Traditionally, when people talked about insurance, it was “Fully Insured”. The employer or its employee pays a premium to the insurance company in return for paying future “covered” medical claims that are beyond the “out of pocket” maximum (the amount that employees and their families will pay for that service). The totality of risk for the medical claims is borne by the insurance company. As insurance is a for-profit industry, the insurance company must cover its risk and make money. As the cost of medical care increases, so too do the premiums. In fact, according to the latest Kaiser Family Foundation Report, average annual employee contributions to premiums and total premiums for single coverage have risen nearly 22% over the past 5 years.