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Life & Health Insurance/corporate health insurance


I work for a company that has a little over 1000 employees. I'm curious. Compared to the normal individual health insurance market rate, how do corporate rates compare? Like, what kind of a percentage might a corporation that size get as a premium versus me getting it myself?

Hello, Victor:

For a number of reasons your question is very tough to answer, there are many variables involved.

The vast majority of large companies are self-insured, using a TPA, (Third Party Administrator,) to process claims, billing, etc. The TPA can be a well known insurer such as Humana, United Health, or Blue Cross. The employee receives an ID card with the insurer's name on it just like anyone enrolled in a typical group plan, but the party responsible for paying the large claims is the employer, not the insurer.

Self-insured plans are not subject to the Affordable Care Act's regulations, as are individual and fully insured group plans, therefore their employee cost may be considerably lower than a typical individual or group plan. (Due to the ACA there is not much difference in benefit coverage between an individual or group plan. The same 10 essential benefits must be covered on both types of plans, neither can deny coverage based on pre-existing conditions, and therefore their costs will be similar.# Self-insured plans decide what is and is not covered. As an example, an ACA plan must cover pediatric dental and, "free," physicals, a self-insured plan may choose not to offer such benefits, hence a lower premium. MLR, #Medical Loss Ratio,) also comes into play regarding fully insured plans, not so with self-insured policies. The ACA requires insurers to keep their overhead at 15% or below on group plans, and the difference in premium amount between young and old cannot be larger than a multiple of three. Before the ACA it was typically five or six. This has forced insurers to charge much more for young policyholder's. Self-insured plans don't have to deal with any of this, again lowering the cost of self-insured plans in most cases.

Self-insured plans will only grow in popularity over the next few years as more and more companies attempt to control health insurance premium costs. And self-insured plans are not just for the large employer any longer, many small employer groups now have them. Premiums increased, on average, 56% this year on fully insured plans, and a report by yesterday stated that they will likely double next year, tripling in certain areas.

However you slice it, whether insured individually, on a small or large group fully insured plan, or a self-insured plan, health insurance premiums will be much higher than before the ACA unfortunately, unless major changes are made to the law.

Hope this helps.

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Michael Higgins


All questions pertaining to health insurance, whether group, individual/family, student, child-only, COBRA, HIPAA, Portability, dental. No expert knowledge in areas such as life insurance, disability, workman's compensation, auto, etc.


34 years as owner of health insurance agency, primarily dealing with Blue Cross Blue Shield of Arizona.

College, Business Administration.

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