Funding Solutions for Health Plans
Explore funding options designed to help employers manage health plan costs, cash flow, and financial risk.
Offered by Cigna Health and Life Insurance Company
How Employer Health Plan Funding Works
Health plan funding determines how an employer pays plan costs and employee health claims. Cigna Healthcare® offers funding options designed to support different budget, cash flow, and risk-management needs.
These solutions help employers:
- Manage financial risk and cash flow based on the funding option selected.
- Offer payment options to help achieve immediate and sustainable cost savings.
- Drive additional savings when health and wellness programs are successful.
- Support informed plan design decisions to improve affordability.
- Help maximize savings when paired with integrated products.
Insured and Self-Funded Health Plan Solutions
The two main funding categories are insured and self-funded. Available solutions vary by employer size, health plan type, and location. Consult your broker or Cigna Healthcare representative for availability.
Insured Funding Solutions
In insured funding solutions, employers can purchase insurance that covers claims and other expenses. Employers pay a premium and the insurer covers eligible claims according to the policy terms. Cigna Healthcare offers multiple insured funding solutions based on an insurance policy.
Self-Funding Solutions
With self-funded solutions, employers pay an administrator to manage the plan while the employer funds claim expenses from their own bank accounts. Cigna Healthcare offers three self-funded solutions based on an Administrative Services Only (ASO) contract.
Compare Cigna Healthcare Funding Solutions
Review insured and self-funded options by eligible employer size, claims-surplus treatment, protection level, and monthly payment structure.
Insured | Self-Funded | ||||
|---|---|---|---|---|---|
Fully Insured | Fully Insured Plus | Cigna Level Funding® | Cigna Healthcare ASO Plus | ASO | |
| % share of claims surplus | 0% | 50% with renewal | 50% and 67% with renewal | 100%; Real time | 100%; Real time |
| Required eligible employees1 | 51+ | 51+ | 25-999 | 25-999 | 200+ |
| Level of protection | Full insurance protection | Full insurance protection | Integrated stop loss | Integrated stop loss | Optional stop loss protection |
| Fixed monthly payment | Premium | Premium | Admin fees, stop loss premium and claim funding | Admin fees and stop loss premium | Admin fees and stop loss premium |
| Variable monthly payment | N/A | N/A | N/A | Claims up to stop loss levels | Claims2 |
1 In most states, Cigna Healthcare offers group insurance coverage to employers with more than 50 full-time employees, as well as administrative services for self-funded plans with as few as 25 full-time employees. Product availability may vary by plan type, group size and location, and is subject to change.
2 Employer funds all claims and is reimbursed by Cigna Healthcare for claims above maximum liability.
What to Consider When Choosing a Funding Option
The appropriate funding option for your business depends on factors such as employer size, budget requirements, cash flow, claims responsibility, and preferred level of financial protection. Your broker or Cigna Healthcare representative can help explain available options and plan requirements.
View Cigna Healthcare Company Names
Product availability may vary by location, group size and plan type and is subject to change. All group health insurance policies, stop-loss insurance policies and health benefit plans contain exclusions and limitations. For costs and details of coverage, contact a Cigna Healthcare representative.
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