BNY Mellon Benefits Guide
What Self-Insured Really Means
BNY Mellon's health plans are mostly self-insured, which generally means that BNY Mellon pays benefit claims rather than an insurance company. As health care costs continue to rise rapidly, every dollar we can save is one less dollar that you and BNY Mellon must spend for health care.
BNY Mellon national health plans are self-insured as described below.
  • Self-insured. When a plan or plan option is self-insured, it means the sponsor (in this case, BNY Mellon) assumes the financial risk of the claims incurred by participants/employees and family members. Claims are paid from sponsor and participant contributions (premiums). A plan sponsor may also hire an administrator to process claims, manage provider networks and handle other administrative tasks.
  • Fully Insured. When a plan or plan option is fully insured, the sponsor pays premiums (consisting of both sponsor and participant contributions) to an insurance carrier, which assumes the financial risk of paying for claims, as well as the responsibility for all of the administrative duties listed above. Fully insured health plans include Kaiser California, HMSA Hawaii and Aetna International.
Self-insured plans include the 2016 health plans available through Aetna and UnitedHealthcare, vision through VSP, the Flexible Spending Accounts, the Live Well programs (i.e., WebMD, Best Doctors, Live Well Health Centers and AccessSolutions EAP & Work/Life Program), and flex vacation purchase. Self-insured health plans give BNY Mellon the flexibility to create customized plan designs and benefits for our eligible employees and their family members and to help manage plan costs. Unlike fully insured health plans, self-insured health plans are not subject to state insurance laws, which typically govern fully insured health plans. State insurance laws may require fully insured plans to provide benefits that may not also be offered under the self-insured health plans.
For example, some state laws extend medical coverage for dependent children under certain fully insured plans. If you have a dependent age 26 or older and you have coverage in one of the fully insured plans listed above, you should contact that plan directly to find out if your dependent qualifies for the extended coverage. For more information, see the Contact Information section.