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Self Funding

You could keep doing insurance their way.
Or, you could put yourself in the drivers seat.

Traditional Health Insurance Experience

If you are like many mid to large size employers, your health insurance experience has been one of frustration because of unmet expectations, such as the ones listed below.

 

Limited Plan design flexibility

Ineffective Care Management Programs

Lack of Price Transparency

Overpaying eight out of ten times

Self funding puts you behind the wheel of your health insurance program, one that’s custom-fit to your strategic initiatives and unique workforce dynamics.

Companies with traditional, fully insured health insurance arrangements pay
5- 0 %
more than their self funded counterparts on average in additional fees & taxes alone.
Fees eliminated or reduced by Self Funding
  • State Premium Taxes
  • Carrier Profit Margin
  • Carrier Risk Assessments
  • Socialized Broker Commissions
  • Withheld Rx Rebate Revenue
  • State Benefit Mandates

Self Funded Health Insurance Overview

Self Funding continues to be a proven solution that more and more organizations are employing to address rising healthcare costs and to customize their benefit programs to better meet their strategic objectives.
Breaking down the sources of savings in a self insured program

Typical sources of savings are through lower admin fees, elimination of carrier pooling charges, claims run-out margin, exemption from fees and taxes that only apply to fully insured programs, drug program PBM, plan design flexibility, stand alone or captive stop loss programs and robust population health management solutions.


Characteristics of Successful Self Funded Programs

Budget Stability through setting appropriate stop loss levels

Plan solvency through proactive cash reserve build-up

Robust claims mgmt. partnerships (i.e. diabetic concierge services) with measurable ROI

Advanced data mining and predictive analytics

 

Dashboard views of health plan performance with actionable insights

Prescription Drug Program Transparency

 

Wellness & Benefit Program Tools that engage & empower your employees

Vendor Performance Guarantees   

Carefully managed Stop Loss through individual or captive programs