Ready to Upset the Status Quo?
More employers are switching to self-funded health plans than ever before. There are, however, a few puzzle pieces required to properly make the shift to a self-funded plan where the employer can regain control costs of their benefits budgets.
There’s the risk-mitigation piece. Another for administration. Another for care providers. Another for pharmacy benefits, and one for utilization. Those are the basics. There also are a few extras.
It’s an unbundled, cut-out-the-middleman approach that more companies are taking every day to curb runaway healthcare spending and improve patient outcomes. In fact, more Americans already are covered by self-insured health plans (67% in 2020, according to the latest estimate) than through conventional employer plans.
For the unfamiliar, self-funding, or self-insuring, means never having to again blindly pay monthly insurance premiums and, instead, turning to a line-up of health care providers and others that are part of a network or that contract directly with the employer.
Determining whether it makes sense to self-fund (or not) will require a review and analysis of historical claims data and a close look at the health of your employee population, to project future costs.
As critically, you’ll want to dig into the question of how much cash flow you’ll need to set aside for claims. It’s important to establish a cash-flow strategy with your benefits broker and their actuarial partners to ensure your claims reserve always has an adequate surplus.
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Video: The Important Role of Stop-Loss Insurance in any Self-Funded Health Plan
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