Sophus Health Programs that reduce costs, improve health and create healthy work environments.

Our Industry Experts Offer Health Programs that Really Work for Employers Who Really Care.

Sophus Health programs are highly customized to fit your unique scenario. These programs include health insurance, often at wholesale costs for classic and alternative services, as well as wellness and lifestyle management programs. They are based on the Five Aspects of Health, against which we regularly measure performance, and they are supported by our interactive Sophus Learning Culture. You see, when claims go down, so do healthcare costs. Those claims go down when your employees stay well. Your employees stay well when we nurture their ability to seek and use information and skills that contribute to personal wellness. It all links together to yield a financial model of the highest order, by increasing productivity and fostering a healthier, more satisfied workforce. Our ultimate goal is to reduce your costs while empowering your employees. We don’t just offer health insurance products; we guide you toward health so your employees and company can thrive!

Best for employers that:

• are tired of the rising costs of health insurance without insight on why.
• understand that the health of employees impacts the success of the company.
• want to implement truly integrated lifestyle programs, rather than separate wellness “products.”

Perhaps partial self-funding is the right path.

Sophus Health offers you the option of a partially self-funded insurance plan as an attractive alternative to traditional plans. It’s a more proactive and innovative approach to managing health benefits. Because the key feature of self-funded—stop/loss protection—protects your organization from unpredictable catastrophic claims. It’s important to understand, however, that self-funding works best when combined with actual data and the Sophus Health Learning Culture approach. It is this combination that controls your healthcare costs. Working closely with your team to satisfy your financial goals, we can get you going with a highly-effective partially self-funded plan that can yield some valuable benefits:

Reduced Fixed Costs

As you’d expect, all health insurance plans have administrative costs resulting from paying claims. A partially self-funded plan saves on these costs when compared to conventional plans.

Improved Reserves

Your organization maintains its own cash reserves. So when claims go down, your reserves go up.

Increased Plan Flexibility

Your organization can choose from nearly unlimited options within the structure of a partially self-funded plan. So you can craft a plan that precisely suits your scenario. Co-pays, coinsurance, deductibles, covered benefits and excluded benefits can all be tailored to meet your needs.

Access to claim utilization data reports.

Detailed reports can help you identify claim trends specific to your organization. This permits you to do a better job of managing the plan and controlling costs.

Take advantage of stop/loss protection.

Partially self-funded plans often include stop/loss insurance to reduce the risk of large claims, whether by an individual or by the group as a whole. If you choose this option, you would self-insure up to the stop/loss attachment point; the dollar amount above which the stop/loss carrier reimburses claims. Stop/loss insurance comes in two forms.

Individual/Specific Stop Loss Insurance protects your organization against big individual claims. It limits the amount you might pay to an individual. So if your stop/loss attachment point is $25,000, then your organization pays the first $25,000 of a claim in a calendar year. The stop/loss carrier would pay anything above $25,000 for a particular participant in that same year.

Aggregate Stop/Loss Insurance protects your organization against high total claims for your entire plan. So if your stop/loss attachment point is $500,000 for the calendar year, the stop/loss carrier begins reimbursing after total claims exceed $500,000. However, any amounts paid by an individual specific stop/loss within the same plan would not count towards the aggregate attachment point.

Sophus Level Program.