A company that wants to give its employees healthcare benefits can choose to buy coverage from an outside insurance company or operate its own insurance plan in-house. Administering an in-house plan is a massive chore, so employers often farm out that responsibility to a specialized administrator such as United Medical Resources or UMR. The employer provides the money, while UMR handles all the messy details that make up a health plan.
Companies that provide outsourced medical plan administration are referred to as third-party administrators, and that's what UMR is. Your employer doesn't need to keep an in-house team trained and up to speed on all the legal issues involved in healthcare or to get involved in the claims process. UMR provides all that expertise, as well as the people and resources to manage the plan at a negotiated cost to your employer. It's important to understand, though, that UMR isn't an insurance company as such. Your employer puts its own resources on the line to act as the insurer.
Self-Funded Plans Vs. Insured Plans
Offering a solid benefits package is one way for companies to stay competitive in the hunt for good staff, but it can be a significant cost as well. For a company with large enough revenues, funding a health care plan in-house instead of paying premiums to an insurance company can be an attractive alternative. Insurance companies are businesses, after all, and need to make a solid profit in order to survive and thrive. Opting for a self-funded plan means your employer can potentially save money — the amount that would otherwise be the insurance company's profits, even after paying UMR or one of its competitors to administer the plan. The downside is that the company also takes on the risk of unexpected expenses that could torpedo its plan. To guard against that possibility, companies often opt for a relatively inexpensive stop-loss policy that would kick in should the plan start hemorrhaging money.
Interacting With UMR
Dealing with UMR is much the same as interacting directly with a conventional insurer. You'll be given an enrollment package when you become eligible for the plan, which includes instructions on how to file claims and how to get in touch with UMR if you need assistance. You can log into UMR's website from your home or work computer or any mobile device, or call the company's toll-free number. The size of the team that UMR dedicates to you and your coworkers depends on how many employees your company has and what level of service it's willing to pay UMR to administer.