How USA Business Choice WorksReduce costs while providing affordable protection
How USA Business Choice Works
USA Business Choice is a flexible self-funded approach to a powerful, yet practical alternative to fully-insured arrangements.
USA Business Choice allows you to successfully manage the rising costs of a fully-insured health plan and rewards your business for its good claim experience and demographics. We can reduce costs while providing affordable protection from high dollar claims, avoiding excess costs and regulation.
A portion of each Health Plan Funding Dollar goes into your Claim Fund Account (an interest–bearing trust checking account used to pay claims for your health plan).
The claims administrator pays medical providers on your behalf from your Claim Fund Account – any interest earned on the account balance remains in the account to help pay claims.
If a positive balance remains in your Claim Fund Account at the end of the plan year, after all covered claims are processed, the remaining dollars may be applied toward future expenses of the plan or returned to the Plan for the benefit of employees.
A portion of your Health Plan Funding Dollars goes toward claim administration, insurance premium to pay for excess loss claims coverage, utilization & medical management, and other plan expenses.
If your eligible paid claims exceed the agreed upon specific and aggregate thresholds, the insurance company will reimburse you directly or by depositing the money into your Claim Fund Account. Monthly and annual reports show you exactly where claim money for health benefits is applied. By using the reports and taking advantage of our expertise, you can confidently manage your plan without compromising your employee’s satisfaction.
Information and Materials Needed for Groups With Less Than 100 Lives
- Broker name, firm name, address, e-mail, phone number
- Current census including name, date of birth or age, gender, coverage type (single/family) and location. Preferably e-mailed in Excel format.
- Current schedule(s) of benefits including any anticipated changes
- Current contract details including rates and factors, plus any renewal information available
- Most recent renewal
- Preferred PPO network(s) – major carrier networks are available – just inquire
- A complete Group Disclosure Statement signed by Officer of Company
- Proposals will likely be subject to Individual Risk Questionnaires and Underwriter approval