Under this model, the employer pays a fixed premium to an insurance company, which then assumes the responsibility of covering medical claims. Advantages of fully-insured group insurance include predictability in costs and reduced financial risk for the employer, as the insurer handles claims and absorbs any unexpected expenses. Disadvantages, however, include higher costs compared to self-funded plans, and limited flexibility in customizing the coverage to meet specific needs.

Under ICHRA, employers reimburse employees for their individual health insurance premiums and medical expenses on a tax-free basis. Advantages include cost control, as employers set fixed reimbursement amounts, and flexibility, allowing employees to choose plans that best suit their needs. Additionally, ICHRAs simplify administration and offer tax efficiency. Disadvantages include the potential complexity of compliance with regulations and the need for employers to manage the reimbursement process, which can be challenging without third-party administration

In this arrangement, employers pay a fixed monthly amount, which covers administrative costs, stop-loss insurance, and a claims fund. Advantages of level-funded group insurance include predictable monthly costs and potential refunds at year-end if claims are lower than expected. This can offer financial stability and the opportunity to save money. Disadvantages include the risk of higher-than-expected claims, which could lead to high renewal rates.