The Basics of Self-Funding

How Self-Funding Can Work for You

Traditional insurance plans require a lot of upfront costs for coverage that you and your employees may never use. Your insurance provider will collect your monthly premium based on the number of enrolled employees, and your premium only changes if you add or remove enrolled employees. 

While there are still fixed costs with self-funded plans, such as administrative fees, stop-loss premiums and any other set fees charged per employee, your employee premiums are billed on a per-claim basis. The per-employee claim costs vary from month-to-month depending on the number of claims filed. In addition to saving money on costly annual premiums that may never be used to their full potential, self-funding gives employers the ability to track their claim costs every month and evaluate the efficiency of their plan. 

Stop-Loss Insurance Mitigates Your Risk

While self-funding protects you from paying higher month-to-month premiums for unutilized services, because self-funding bills per-claim, it does leave you susceptible to a catastrophic claim. To protect you against having to cover an excessive amount due to a catastrophic claim, self-funded plans give you the option to purchase stop-loss insurance.

With stop-loss insurance, you pay a fixed fee and your claim costs are set a predetermined level. If a claim exceeds that level, the stop-loss insurance will pay the rest. This coverage can be purchased to cover catastrophic claims on one member (known as specific coverage) or it can cover claims that significantly exceed the expected level for the entire group (aggregate coverage).

A True Benefit to Your Employees

Self-funding gives you the flexibility to determine exactly the right coverage for your company while keeping your monthly costs low. This creates a savings and a benefit that you can pass on to your employees. 

With all of our self-funded plans, you’ll have access to our broad regional and national PPO network, and we can design your self-funded plan around the PPO that best meets your company’s and your employees’ needs. 

Through a thorough review of your current employee census, your premium rate history and the parameters of your current plan, our team of dedicated professionals can help you determine exactly which plan is right for you. If we conclude that self-funding is right for you, we will then work directly with you to determine the proper levels of coverage and all plan parameters.

The fact is there are better health care benefit options available, and we’ll help you find them.Contact us today for your free, no obligation quote.