Group Health Insurance
At Creekstone Benefits, we help businesses build benefit packages that support their people and their bottom line.
Fully-Insured Group Health Plans
A fully-insured plan is the traditional approach to group coverage.
- You pay a fixed monthly premium to an insurance company.
- The insurer handles claims processing and financial risk.
- Premiums may be adjusted annually based on claims history and overall risk.
There are several different
plan types, with a range of network structures to suit you and your employees’ needs:
- HMO (Health Maintenance Organization)
Lower cost, but more restrictions. Requires a primary care doctor and referrals. No out-of-network coverage except for emergencies. - PPO (Preferred Provider Organization)
Higher premiums but more flexibility. No referrals needed and broader provider access. - HDHP (High-Deductible Health Plan)
Designed for cost savings, usually paired with an HSA (Health Savings Account). Good for employees who use minimal care and want lower premiums.
Best for:
Employers who want a familiar plan model with predictable monthly costs and less financial risk.
Level-Funded Group Health Plans
Level-funded plans are a growing option for small and mid-sized employers. They offer the predictability of a fully insured plan with some of the cost-saving potential of self funding.
- You pay a fixed monthly amount that covers claims funding, stop-loss insurance, and administrative fees.
- If claims run low, you may receive a refund at the end of the year.
- If claims run high, you’re protected by stop-loss coverage.
Many carriers offer level-funded plans with access to national provider networks, making them competitive with traditional fully insured options.
Best for:
Employers who want cost control and claims transparency, without the full risk of self funding.
Self-Funded (Self-Insured) Plans
With a self-funded health plan, the employer takes on financial responsibility for employees’ medical claims instead of paying fixed premiums to an insurance company.
- You pay for claims as they’re incurred, often with the help of a third-party administrator (TPA) to handle billing and networks.
- Most employers purchase stop-loss insurance to protect against large or unexpected claims.
- Offers more transparency into claims data, which can inform cost-control strategies.
Best for:
Mid-size and large employers with predictable cash flow who want to customize their benefits and manage costs more directly. While self-funding can save money over time, it also comes with higher financial risk, especially for smaller companies without stop-loss protection.
How We Can Help
We’re here to support you during open enrollment and throughout the year. We can help compare plans and design benefits packages, and we offer guidance with enrollment and communications. We look forward to being your health insurance partner for immediate needs and long-term planning.
Frequently Asked Questions
Group Health Insurance FAQ
What's the minimum group size for a plan?
We work with carriers who offer coverage for groups as small as 1-5 employees. Some level-funded options start at 5 or 10 employees.
What's the difference between a broker and a TPA?
We are brokers, helping you design, select, and manage your plan. A TPA (third-party administrator) handles day-to-day claims and billing.
Can we offer multiple plan options to our employees?
Yes. Many employers offer a base plan and a buy-up option to give employees choices.
What happens when an employee leaves?
Former employees may be eligible for COBRA continuation coverage. We can help with those transitions, too.
