MNLA Member Benefit Affinity Program Affordable Health Plans for the Landscape and Nursery Industry

by Dom Maggiore

Many large employers throughout the country use self-funded health plans to get control of health insurance cost. Now, these types of plans are gaining traction with smaller groups seeking to reduce the cost of health coverage, and with expenses on the rise, it’s time for employers in the landscape and nursery industry to take a closer look at what’s available.

Self-funded health plans used by small groups are usually level-funded which means the employer pays the same amount every month regardless of claims. This approach allows money to build up in the plan’’s claims account while also eliminating the financial ups and downs of monthly healthcare claims. No further payments are required regardless of the cost or number of claims as the plans use stop-loss insurance. If the claims are higher than expected, stop-loss insurance kicks in to make the claim payment.

Potential Refunds

A unique feature of level-funded health plans is the potential for receiving a refund of unused claims funds. The claims fund keeps accumulating and if these funds are not spent, the health plan administrator, known as a TPA (third party administrator), will refund a portion to the employer. Depending on the plan design, the refund can be 50 to 100% of the unspent claims funds.

So, level-funded plans can save money by lowering the cost of the health plan and provide a refund if the claims are less than expected. The expected claims are based on factors such as the age and health risks of the group. Younger groups with active and healthy employees can expect to see the greatest savings and refunds which is why this strategy may be a win-win for our industry.

Allstate Level-Funded Health Plan

After purchasing National General for $4 billion in 2020, Allstate has taken center stage in the health benefits industry by offering level-funded health plans to employers.

In Massachusetts, Allstate level-funded health plans can be established with as few as 2 employees. The plans can include medical networks such as Cigna and Aetna. Lower cost Allstate plans use reference-based pricing, which allows employees to use any hospital or doctor and the plan will pay 140% of Medicare. This approach gives employees the flexibility to use any healthcare provider or facility while giving employers maximum savings..

Allstate has an online portal to check claims, utilization, and watch your money. In an Allstate plan, employers receive 50% of their unspent claims funds back after 12 months. When employees are healthy for the year, the employer saves money instead of increasing profits for health insurance carriers.

There’s more flexibility in level-funded plans offered by Allstate, as employers can cover employees who work 20 hours per week making this a great way to incentivize part-time employees. 1099 and seasonal employees can also be covered, That’s why we think this is a great opportunity for the nursery and landscape industry.

MNLA members can receive a proposal from Allstate in just a few days once they know who is being covered. Dental and vision can be added to the plan making MNLA a convenient, one stop source for all of your health benefit needs.

Please contact Memberly Benefits, MNLA’s broker partner, for questions and quotes. Memberly will collect your employee census and work with Allstate to prepare a customized health plan for your landscape and nursery business.

For Questions and Quotes Contact: Memberly Benefits

Dom Maggiore, President www.memberlybenefits.com

(631) 905-6555 dom.maggiore@memberlybenefits.com

For General Inquires: MNLA

Massachusetts Nursery and Landscape Association, Inc. P.O. Box 387 Conway, MA 01341 413-369-4731 mnlaoffice@aol.com