Hausmann Group March 11, 2025 2 min read

Group Health Plan Funding Options - Definitions

ICHRA (Individual Coverage Health Reimbursement Arrangement)- allows employers to reimburse employees for individual health insurance premiums and qualified medical expenses using pre-tax dollars.
Fully Insured - employer pays fixed premiums to an insurance company, which then assumes the responsibility for covering employees' medical claims.
HSA (Health Savings Account) - a tax-advantaged savings account designed to help individuals save for medical expenses.
HRA (Health Reimbursement Arrangement) - an employer-funded plan that reimburses employees for qualified medical expenses and, in some cases, insurance premiums.
Level Funded - combines elements of both fully insured and self-funded plans.
Captive - a group of companies pool their resources to self-insure their employees' healthcare costs.
Bundled Self-Funded - an employer partners with a single vendor to provide a comprehensive package of services, including claims administration, stop-loss insurance, and network access.
Unbundled Self-Funded - an employer separately contracts with multiple vendors for different components of the plan, such as claims administration, stop-loss insurance, and network access.
Fully Self-Funded (with no specific or aggregate stop-loss insurance) - the employer assumes the entire financial risk for their employees' healthcare costs without any insurance to cap or limit those costs.
Reference-Based Pricing - reimbursement rates for medical services are based on a specific reference point, such as Medicare rates, rather than the provider's billed charges.

Hausmann Group

Group Health Plan Funding Options - Definitions

Hausmann Group

COMMENTS

RELATED ARTICLES

HSA and HDHP Plans Are Common Practice, But Why?

Proposed Rule on Health Care Transparency to Affect Some Employer Plans

Attestations for Gag Clause Prohibition Compliance Due by December 31, 2024