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UPMC Self Assure Level Funding

A self-funded quality health plan in which your company funds any claims.
Greater transparency through reporting.
Financial predictability—aggregate stop loss insurance coverage limits your company's liability due to overall claim fluctuation.
A third party administration agreement.

Overview

Like any good employer, we know that you want to provide quality health care benefits for your employees. Yet you also need to contain costs. We’re here to help! UPMC Self Assure with level funding and aggregate stop loss coverage gives you the best of both worlds—the advantages of being self-insured without the unpredictable costs. You also get all the services that come with membership in UPMC Health Plan—access to all our providers and facilities at discounted rates, health and wellness programs, medical management, and outstanding customer service.

Eligible Groups

All our plan designs are available as self-funded or fully insured.

Level funding is available to employers with as few as 25 employees as well as mid-size and large employer groups. Traditional self-funding is available to employers with 51 or more employees.

UPMC Self-Funded Options

Offering health insurance to your employees is an important part of your business. It helps you attract the best talent, inspires loyalty from your current employees, and helps your workforce stay healthy and productive. Self-funding arrangements are plans that provide opportunities for savings along with transparency through reporting.

Health Plan offers two approaches to help manage a self-funded plan:

  • Administrator Services Only (ASO): The self-funded client, you, pay an ASO fee to UPMC Health Plan to administer your claims for you. You will be billed for any claims incurred based on your benefit selection.
  • Stop Loss Coverage: UPMC Health Plan provides catastrophic coverage for your business, protecting you from large, unpredictable claims.

Advantages of self-funding:

  • Lower operating costs
  • ACA Premium tax reduction
  • Improved cash flow
  • Access to utilization data
  • Ability to avoid certain benefit mandates

When you choose UPMC for funding arrangements for your business, we will manage your health care dollars as carefully as we do when our own money is at risk. We monitor all aspects of the health care process, starting with the initial claim to potential high payouts. Along the way we have procedures in place to control costs while ensuring that your employees get the best care possible.

Self Assure Level Funding is UPMC Health Plan’s solution for smaller employers that want the benefits of self-funding, but predictability as well.

Self Assure Level Funding is an ASO arrangement with built-in stop loss coverage that allows UPMC Health Plan to add a stable monthly payment for you while still offering many of the advantages of traditional self-funding. Also, Self Assure Level Funding provides you with the opportunity for a refund if you perform better than expected.

To learn more about UPMC Health Plan’s self-funding arrangements for your business, call your sales agent or UPMC Health Plan Sales Support today at 1-855-862-6515.



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