Here’s what every business owner needs to know before you make decisions.
Employees see benefits as part of total compensation. A strong plan keeps you competitive.
Group coverage helps your team access healthcare without overwhelming costs.
Plans often cost as little as 5% of payroll - a small investment with a big return.
Your company’s own claims drive renewals.
Insurer targets a ~70% loss ratio (e.g., $10,000 in premiums = $7,000 in expected claims).
Higher upside if claims are low, more volatility if claims spike.
Allows more plan design levers and cost-control strategies.
Best for: 20+ employees or groups with stable claims who want more control.
Your rates are based on the larger pool of many small employers.
Renewals follow pool averages - steady, predictable changes (often 5-10%).
Simple to run, with fewer moving parts.
Best for: Smaller groups (typically under 20 employees), new plans, or teams that value predictability.
Employer sets an annual allowance; employees claim eligible health/dental expenses.
Pay-as-you-go funding with 15% admin fee per claim.
Cost certainty and flexibility; can stand alone or top-up a pooled/experience-rated plan.
Best for: Companies wanting tight budget control or a flexible complement to a core plan.
Plans require 100% mandatory participation for all eligible employees & their families.
All plans have “reasonable and customary” limits to prevent abuse of the plan.
Plans have a “waiting period”, a length of time that new employees must wait before being enrolled in the plan. (Typically 3 months).
Premiums can be split between the employer and employees (50/50, 75/25, etc). However, the company is required to fund a minimum of 50% of the benefits.
A quick, no-pressure call to review your plan and give you real clarity - no jargon, no pushy sales.