A Mid Year Health Insurance Update
September is mid-year for our healthcare plan. We are fully insured with United Health Care (UHC). We moved to a fully-insured plan two years ago after many years of more-or-less paying our own medical claims. In being quasi "self-insured" we saved the cost of insurance, paying only actual claims and administrative fees (about 16% of annual cost). The bad news was that we were on the hook for almost all the medical expense. This program lost us money for years, as an employee group this small cannot spread the risk over a large enough group of people to absorb a catastrophic health claim such as might arise from a terminal cancer, severe auto accident, or heart surgery. With the move to full insurance, we track financial performance through "claims to premium" ratio. This is short-hand for how much in medical claims UHC pays as a percentage of the monthly premium we pay them. At mid-year, our paid claims were 81% of our premium. Add to that about 16% administrative ...