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Fully Experienced-Rated Funding

A fully experience-rated funding arrangement/underwriting basis is one where there is full financial accountability. All risk is shared between the plan sponsor and the insurer, and there is no element of pooling. The insurer must provide the plan sponsor with full details of the experience results under the plan. The details include reporting of premiums, claims charges, expenses, reserves and interest credits or charges. The result is either a positive balance (gain or surplus) or a negative balance (deficit). The margin may be structured to amortize the deficit over a period of years—it does not usually represent an attempt to recoup the deficit in one year. However, a small deficit may be recovered in one year.

All of the experience under a fully experience-rated group is taken into consideration when the insurer considers the premium renewal requirements for the coming year. If there is a deficit under the plan, the insurer has a right to propose that a deficit recovery margin be included in the renewal rates proposed to the plan sponsor.