Health insurance for mid-sized businesses 

Geisinger Funding Alternative (GFA) level-funded plan is available to groups with 5 to 199 enrolled subscribers. These plans combine the predictable payments of fully-insured plans with the cost savings of traditional self-funding. GFA plans are ideal for businesses with generally healthy employees and a low number of high-cost claims. 

Benefits of GFA plans include: 

• Standard plan designs with four formulary options
• Cost-efficient pricing
• Stop-loss coverage for protection against large claims
• Predictable monthly payments based on employee’s health trends
• Experience credit (portion of unused claims funding returned)

With a self-funded health plan, an organization takes on the responsibility and financial risk of providing health insurance benefits to their covered members. Meanwhile, we manage the day-to-day operations like processing claims, issuing ID cards, answering your covered members’ questions and more. Geisinger’s Self-Funded Administrative Services Only (ASO) plans are a cost-effective and flexible solution for your business.

Benefits include:

• Three plan options: Geisinger ASO Traditional, ASO A La Carte and ASO A La Carte with Veris™ Stop Loss.
• Low-cost base medical fee: Essential core services such as enrollment, claims processing, customer service and standard reporting — at a fraction of the cost.
• Custom plan designs*: Ala-carte service options such as Teladoc, claims fiduciary, maternity management program, biometrics screenings and upgraded health wellness services are all part of designing the right plan for your company.
• Diverse provider network:
  • In-network coverage:
    • More than 33,000 primary and specialty physicians
    • More than 150 hospitals, including Geisinger hospitals, Hershey Medical Center and Johns Hopkins
    • Over 230 urgent care and convenient care locations
  • Out-of-network (First Health Network):
    • More than 5,000 hospitals
    • 90,000 ancillary facilities
    • More than 550,000 providers
    • 1 million healthcare service locations
    • ASO members have in-network rates regardless of where they live
• Stop-loss options*: Protects clients from the risk of high-cost catastrophic claims through stop-loss coverage and carve-outs for prescription coverage.
• Proof of savings: Our new claims repricer tool takes your detailed claims file for the past year and reprices the claims as if we were the carrier to show how much you’ll save. Carriers who reprice their claims see an average of 15% to 35% in savings.
• Business size: Is best suited for organizations with 200+ enrolled subscribers.

*Size restrictions and fees may apply for certain benefit options. Stop-loss coverage is available for groups with 100+ subscribers, while level-funding options are available for groups with fewer than 100. 

We offer a variety of custom and standard fully-insured plans to help meet the needs of your business. 

Benefits of fully-insured plans include:

• Robust HMO and PPO plans
• Extensive provider network locally and through our national provider network
• Nationally recognized condition management programs
• Wellness and care management programs
• Specially trained client and customer support teams
• Renowned medical and pharmacy management services 
• Innovative population health management services 
• Award-winning Centers of Excellence
• Health reimbursement and savings accounts
• Critical group information on our secure employer service center
• Analytics and reporting for eligible groups from MedInsight by Milliman