Health Insurance Pools
2015 ACH Schedule (Bill Cycle) - SSC Pool Health Premiums
Service Cooperative Pool Administrative Guide for Employers - updated 3/2014
Suzanne Riley, Executive Director, 507-281-6673, firstname.lastname@example.org
Bill Colopoulos, Health Benefits Consultant, 507-281-6690, email@example.com
Dale Walston, Director of Operations, 507-281-6675, firstname.lastname@example.org
What is an Insurance Pool?
Insurance pools are formed by groups who band together to leverage economies of scale to lower their costs and achieve claim cost stability.
Southeast Service Cooperative administers two pools that are governed by state law and consist of public employers who maintain a Joint Powers Agreement with the Service Cooperative.
The Southeast Service Cooperative manages the pools, collects premiums, conducts a carrier proposal every four years and negotiates stop loss and administrative costs.
How do the Service Cooperative pools stabilize costs?
One way is through statewide price negotiations with insurance companies, healthcare providers and administrators:
· Deeper discounts with healthcare providers.
· Lower administrative and stop loss costs.
· Superior competitive cost structure.
· Consumer-driven healthcare optionsVEBA, HSA.
· Improved prescription drug value.
· Uses best practice health care support services.
· Assistance with worksite wellness initiatives.
· Improved administrative process efficiency.
· Health care quality initiatives.
· Informed and educated consumers.
The Service Cooperative pools provide participating groups and their members the advantage of size and expert management in meeting their health insurance needs. Among the key values are:
Economies of Scale: The Southeast Service Cooperative is one of seven regional Service Cooperatives who leverage their purchasing power statewide to form a single competitive purchasing pool for health benefits administration, high claim protection, and a lower maximum overall risk exposure than other pools.
Regional Claim Pooling: At the regional level, each Service Cooperative reduces the volatility of claim cost fluctuations by managing pools of similar risk groups (schools in one pool, political subdivisions and other governmental entities in another pool).
Stabilization Fund Pooling: While the pools are managed regionally, there is a common method used statewide for ensuring each has a reserve fund that is maintained for the purpose of keeping pool costs as stable as possible. Each pool manages a Rate Stabilization Fund expressly for this purpose. Each participating pool group has a membership interest in this fund.
Group Level Planning Services: The pool provides expert, individualized planning assistance to the local insurance committee to help them assess and implement solutions that will produce better outcomes. The Coop pools also satisfy participating groups bid law requirements; providing full disclosure and price transparency.
Pool Level Planning Services: The regions work individually and cooperatively to research and update best practices and develop strategies that align with them. This process includes direct input and active participation by group representatives in pool planning and decision making.
Leadership Position in Consumer Healthcare: The Service Cooperative pools have led the design and development of consumer healthcare plans for more than five years. These pools and their member groups have implemented more high-value, practical consumer driven plans than the national average of health plans. This has resulted in lower costs for our groups while putting more healthcare dollars into the pockets of VEBA and HSA (health savings account) plan participants.
These key values make the Service Coops not-for-profit insurance pools the best, long term choice for the vast majority of Minnesotas school districts, political subdivisions and governmental entities. The Southeast Service Cooperative manages pools for both schools and government; providing the advantages of pooling for more than 40 groups and 5,000 members.
History of the Insurance Pools
The insurance pools for public schools were developed by Minnesotas network of Service Cooperatives in 1982. In 1993, the Service Cooperative pools became self-insured. In 1995, pooling was extended to Cities, Counties, and Other Government Agencies (CCOGA).
The Service Cooperative health insurance pools have grown voluntarily through a market driven system. We administer contracts for over 600 groups across Minnesota, including small to large groups, covering more than 100,000 people.
Why participate in the insurance pool?
Southeast jointly negotiates with six other Service Cooperatives on behalf of insurance pool participants for:
· Administrative charges and standardized agreements.
· Network arrangements and provider savings.
· Manufacturer drug rebates.
· Stop loss charges.
· Improvements in claims tracking reports.
· Professional health support and self-care education.
This statewide coalition also collaborates in other ways:
· Bid specification development.
· New products and Department of Commerce filings.
· Program audits.
Special features of the Southeast Service Cooperative health insurance pools include:
· Advisory committees consist of pool group representatives and afford participants a voice in program planning.
· The Southeast Service Cooperative staff is local and accessible.
· SSC staff work closely with the carriers local account representative to analyze and advocate your groups needs.
· Group coordinators can receive help from the pool with open enrollment meetings, presentations, and individual consultation.
· Annual renewals are conducted by the pool with the guidance of internal insurance and underwriting expertise.
· Insurance pool members receive free employment law seminars (COBRA, HIPAA, insurance law, pharmacy updates and trends, etc.).
· Groups can access local and regional health promotion (wellness) program development assessment and free resources, including health assessments.