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A Broker’s Guide to Self-Funded Business
Enable clients to take control of their health plan and win more business along the way.
Comparing Self-Funded and Fully Insured Plans
Self-Funded SOLUTION
1
Overpaying for Healthcare
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Cost Saving & Flexibility
Self-funded plans allow employers to avoid paying high insurance premiums through uniquely designed plans that best fit their workforce’s needs instead of using a one-size-fits-all insurance option.
2
Less Control Over Claims Data
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Data Transparency and Fraud Protection
Employers who self-fund have access to detailed claims data, enabling better decision-making. This increased oversight also allows for the identification of billing errors or fraudulent claims.
3
Expense Management
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Improved Cash Flow
With self-funding, you only pay for the actual claims incurred, which can often result in increased savings and improved cash flow. Self-funded employers can limit financial risk with stop-loss insurance, which protects against unexpectedly high claims.
4
Compliance Requirements
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Reduce Regulatory Burden
While fully insured plans must comply with state and federal regulations, self-funded plans are governed by the Employee Retirement Income Security Act of 1974 (ERISA) and are exempt from most state insurance regulations. This means more flexibility and exemption from state premium taxes.
Build a Smarter Benefits Strategy for Your Clients