Category Archives: Considering Self Funding

Association Health Plans (Small Business Health Plans)

For small businesses that have struggled under the Affordable Care Act, a new proposal has been introduced that would expand health insurance options afforded to small employers. The new proposal, known as the Association Health Plans, would help small businesses unable to afford employee health coverage to join together and increase their bargaining power. This proposal is expected to see the addition of self-funded plan options in the coming years, but the effects are currently unclear. Continue Reading >

How HRAs, FSAs and HSAs are Administered in Self-Funded Plans

At a time when many people feel powerless over their own health care, giving your employees choices about how they manage their own medical costs is a good thing — both for them and for you. With Health Savings Accounts (HSAs), Health Reimbursement Arrangements (HRAs), and Flexible Spending Accounts (FSAs), self-funded plans are possible for employees to utilize. Continue Reading >

Pros and Cons of Pooled Stop Loss Insurance

Pooled stop-loss insurance has its pros and cons, depending on your business structure and employee needs. It's essential to take the time to carefully weigh these pros and cons of pooled stop-loss insurance before committing to a policy. Obtaining coverage with a large group of fellow sponsors can garner your company with additional benefits, but also less overall control of the process. Continue Reading >

How Self-Insured Plans Can Avoid the High Cost of Gaps in Coverage

Stop-loss insurance is not health insurance, but rather a type of financial reinsurance. Unlike health insurance, stop-loss ensures protection from debt when payable claims exceed a deductible. Stop-loss and health benefit plans have seen an increase in disputes regarding what is payable, how much is payable, and what can be covered by stop-loss. This has in turn led to higher amounts of claims paid by benefit plan sponsors that are not covered by stop-loss insurance. Continue Reading >

How Cyber Secure is Your Self Funded Plan?

Self-Funded Insurance plans are not immune from the many data breaches that have been occurring in the last several years. Not only has the number of breaches increased, but the level of sophistication used by hackers to steal date has also increased. Preventing a breach requires diligence but the alternative can be detrimental to an organization. Continue Reading >

The Value of Self Funding

Read the The Value of Self Funding PDF created by the Self-Insurance Educational Foundation, Inc. (SIEF), a 501(c)(3) non-profit organization affiliated with the Self-Insurance Institute of America, Inc. (SIIA). The foundation’s mission is to raise the awareness and understanding of self-insurance among the business community, policy-makers, consumers, the media and other interested parties. Continue Reading >

Managed Care Vendors: Part of a Self-Funded Health Plan

Most self-funded plans utilize the services of a third party administrator (TPA) or an Administrative Services Only (ASO) carrier to act as the medical claim payer for their self-funded plans.   The services provided by these organizations typically include claims adjudication and benefit plan administration.  The services should also include management of service providers to help lower the cost of claims. Continue Reading >