PreferredOne Simplicity™ FAQ
Question 1
What percentage of the unused claims fund does PreferredOne pay your company back?
Answer: 100%. It's your company's money. You SHOULD get back any unused portion that PreferredOne Simplicity does not pay out in claims. PreferredOne does not keep any of the unused claims fund. We charge for the administration of the plan (claims processing, enrollment, reporting, customer service), stop loss premiums and taxes.
Question 2
How many covered employees does a company need to be eligible for PreferredOne Simplicity?
Answer: 25 covered employees or 50 members. PreferredOne Simpicity is designed for small to medium-sized companies who are looking for a way to save without the risk and peaks and valleys of a traditional self-insured plan. With PreferredOne Simplicity the monthly rate will remain the same with the opportunity to get money back.
Question 3
What percent of companies, with PreferredOne Simplicity, are currently getting part of their claims fund returned?
Answer: 70%. Based on our current PreferredOne Simplicity block of business, 70% are getting money back.
Question 4
With PreferredOne Simplicity are there any hidden financial risks if my company experiences a big claim of high overall utilization?
Answer: No additional risks. Simplicity includes stop loss insurance to eliminate your company's financial risk for a high individual claim (specific stop loss) and overall high utilization (aggregate stop loss). Your company is only responsible for the monthly rate that is established at the effective or renewal date.
Question 5
Would the company ever pay more than the rate quoted during the plan year?
Answer: No. The monthly rate is capped at the established monthly rate.
Question 6
Will employees see any difference in their health plan (benefits and provider networks)?
Answer: No. Since PreferredOne is a way to fund claims it does not have any impact on the benefits or coverage offered to employees of the provider network.
Find out More
Contact your broker or PreferredOne representative and get the details. If you do not have a PreferredOne representative you can reachus at 763.847.3022 and/or 855.405.9219.
PreferredOne Simplicity is a self insured product. Administrative services are provided by PreferredOne Administrative Services.