Comprehensive Employer Provided Benefits Solutions

Innovative Health Insurance Strategies Control Costs and Empower Your Workforce

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​For Wisconsin health insurance brokers, presenting a competitive benefits package requires more than a "one size fits all" employee benefits plan. Area Benefits knows employers are facing rising premiums and a shifting labor market, making it essential to leverage strategic health insurance products. Area Benefits solutions are designed to provide predictability for the business while offering high-quality benefits for employees.

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1. What Is Self-Funded Employer Health Insurance

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Self-funded insurance allows ae Wisconsin employer to pay for their employees' healthcare claims directly, rather than paying a fixed premium to a traditional insurance carrier. Under this model, the company assumes the financial risk of providing healthcare benefits to its employees, typically protected by "stop-loss" insurance to prevent catastrophic losses.

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The Benefits of a Self-Funding:

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This type offering is the gold standard for Wisconsin businesses looking to reclaim their healthcare spend. By cutting out the profit margins and taxes built into traditional "fully insured" premiums, companies can save significantly during healthy years. Because you own your claims data, you gain the power to identify exactly where costs are coming from such as high-cost prescriptions or specific chronic conditions allowing you to implement targeted wellness programs that improve employee health and your bottom line simultaneously.

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2. Reference-Based Pricing (RBP)

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Reference-Based Pricing is a disruptive model that eliminates the traditional, often inflated, "PPO network" pricing. Instead of paying a percentage of a hospital's arbitrary billed charges, the plan pays providers based on a set benchmark, such as a percentage of Medicare reimbursement rates (e.g., Medicare + 40%).

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The Benefit of Reference-Based Pricing:

RBP is the most effective tool available for reducing the cost of Wisconsin medical procedures. By establishing a "fair price" for services, employers can see immediate reductions in healthcare spend compared to traditional plans. For Wisconsin employees, this often results in $0 or very low co-pays when they use "high-value" providers who accept the reference price. It brings transparency to a murky industry, ensuring that neither the company nor the employee is overcharged for routine or emergency care.

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3. Level-Funded Plans

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Level-funded plans combine the cost-saving potential of self-funding with the predictable monthly budgeting of a fully insured plan. The employer pays a set monthly "level" premium that covers administrative fees, stop-loss insurance, and a claims fund. If claims are lower than expected at the end of the year, the employer receives a refund or credit.

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The Benefits of Level-Funding:

This is the ideal entry point for small and mid-sized Wisconsin businesses that want the benefits of a self-insured model without the volatile month-to-month cash flow risks. It offers the safety net of fixed monthly costs, ensuring your budget remains stable throughout the year. The primary advantage is the "upside" potential: unlike traditional plans where the insurance company keeps the surplus if your employees stay healthy, a level-funded plan returns that surplus to you, rewarding your company for a healthy workforce.

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4. Voluntary Benefits

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Enhancing the Employee Experience Without Increasing Employer Premiums

Voluntary benefits are optional insurance products—such as Accident, Critical Illness, Hospital Indemnity, or Disability insurance—that employees choose to purchase through payroll deduction. These products provide direct cash payments to employees in the event of specific medical incidents or life changes.

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The Benefit of Voluntary Benefits:

In an era of high-deductible health plans, voluntary benefits serve as a vital "financial safety net" for your staff. They allow you to offer a robust, enterprise-level benefits package that caters to diverse needs from a young employee wanting accident coverage to an older worker seeking critical illness protection at little to no cost to the company. By offering these "gap-fillers," you significantly reduce your employees' financial stress during medical emergencies, which boosts morale, increases retention, and positions your company as a preferred Wisconsin employer.

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