Category Archives: Considering Self Funding

The 5 Least Understood Benefits of Stop Loss Insurance

As self-funded health plans have steadily grown in popularity over the last decade, many business leaders have found themselves in unfamiliar territory. After switching from fully-funded insurance to self-funding, there’s a great deal of information to absorb. Stop loss insurance is one tool that self-insured employers may utilize but not fully understand. Continue Reading >

Woman working on red roses in a greenhouse. Stop Loss.

Top 5 Ways Stop Loss Insurance Helps Self-insured Employers

Employers are clear about the fact that they need to control healthcare costs. They often aren’t as clear about the strategies they can use to do that, in a way that benefits both the organization and its employees. Self-funding a health plan is an increasingly popular choice among businesses of all sizes, but business leaders might be wary about the financial risk of taking direct responsibility for paying employees’ claims. Continue Reading >

Child smelling a red tulip in a garden. Stop loss insurance.

7 Questions to Ask When Comparing Stop-Loss Carriers

Self-funded health insurance is the right choice for many midsize and even small employers. Self-funding may allow your business to save on healthcare costs and customize your coverage to better suit your employees’ specific needs. This kind of plan can be financially risky; instead of paying set premiums to an insurance carrier, a self-insured employer is responsible for all of its employees’ claims. Those are unpredictable costs.  Continue Reading >

Self-funded insurance can be financially risky, but stop-loss coverage limits your liability. Puzzle pieces with insurance fits into risk space.

What to Consider When Moving from Fully Insured to Self Funded Insurance

Making the move from fully insured to self funded health insurance may allow a business to save money, enjoy greater flexibility and assume more control over its health care plan. When the transition is smooth, employees may hardly realize a shift is happening. But for the business leaders working behind the scenes, moving from fully insured to self funded can take months of careful planning and strategizing.  Continue Reading >

When the transition from fully insured to self funded health insurance is smooth, employees may hardly realize a shift is happening. But for the business leaders like this woman working behind the scenes on behalf of her staff behind her, the move can take careful planning and strategizing.

Can Self-funded Employers Offer Plans That Will Appeal to Potential Employees?

Without its employees, your business is nothing but an idea. If you have a team of highly-qualified, deeply-engaged people working for you, you’ll generally go a lot further than you would with a team of middling performers. The best employees also tend to be the people who have the most job options. Someone who has an incredible resume, glowing references and a long list of skills and certifications may be able to be picky about where they work. Not only do you want those employees coming to work for you, but you also don’t want them going to work for your competitors. To get them on your team, you’re going to have to offer competitive health benefits. Employers considering going the self-funded route often wonder if they will be able to offer appealing healthcare benefits. Continue Reading >

A young professional sits on a desk smiling and working on a laptop. Send-funded plans can be designed to appeal to prospective employees.

Why Small Businesses are Moving Toward Self-Funding Plans

Small businesses have to be creative to survive in a competitive market. For many of these businesses, embracing a new kind of healthcare strategy is key to controlling costs and attracting top talent. Self-funding your healthcare plan means paying employees’ claims directly instead of paying premiums to an insurance carrier. Continue Reading >

A cafe owner leans against the counter. Today, self-funding plans can be an option for small businesses like his.

Startups, Self Funding and Stop Loss

For a startup to last beyond a few years, all the stars have to align. The business has to have a great product and a way to reach its customers. There has to be a place for that product in the market. Investors have to be willing to fund the business until it starts earning profits, which may take years. A successful startup also needs a team of skilled employees who are engaged in the work and committed to building something that lasts. Providing high-quality health insurance is one way a growing startup can attain and retain top talent. Self funding and stop loss coverage are two tools that can make that goal achievable. Continue Reading >



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    In 2011, the top 5 most expensive medical conditions treated in US hospitals were: Septicemia, Osteoarthritis, Complication of device, implant or graft, Liveborn, and Acute myocardial infarction

    From 2010 to 2013, the number of claims that were individually $1 million or above rose by 1,000%

    In 2017 approximately 18% of the American public will purchase insurance through exchanges, radically transforming the health insurance landscape.

    In 2014, 98% of large firms (= 200 Workers) offer 1+ wellness programs to their employees.

    The most costly 1% of patients account for 20% of national health expenditures – accruing average annual expenses of nearly $90,000 per person.

    6% of firms offering fully-insured plans report they intend to self-insure because of Obamacare.

    In 2014, PPO plans remained the most common plan type, enrolling 58% of covered workers.

    In 2012, 93% of businesses with 5,000+ employees and 80% of companies with 1,000-4,999 employees were self-funded

    Massachusetts has the third-highest prevalence of self-funded insurance in the small-group market (Fewer than 50 employees).

    In 2013, the average deductible was $2,906 for individuals selecting plans from marketplaces. This compares with average deductibles of $1,135 for an individual with employer coverage.

    In 2013, the average annual premiums for employer-sponsored health insurance are $5,884 for single coverage and $16,351 for family coverage, up 5% and 4% respectively from 2012.

    From 2010 – 2013, cancer followed by chronic/end stage renal disease and leukemia accounted for the top 3 costliest illnesses.