Category Archives: Considering Self Funding

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 >

Factors to Consider for Self Funding Your Health Plan

If you are considering a self-funded health plan for your company you are certainly not alone!    Many employers, both small and large are now exploring the option of self insuring their health plan for a variety of reasons with larger long term savings topping the list.   However, self funding isn’t right for everyone; therefore we will discuss some of the factors you’ll want to consider before making any changes to your health plan. Continue Reading >

Factors to Consider

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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.