The Michigan EBS Bridge Program

Pay less group health premium while enjoying better coverage!

Most employers see a 10% - 30% savings while reducing deductibles to as little as $0 while staying with the insurance company they're comfortable with.

How Do We Do It?

Return of Claims Surplus

The EBS Bridge falls into the industry category of a level-funded benefit plan. Level-funded is a type of benefit plan where the employer pays a steady monthly payment that covers all the plan's cost components. The largest cost component is the claims allocation, and then there is stop loss insurance coverage and plan administration.

A big advantage of the level-funded approach versus fully insured has to do with the largest cost component - the claim allocation. In a fully insured arrangement, all money is paid to the insurance company (premiums), and nothing is ever refunded back to the employer. If the group has low claims, any surplus stays with the insurance company.

However, with a level-funded approach, if the group has low claims, typically up to 50% of the claim surplus can be returned to the employer. With the EBS Bridge, 100% of the claim surplus belongs to the employer.

At the end of the plan year, claim utilization is reviewed to determine how and when surplus funds can be returned to the employer (assuming surplus funds remain). The timing of surplus return payments depends on the claim utilization for the plan year, the runout claims volume, and the employer's preference.

In some cases, the surplus may be held until the full 12-month runout period is completed. While in other cases, part of the surplus can be returned shortly after the plan year-end. Some clients choose to have their claim surplus build up for future years, while others prefer to have surplus returned either in increments throughout the runout period or in lump sum once runout ends. We will be happy to discuss those options with you.

How claims are paid with the EBS Bridge Program

Each employee receives an EBS Bridge ID card. For medical claims, the employee needs to present both ID cards - their primary medical plan card and their EBS Bridge ID card. The medical provider submits both for payment. They will bill you for any balance you may owe.

For prescriptions, the employee presents only their primary insurance card, as pharmacies are not set up for processing pharmacy claims through secondary insurance programs. The employee then pays their share of the prescription and sends their prescription receipt to Employee Benefit Services for reimbursement. Reimbursement can be in the form of a mailed check, or for quicker turnaround, direct deposit into the employee's checking account.