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Old 09-29-2009, 10:17 AM   #61
scottw
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the HUH? and SO?... the things that you questioned were directly from WIKIPEDIA....I guess they're "incoherent" too....

you don't get it because you are looking at this from...I don't even know where you are anymore...big government statist I suppose

if a large company desides to self-insure through an ASO/TPA they've calculated that they can create their own pool based on a large number of employees to cover incidental healthcare costs with existing premiums pooled and additionally carry a major medical coverage....the payments are made with pool money which is either direct employee contributions or deferred compensation....the employees are still paying for their healthcare....not the company...the company will compensate for overruns through higher employee contributons or higher consumer prices....any insurance or other perks provided to any employee is figured into the compensation package and not simply a lollipop thrown in by the company...and major medical is still run through an insurer....

this was my exact "fix" for healthcare, insure major medical and pay incidentals out of pocket.......although it should be done individually.....it's what I do presently...that would motivate individuals to be more healthy and use the health care system more wisely rather that thinking that their health insurance card is nothing more than a credit card with no pre-set limits....

again...from WIKI

Avoidance of state insurance regulation is one reason for the increase in self insured plans. Since self insured plans does not involve a traditional insurance arrangement between an employer and an insurance company, self insured plans are exempted from many types of state insurance regulations by the federal ERISA statute. For example, state law coverage mandates (e.g., a state law that requires that certain health benefits be covered by insurance contracts, such as fertility treatments) do not apply to self insured plans. In addition, self insured plans can avoid other costs built into traditional health insurance premiums, such as state premium taxes, contributions to the state high-risk insurance pools (if any), and contributions to a health insurance company’s profits and reserves.

Employers that self insure, however, typically do no bear all the risk of a self insured plan. Instead, self insured employers usually buy traditional insurance to cover the risk of very high losses due to large or unexpected health claims by their employees


amazing what you can accomplish when you get governement mandates the hell out of it

Last edited by scottw; 09-29-2009 at 10:22 AM..
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