Take the guesswork out of your healthcare costs

When you have a business to run, predictable can be good—like knowing up front what you’ll pay each month for your health plan.

To help you have more control over your healthcare costs, Blue Cross® Blue Shield® of Arizona (BCBSAZ) is excited to offer Balanced Funding to businesses with nine or more enrolled employees.1 This may be a great option for employers whose employees are engaged in their healthcare and use their plan in a cost-efficient and effective manner.

Advantages of Balanced Funding

  • Easier budgeting. Your business may qualify for a lower fixed monthly cost than what you are paying today.2
  • All-inclusive. Your monthly payment covers administrative services, stop-loss insurance, and claims liability.3
  • Potential refunds. You have the ability to earn dollars back if claims are lower than expected. 4
  • No surprises. If the amount of your claims is more than what you’ve paid, you don’t owe more.
  • Enhanced transparency. Monthly reports let you easily understand your healthcare claims costs throughout the year.

Predictable, affordable, transparent.

Ask your BCBSAZ representative how Balanced Funding can work for you.

Contact Us


1Prior to January 1, 2021, Balanced Funding was only available for businesses with 15 or more enrolled employees.
2Medical criteria are used to establish rates for Balanced Funding arrangements. Not all businesses will qualify.
3 With Balanced Funding, composite rates are fixed; however, monthly payments may still change based on an employee census, as employees or dependents are added or removed.
4Any surplus is paid after plan renewal, as long as the business retains a BCBSAZ Balanced Funded plan or a major medical plan.


  

Easier budgeting

Your business may qualify for a lower fixed monthly payment than what you are paying today.


 

Enhanced transparency

Monthly performance reports let you easily understand the overall healthcare costs of your employees.


Healthy focus

Insights into the health of your employees can help you save               on overall healthcare costs.


  

Surplus savings

You have the ability to earn dollars back if claim costs are lower than expected.

Balanced Funding protects you both ways:

EXAMPLE #1

EXAMPLE #2

Annual Claims Funding: $50,000

Actual Claims: $46,000

Annual Claims Funding: $50,000

Actual Claims: $55,000

Congratulations!

Your business will receive $4,000 back!*

*Surplus is paid after plan renewal.

Don't worry! Even if you exceed your

projected claims allowance for the year,

you won't owe any additional dollars.

Balanced Funding Plans

ACA Plans

  Availability

9+ employees1

1-50 employees

  Administered by BCBSAZ

  PPO and HMO plans designs

  HSA-eligible options

  Selection of provider networks

  Satisfies employer mandate

  1095B reporting supplied

  Financial predictability

  Employer pricing

Employer-specific

Community-rated

  Potential for lower monthly costs

  Access to reporting           

  Ability to earn surplus           

  Wider range of plan design options           

  Save when employees engage in a healthy lifestyle           

1Prior to January 1, 2021, Balanced Funding was only available for businesses with 15 or more enrolled employees.

Important Health Plan Documents

April 2021 Balanced Funding Product Guide

April 2021 SBCs for Balanced Funding

2021 Formulary

 
April 2020 Balanced Funding Product Guide

April 2020 SBCs for Balanced Funding

2020 Formulary


 
January 2020 Balanced Funding Product Guide

January 2020 SBCs for Balanced Funding

2020 Formulary

Predictable, affordable, transparent.

Ask your BCBSAZ representative how Balanced Funding can work for you.

Contact Us