Health Insurance Plans

Houze & Associates designs and administers both fully-insured and self-funded Health Insurance plans.  Fully insured plans are the traditional plans where monthly premiums are paid by the employer and/or employees and the insurance company reimburses providers when services are rendered. In the case of an HMO, participating plan providers are paid, at least partially, on a fixed basis regardless of service frequency.  Self-funded plans provide an alternative to the cost of fully insured benefit plans and can allow more flexibility of plan design and the potential for savings.

With self-funded or “self-insured” plans, instead of paying an insurance company premium dollars to pay claims, with a self-funded plan the employer deposits money into a trust fund that is overseen by strict Federal government regulations, and that trust fund pays claims as incurred.  Claims are processed by a Third Party Administrator (TPA).  To avoid catastrophic losses, self-funded plans usually buy re-insurance, to set in advance the maximum loss levels it is willing to sustain on any specific individual or on the aggregate of claims for the whole group.

In our evaluation process with clients we consider both fully-insured and self-funded plans and our recommendations are based on many factors, availability of network providers, financial stability of the client, client tolerance for varying monthly healthcare costs, etc.

Houze & Associates has extensive experience in working with hospitals, school systems, and municipalities.  This experience and client base gives us expertise in various alternative plan designs and funding methods.  We have installed and administered virtually all types of health insurance plans, (HRA’s, PPO’s, POS’s, HMO’s, HSA’s, 340B’s, as well as plans that include health assessments.)

For example, several years ago we instituted a plan for one of our City clients which offered voluntary health assessments.  Employee health insurance payroll deductions are discounted for employees who have acceptable levels of glucose, blood pressure, cholesterol, body mass index and are smoke free.

Each year an increasing number of employees participated in the health screenings with over 96% participating during the last open enrollment. With the screenings, employee life styles have improved and rather than double digit increases in claims, we have seen a strong stabilization in claims experience and even decreases in some of the four years since the plan was adopted. In the first year total claims costs were reduced by 17% and annual increases have been less than 3%.

Houze & Associates can shop your needed coverage to some or all of the following carriers:
  • Blue Cross Blue Shield of Georgia
  • Cigna
  • Aetna
  • Humana
  • United Healthcare
  • Trustmark
  • Covenant Administrators
  • MedAdmin Solutions
  • MedCom Administrators
  • Paragon Administrators
  • Secure Health Plans of Georgia

    • For more information about Bill Houze, contact:

    • Bill Houze Bill Houze 800.523.7135 billhouze@houze.org

    or you can call us:
    1.800.523.7135 M-F 8am to 5pm Est