Group Health- Self-Insured
True self-funding is when an employer with predictable claims, hires an administrator to process their claims through a contracted network of medical providers. The employer pays for all claims incurred by their plan by funding a dedicated bank account.
Advantages Self-funding allows employers to choose their own benefit levels and coverages; they are subject to federal regulations but not state regulations which saves tax dollars; and they fund claims as they occur giving a tax flow advantage.
Stop Loss Most companies who choose self-funding will protect themselves with stop loss insurance. Stop loss provides a layer of protection if medical expenses go far above the expected claims (usually 20% to 25% higher than expected).
Pharmacy Benefits Employers can negotiate separately for pharmacy benefits. This gives them flexibility and can help to reduce prescription costs.
Data Warehouse At Solutions Insurance Agencies, we utilize a data warehouse. This software tool allows us to analyze claims and determine how small changes to the benefit design can impact claims for our clients.
Your Specific Needs The needs of each business are unique. Our Professional Team can help. Contact us for more information.