Employer group
Group coverage your HR team can actually administer.
Fully insured, level-funded, and self-funded plans for employers from two employees to twenty thousand. Three funding models, one service model, and an eligibility file that does not need a person to babysit it.
Are you an employee looking for your own plan? Your employer sets the enrollment window and decides which plans to offer, so this page will not tell you what you have. Your HR team can, and once you are enrolled you can sign in as a member.
Three ways to fund a group plan
The benefits your employees see can be identical across all three. What changes is who carries the risk of a bad claims year, how much of a good year you keep, and how much visibility you get into where the money went.
| Fully insured2–500 employees | Level-funded25–300 employees | Self-funded (ASO)200+ employees | |
|---|---|---|---|
| Who carries claims risk | Veranta | You, up to a capped amount | You, above the stop-loss attachment |
| What you pay monthly | A fixed premium | A fixed amount covering claims, admin, and stop-loss | Admin fee plus actual claims as they are paid |
| Good claims year | No refund | Surplus shared back after run-out | You keep all of it |
| Bad claims year | No extra cost mid-year | Capped, stop-loss absorbs the rest | Capped by stop-loss you buy separately |
| Reporting | Aggregate only | Monthly claims summary | Full claims detail, monthly |
| Plan design freedom | Choose from filed plans | Choose from filed plans | Design your own |
| State premium tax | Applies | Applies to the insured portion | Does not apply |
| Governed by | State insurance law | State insurance law | ERISA |
Level-funded is where most groups between 50 and 200 lives land. It gives back some of the upside of self-funding without asking a small HR team to absorb the volatility of a single catastrophic claim.
By group size
Small group, 2–50
Community-rated plans off the shelf, quoted in two business days. Choose up to four plans for employees to pick from. Enrollment runs through the portal with no file feed to build.
Mid-market, 51–500
Experience-rated, with level-funded available from 25 lives. A named account manager, quarterly reporting, and support on site during open enrollment.
Large & national, 501+
Self-funded with custom plan design, multi-state networks, dedicated claims and clinical teams, and monthly claims detail delivered to your analytics stack.
What your HR team gets
- Employer portal for eligibility, billing, and documents
- EDI 834 eligibility feeds, or SFTP drop, or manual entry
- Automatic ID card fulfilment, digital on day one
- A named account manager from implementation onward
- Open enrollment materials, printed and digital
- On-site or virtual enrollment sessions
- Monthly invoices reconciled against your census
- COBRA coordination with your administrator
- Standard reporting pack, monthly
- Single sign-on into the portal from your HRIS
- A dedicated line your employees can call
- Annual renewal presented 90 days before the anniversary
Implementation, week by week
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Weeks 1–2 · Paperwork and kickoff
Signed group application, plan selection confirmed, and a kickoff call with your account manager, an implementation lead, and whoever owns your HRIS.
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Weeks 2–4 · Eligibility build
We map your file format, run two test feeds, and reconcile them against your census before anything touches the live system. This is the step that decides whether the first month goes smoothly.
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Weeks 4–5 · Open enrollment
Materials out, sessions run, questions answered. Elections come back through the portal or your existing benefits platform.
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Week 6 · Cards and confirmation
Digital ID cards available immediately, printed cards mailed. Every enrolled member is confirmed against the final census.
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Day 1 · Effective date
Coverage begins. Your account manager stays on the group permanently rather than handing off to a service pool.
Questions we get asked
How quickly can you quote?
Two business days for small group off a census. Five to ten for mid-market and level-funded, because those are experience-rated and we need claims history. Self-funded quotes depend on how much of the plan design is custom.
Can we keep our current benefits platform?
Yes. We take an EDI 834 from any major benefits administration platform, and single sign-on into the employer portal is available. What we do not do is ask you to run two systems of record for eligibility.
What happens at renewal?
You get the renewal 90 days before your anniversary date, with the claims experience behind it rather than just a percentage. If the number is bad we would rather show you why and talk about plan design than have you find out from your broker.
Do you offer dental, vision, and life?
Dental and vision, yes, on the same invoice and the same eligibility feed. Life and disability we do not underwrite, but we coordinate eligibility with the carriers most of our groups use.
We have employees in several states. Is that a problem?
Not for self-funded or level-funded groups. Fully insured groups are filed state by state, so a multi-state group typically needs a national network product, which we sell from 200 lives up.
Veranta Health is a fictional organization used for demonstration purposes. Group counts, covered lives, implementation timelines, and product availability on this page are invented. Nothing here is an offer of coverage or a quote.
Get a quote for your group
Send a census and your current plan summary and we will come back with options across all three funding models, not just the one that suits us.