, CFP increase. Delisting of services and inflation are
given for the reasons. The 25%-30% profit
forward to the next year. CERTIFIED FINANCIAL PLANNER
margin is maintained.
No provision for catastrophic claims, but HSA DESJARDINS FINANCIAL SECURITY
PHONE: 905 707-5795 EXT. 226 Any unused premiums in ‘good’ years remain the
dollars can be used for catastrophic claim coverage.
property of the insurance carrier.
EMAIL: RICK.MACHTINGER@DFSIN.CA