Administered-Only Members

People whose health plan an insurer RUNS but whose medical bills it does not PAY. A large employer self-funds its own employees' claims and hires an insurer to process them, build the provider network and handle customer service -- an arrangement usually called administrative-services-only, or ASO, and sometimes fee-based. The insurer earns an administrative fee per member instead of a premium, so the revenue per head is far smaller and the insurer bears no underwriting risk. This is why a headline membership number can be misleading: two insurers with the same total membership can have very different revenue and very different exposure to medical cost trend, depending on how much of that total they merely administer.

Related terms

Accounts Payable · Adjusted EBITDA · Adjusted EBITDA Ex-SBC · ADR · ARPU · Average Length Of Stay

Open this term in the app → — no account needed; browse the full glossary while you research.