Receive a refund when your claims and fees are less than your premiums
The total amount you pay to get health benefits.
Your employee claims (dentists, prescriptions, massages etc) and our fees.
Since premiums were higher than claims & fees, you would be entitled to a refund.
If your claims and fees are more than your premiums, your deficit is covered by the Co-operative, not you.
Your premium is total amount you pay to get health benefits.
In this scenario, your employees claimed higher than normal health expenses.
Employers are not required to pay out of pocket. This deficit is forgiven by the Co-operative.
Here's how our refund model works - receive a refund when your claims and fees are less than your premiums.
The total amount you pay to get health benefits.
Employee claims (dentists, prescriptions, massages etc) and our fees.
Since premiums were higher than claims & fees, you would be entitled to a refund.
If your claims and fees are more than your premiums, your deficit
is covered by the Co-operative, not you.
Your premium is total amount you pay to get health benefits.
In this scenario, your employees claimed higher than normal health expenses.
Employers are not required to pay out of pocket. This deficit is forgiven by the Co-operative.
Nick Moschella
George Zeni
Put simply, if members used less than what they contributed, they are entitled to a refund. If they used more than their contribution, the loss is covered by the co-operative's central pool of funds.
of refunds given back since 2000
of members receive a refund every year, on average
of group premiums are refunded every year, on average
Beneplan customers received an average of $4,920 in refunds in 2022.
FREQUENTLY ASKED
FREQUENTLY ASKED
As a co-operative, our goal is to maximize the well being of our members and not the bottom line. Our Third Party Administrator, Beneplan Inc. manages the day to day operations of the co-operative (service, underwrite, market etc.) for which it charges standard admin fees.
No, we price your premiums based on your claims experience. Our goal is not to produce a refund, the goal is simply to provide you with the lowest possible rate. The refund is an added bonus should your claims & expenses be less than your premiums.
No! Deficits are absorbed and paid for by the co-operative. This is achieved by taking small amounts from other members in the co-operative who had surpluses that year.
Rates are always based on claims experience, therefore a rate increase could happen but not to recoup the deficit but rather to properly fund the expected claims for the upcoming year.
Most employers realize that even though they may have surpluses year over year, deficits can occur at any time and this is why sharing their surpluses is important. Should employers want to have greater control of their surpluses, they can always opt-out of the co-operative and fund their health & dental benefits on a self insured basis (ASO).
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