Fully Insured Financing Option

For employers of all sizes

Fully insured financing is the traditional way to finance your group’s health care. Being fully insured means that Wellmark Blue Cross and Blue Shield processes and pays claims for your covered individual members according to the terms of the benefit options you chose. Each month, you pay a premium amount based on your projected claims experience and operating costs.

Operating costs include:

• Costs of processing and paying claims
• Providing benefit management services
• Providing access to Wellmark Blue Cross and Blue Shield’s network
• Executing coordination of benefit provisions
• Large claims pooling charges
• Premium tax

Advantages of Fully Insured

• Allows you to manage your cash flow because you pay a predictable premium rate each month during the contract period
• Wellmark Blue Cross and Blue Shield absorbs all losses
• Wellmark Blue Cross and Blue Shield is responsible for claims reserve
• Your group has no liability in the event of termination
• Wellmark Blue Cross and Blue Shield assumes the total liability regardless of your group’s actual claims experience
• Individual claims that exceed a predetermined amount are pooled with the large claims of all other fully insured groups

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Wellmark Blue Cross and Blue Shield is an Independent Licensee of the Blue Cross and Blue Shield Association doing business in Iowa and South Dakota. Blue Cross®, Blue Shield®, and the Cross® and Shield® symbols are registered marks of the Blue Cross and Blue Shield Association, an Association of Independent Blue Cross and Blue Shield Plans.