Funding Arrangements

There are three ways that you can fund your Medical, Dental, or Disability program:

FULLY-FUNDED

Costs for your medical plan are paid monthly to one insurance carrier. The costs are determined prior to your open enrollment period, and remain in force for 12 months. You pay each invoice in full, adjusting it for new hires and terminations. At year end you get a renewal notice, and rates are set for another 12 months.

PARTIALLY SELF-FUNDED

You continue to pay a monthly cost to ONE insurance carrier, but under this type of funding, you issue two checks a month. The first check is for the cost of administering and paying your claims; and the second check is for the cost of your claims.

This is a popular approach because it allows companies to be rated based on their actual claims usage, and not on a “pooled approach”. They believe with a proper medical plan design, a highly discounted provider network, competitive reinsurance, and a reasonable administration fee, their costs will be at least 20% lower than a Fully-Funded approach as long as the health of their employees is good. As in Fully-Funded, employees carry but one I.D. Card, in the name of the insurance carrier.

Corporations of all sizes have been successful in using a Partially Self-Funded approach, some with less than 100 employees, others over 500 employees.

FULLY SELF-FUNDED

Under this approach, Modern Concepts designs an ERISA qualified medical plan that fits your needs, and contracts with the insurance vendors that make it work to perfection. Operating at optimum efficiency, the cost can be 30-50% lower than the marketplace. The only risk is fluctuations in claims usage that can affect your cash flow. But even this can be remedied through special reinsurance contracts.

Corporations with 300 to 5,000 employees normally favor this approach in funding their medical plans. The profit margin of the insurance carrier is removed, retention costs are the lowest possible, administration and reinsurance costs have been negotiated to the bone, (much lower than most carriers can offer), claims cost have been severely discounted through the use of special national provider networks, large claims are protected by utilization review and reinsurance limits, and prescription drugs are purchased at wholesale levels directly from the manufacturer.

When Modern Concepts puts all the pieces together and knits a perfectly designed and administered Self-Funded medical plan, it is not unusual to see costs 30-50% below the market.

Modern Concepts assembles the following insurance providers to create a Fully Self-Funded medical plan: - A+ rated Reinsurance Carrier - Utilization/Large Case Review - Third Party Administrator (TPA) - National Provider Network(s) - Wholesale Drug Vendor - COBRA/HIPAA Administrator - Custom ERISA qualified & cutting edge designed medical/dental plan documents

Modern Concepts creates a custom medical plan that fits your needs, works with ERISA Attorneys, and Administrators to verify its coverage and compliance with state and federal statues, and uses a team of bilingual enrollers to help you implement this plan with your employees. The document itself is a thing of beauty, with a benefit design that will guarantee claims usage that will be less costly than any other form of medical/dental insurance.

You and your clients are protected against catastrophic claims in excess of ,000-5,000 (depending on your company’s size), and claims in total aggregate. Your claims are discounted tremendously, Rx is at wholesale prices, and the TPA pays the claims like clockwork on a weekly, bi-weekly, or monthly basis (your choice). You are billed for actual claims usage on a monthly basis from a Zero Balance Bank Account. All plan components are welded together like a clock, manifesting in low costs and a happy labor force. You will receive only two bills a month for fixed costs and claim costs.

To date, Modern Concepts has helped dozens of mid size and large companies save MILLIONS of dollars through the use of Self-Funded Medical Plans, in all types of industries, and in locations throughout the entire USA.

Why not let Modern Concepts analyze your medical plan, and help you decide if an alternative funding arrangement could be in your best interest.

You can be leaving cash on the table and not even know it.