Free Self-Funding Guide

A Free Guide to Health Care Cost Control in the Midst of Reform

Self-Funding Guide

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Why Self-Insure?

Don't just take our word for it.

Top analysts and experts in the field state that healthcare reform has introduced new requirements that will affect the fees and configuration of insured benefits.

The May 2011 Issue of HR Magazine, from SHRM.org features the article Is Self-Insurance for You? by Joanne Sammer.  She makes several important points:

  • A self-insured employer chooses its plan design and usually hires a third-party administrator to manage the plan
  • Self-insured health plans are exempt from state insurance laws covering reserve requirements, state-mandated benefits, premium taxes and so forth.
  • Health care reform’s elimination of annual and lifetime payment caps has made stop-loss coverage more imperative, analysts say.

All employer health plans, whether self-insured or fully insured, have to meet new federal mandates:

  • Dependent coverage for children up to age 26.
  • No pre-existing condition limitations.
  • No lifetime limits on coverage.

Self-insurance may help employers contain the costs associated with these mandates.  (Source:  SHRM.org)

Insurance & Financial Advisor's (IFAwebnews.com) May 2011 article by Bob Graham "Self-Insuring Called 'Most Cost-Effective Way’ to Cut Health Costs” suggests that self-insuring allows employers to control cost by enabling them to:

  • Obtain more specific information about their actual healthcare expenditures.
  • Control costs because they pay for routine expenses such as doctor visits, procedures and prescription drugs through a self-insured plan, obtaining lower-cost catastrophic or “stop-loss” policies to cover major medical events.
  • Enable better “human capital management” by recognizing in advance what types of health events are emerging in their covered population in time to help employees avoid a catastrophic event.

selffunding 

Self-Funding Alternatives

We have found that employers in all industries are struggling with the same problem, controlling healthcare costs!

There was a time when self funding your healthcare benefits was only for large companies.  Those times have changed and given the current economic environment many companies with 50 or more employees are turning to this effective cost containment solution.  It provides a way to pay only for actual claims, but with full protection while providing detailed reporting to analyze employee behavior and plan flexibility to adjust their options.  Download our free Self-Funding Information Guide for quick facts and tips.

When you self insure your healthcare you are taking a proactive approach to cost containment and will benefit from a well designed plan.  The best way to keep plan costs in line is to help employees stay healthy and move to a self-funded arrangement.  This solution delivers robust reporting for a hands-on experience, full benefit design control and stop-loss protection to limit exposure.

With self-funding, you pay only for actual claim costs incurred and agreed upon administrative costs. With self-funding, low claims mean a lower cost, while high claims mean a higher cost.

Benefits of Self Insuring to Control Healthcare Costs …

  • Gain greater cash flow management
  • Pay only for claims incurred with additional stop-loss insurance for full protection
  • Avoid costly state premium taxes and carrier administrative costs
  • Receive and benefit from claims management as well as carrier profit margin
  • Standardize benefits across multiple states with no state mandates
  • Plan flexibility to accommodate for utilization trends, HR needs and inflation
  • Gain complete control of benefit costs with detailed reporting providing a comprehensive view of claims
  • Identify and control high risk claims and adjust plans accordingly
  • Benefit financially directly from wellness and education programs
  • Define exact exposure and maximum cost due to stop loss insurance coverage
  • Combine with a CDHP and health & wellness program for maximum results 

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Self-Insurance FAQs

Q. What is a self-insured health plan?

Q. How many people receive coverage through self-insured health plans?

Q. Why do employers self fund their health plans?

Q. Is self-insurance the best option for every employer?

Q. Can self-insured employers protect themselves against unpredicted or catastrophic claims?

Q. Who administers claims for self-insured group health plans?

Q. What about payroll deductions?

Q. With what laws must self-insured group health plans comply?

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