Highmark offers two primary funding options for our commercial group health plans: fully insured coverage and self-funded, or administrative services only (ASO), plans. We can work with you to identify the best option for your organization’s needs. Both offer strong benefits for your organization.
With fully insured coverage, your company makes a regular monthly payment to Highmark. You enjoy the benefit of our provider negotiated rates and pay a fixed rate (premium) throughout the contract period, based on the number of employees enrolled and type of policy.
This type of coverage is prospectively rated, meaning the rates are based on your organization's past claims experience projected into the future contract or policy year.
With fully insuraced coverage:
Based on how employees fill out their wellness profile, we provide personalized outreach through our health coaches. Together, we can lower risk for illnesses, better manage health conditions, provide extensive support for complex health problems, and change unhealthy habits. Our health coaches work with your employees to:
With self-funded plans, also called administrative services only (ASO) plans, Highmark acts as a third-party claims administrator (TPA) for the group’s health benefit plan.
With self-insured coverage:
For more information on ASO coverage options, contact your broker or a Highmark representative today.
Help your employees take advantage of all their health plan has to offer, including our member portal, online tools, and member discounts.