A modified self-funded pool has a particular advantage in light of current Affordable Care Act requirements and includes advantages from both modified self-funded and fully insured plans. This option allows the employer to decide on a benefit plan and then the group pays a fixed premium and if claims are lower than expected then a portion of the claims funding will be refunded to the group.

Under the Credit Union Employee Healthcare Pool, groups will be able to have rates based on their particular demographics and claims experience rather than the over state (community rating) average.

Estimates vary, but small group fully-insured premiums could increase by as much as 50%. Self-funded groups can avoid much of these increases and can save as much as $10 per member per month in just fees and taxes.

A great advantage for participating in the pool is that credit union groups will have the opportunity to assist in the management of their plans, including reviewing claims experience and utilization patterns and suggest plan design changes.

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