Fully Insured (FI)
A fully-insured health plan is the more traditional way to structure an employer-sponsored health plan. With a fully-insured health plan:
An employer pays a premium to the insurance carrier.
The covered persons (eg: employees and dependents) may share in the cost of the premiums and are responsible to pay any deductible amounts or co-payments required for covered services under the policy.
Premiums are based on the number of employees enrolled in the plan each month and rates are fixed for a year but may change if the number of enrolled employees in the plan change.
The insurance carrier collects the premiums and pays the health care claims based on the coverage benefits outlined in the policy purchased.