Health Group Insurance
Optimyl Benefits is changing the way small businesses experience their health insurance by using bold ideas, data-driven technology, and a laser focus on customer service.
We offer a compelling health insurance group plan that we believe would greatly benefit your business!
Specialists in providing medical and dental level-funded solutions to employers with 2 to 300 employees.
If your group is fairly clean throughout the year there is an opportunity to earn a return of surplus!
How Level-Funding Works
Level-funded products help solve many of the historical complaints of small employers purchasing fully insured coverage.
With fully insured products, employers have low levels of:
- Transparency
- Flexibility
Any profits created when claims are low are kept by the insurance company.
Level-funding works differently:
- As a self-funding arrangement, claims are paid directly from your claims account and unused amounts are eligible to be refunded to you.
Stop loss insurance is included in the package to help protect you:
- From large claims
- Keep cash flow predictable.
If claims exceed your claims account funding at any point in the year:
- stop loss will advance funds into your account.
Regardless of the level or timing of claims:
- Your monthly bill will remain one level payment that does not change during the year.
- The primary cash flow risk is whether or not you will get a refund.
What do you think?
- Do you currently have insurance benefits for your business?
- Do you have affordable coverage which does not sacrifice your employee’s needs?
- Did you know there is a potential of having a return of surplus for unused premiums?
What makes US unique
Savings
Delivering significant savings to the right clients via a lower monthly bill as well as the potential for a refund of unused claim funds on the back end.
Transparency
Helping employers understand plan performance, including insight into Rx rebates, and guiding members through technology and rewards to lower cost, higher quality providers.
White Glove Service
Providing top tier service both pre-sale and post-Sale with dedicated support.
Plan Flexibility
Offering customizable benefit designs while keeping administration simple with a one-stop-shop package.
Network Flexibility
From PPO to EPO, broad to narrow, RBP and RBP hybrid options.
Tech Flexibility
Offering proprietary online tools but willing to work with third party tools or paper.
Under a level-funded product, your monthly bill will include three components
Claims Account Funding
This is your money and these amounts prefund your maximum claims exposure for the year in monthly 1/12 increments. At the end of the year, depending on the option you select, you could receive 50-100% of the remaining unused funds after the claim’s runout period.
Stop Loss Premiums
Premiums are paid to the stop loss carrier in exchange for protection from Claims above expected and provide the coverage that puts the “level” in level-funding.
Administrative Fees
These amounts pay for the ongoing admin- istration of your plan, Including customer service, claims adjudication, reporting, network access, and broker fees.