Happy to Help
We are fluent in “insurance jargon” and are skilled at translating it into plain speak. Each business, like each business owner, is unique. Have other questions? We are here as a resource, happy to help.
Overview
Membership.com is an agency formed by a team of insurance professionals who want to change the game. We connect small to medium-sized businesses with affordable, personalized health insurance plans and employee benefits packages that go beyond basic coverage.
We were frustrated by the confusion and complexity of purchasing health insurance and other benefits for our own businesses, as well as the lack of transparency around pricing in the industry as a whole. We partner with your business to make buying health insurance the way it should be:
- Affordable: Level-funded health plans can often mean significant savings for employers and employees. In the last decade, employer sponsored health plan premiums have increased by 51% and the number of firms offering health benefits decreased by 14%.* Level-funded health plans provide rich benefits while lowering costs, which allows more employers to offer health benefits and more employees to enroll.
- Simple: Many employers would like the cost savings of a level-funded plan but don’t want to deal with the complicated process of creating a plan from scratch. We have worked with our carrier partners to offer out-of-the-box solutions for every business. Tell us about your business and needs, and we do the rest. From finding the right plan, to enrollment and ongoing care, we have you covered.
- Transparent: Our clients know exactly how much they expect to pay for their health plan each year. We work with you to understand your costs and plan a holistic benefit package that can lower your costs long term.
- Customized: We customize benefit solutions to your needs and budget.
*Source: Kaiser Family Foundation 2020 Employer Health Benefits Survey
It starts with a conversation. We want to get to know you and your business so that we can partner with you to create a plan that is best for your needs. We can compare coverage and costs of traditional major medical plans, level-funding plans and ACA compliant care plans for hourly employees, partnering plans to accommodate your whole team. If we are the best fit, we would love to work with you. If not, we are happy to refer you to another trusted partner.
Your Membership.com Benefit Partner will work with you to complete everything necessary for enrollment. After enrollment, your dedicated Member Services Associate will take care of any day-to-day needs. Our clients have direct access to their Membership.com Team.
Employers
- Level-funding is a way to pay for a self-insured plan, but with a stable monthly payment and coverage on the risk of catastrophic claims. Unlike a traditional fully-insured plan that charges high premiums regardless of claims, level- and self-funded plans allow you to pay for only the healthcare that you use. This can result in significant savings.
- Level-funding gives employers a stable monthly payment, unlike self-funding plans. You will have a fixed payment billed monthly and will never be asked to pay more than that amount. If claims are high, stop-loss insurance kicks in and pays the difference. If claims are low, you will get a refund at the end of the plan year. Membership.com only works with carriers that provide a 100% refund of unused claims dollars.
You only need 2 employees to qualify for some Membership.com plans. Minimum group size varies between plans, contact us today so that we can connect you with the right plan for your group.
With a fully insured plan, the employer pays a fixed amount each month (the premium) to the carrier to pay for the costs of employee healthcare. The carrier assumes all of the risk and the employer has the benefit of knowing exactly how much the plan will cost. The employer has no way to know how much of the premium paid to the carrier was spent on actual claims. If employees don’t use much healthcare, the employer has spent a lot of money and doesn’t get anything back. At Membership.com, we call this the black hole of premium.
Self-funding is where the employer pays the full costs of employee healthcare rather than paying premium for a traditional fully-insured plan. This means the employer pays the healthcare provider directly for any employee claims. Very large employers can save significantly on benefit costs by switching to a self-funded plan because self-funded plans pay for only the care that is used. For smaller companies, the instability of claims and risk of high claims that comes with self-funding outweigh the benefits. Some months could bring minimal medical bills, but the employer is unprotected from a big event. Level-funding allows smaller employers to self-fund without these risks.
- For groups with low health risks, level-funding saves employers because you are paying for the healthcare that you and your employees actually use.
- For underwritten level-funded plans, your price is based on the health conditions of your team. Fully-insured plans are priced using a “community rating” of all covered employees your entire geographical area. This means you can see a large premium increase even if the claims for your employees are low. Depending on how accurate your current pricing is, quoting based on your employees only can save some groups a lot of money.
- Level-funded plans are a form of self-funding and don’t have to pay certain federal and state taxes that apply to fully-insured plans.
Stop-loss is a type of insurance that protects against very high claims. It kicks in to pay the excess if claims exceed what is expected.
The employer can choose if part-time employees are eligible to participate in the group’s health plan. Membership.com has solutions for employers needing a plan especially suited to part-time employees.
Usually not, but some carriers offer flexibility on this issue. Membership.com has solutions for 1099 groups.
Did you find us after receiving an especially large increase at renewal time? Many of our clients did. Insurance carriers use “community rating” to set premium prices in a geographical area. One of the benefits of level funding is that your group is quoted based on the claims of YOUR employees. Groups with fewer health risks can see significantly reduced costs. Employers can further reduce costs through wellness programs and other initiatives. While we can’t guarantee you will never see an increase at renewal, we can guarantee that you will be able to understand why a rate has gone up, and partner with you to design benefit programs that work to lower your costs.
No, Membership.com is only able to offer health insurance to employer groups.