Fully-Insured Group Health Insurance Plans

Straightforward Health Benefits for Your Workforce

A fully-insured group health insurance plan is a traditional form of coverage in which an employer contracts with an insurance company to provide health benefits to employees. These plans are regulated at the state level and must comply with specific requirements under the Affordable Care Act (ACA), such as providing essential health benefits and limiting out-of-pocket costs.

Types of Fully-Insured Plans

EPO (Exclusive Provider Organization): Hybrid between HMO and PPO; no referrals required but non-network care is only covered in emergencies.

HMO (Health Maintenance Organization): Affordable, network-limited service requiring referrals; out-of-network care generally excluded except emergencies.

HDHP (High-Deductible Health Plan): Lower premiums, higher deductibles; often paired with HSAs for cost-conscious, healthier individuals.

POS (Point of Service): Combines HMO’s gatekeeper model with PPO’s out-of-network flexibility at higher cost.



PPO (Preferred Provider Organization): Most flexible—allows providers outside a network and doesn’t require specialist referrals.

Benefits Fully-Insured Group Health Insurance Plans

Comprehensive Coverage: Includes preventive care, maternity, mental health services, prescription drugs, and more.

Predictable Costs: Fixed monthly premiums simplify budgeting for employers and employees.

Low Administrative Load: The insurer handles claims processing, compliance, and customer support.



Assured Compliance: All plans are designed to meet federal and state regulatory mandates.