A fully insured plan is the traditional arrangement: your business pays a fixed monthly premium, and the insurance carrier takes on all of the claims risk. If your employees have an expensive year, that is the carrier problem, not yours. It is the simplest structure to administer and the most common choice for small Oklahoma employers.
How It Works
You pay a set premium per employee per month. The carrier collects those premiums, pays the claims, and keeps or loses the difference. Your rate is set at renewal based on the filed rates and your group demographics, and it does not move mid-year no matter what your claims do.
Where It Wins
- Predictable budgeting. One fixed number per month for the whole plan year. No surprise claim months.
- No claims exposure. A single catastrophic claim does not touch your cash flow.
- Minimal administration. The carrier handles claims, compliance, and reporting. There is no stop-loss contract to manage.
- No underwriting surprises. Small group fully insured plans are community-rated, so an employee health condition cannot spike your rate.
Where It Costs You
- No refund for a good year. If your group barely uses the plan, the carrier keeps the margin. You never see it back.
- Less pricing leverage. A young, healthy group subsidizes the broader risk pool rather than being rewarded for its own experience.
- Limited plan design flexibility. You choose from the filed plan menu rather than building around your workforce.
If your group is young and healthy, fully insured is often the more expensive choice over a multi-year window - which is exactly the case where level funding is worth pricing.
Get Your Group Priced Both Ways
Compare Funding Models for Your Group
Send us your employee census and we will price it across the Oklahoma carriers under each funding model, so you can see the actual difference for your group rather than a rule of thumb. No fee to your business.
Or call (855) 847-7020 and we will run it with you.