Self-Funding vs. Fully Insured

• Elimination of most premium tax – Self-Funded arrangements are exempt from most state mandates such as premium tax
• Lower cost of operation – Employers may find that administrative costs for self-funded programs are lower  than fully insured
• Improved cash flow – Faster turnaround of funds between the employer funding the claims and the actual claim payments
• Potential savings – When claims are lower than expected, the employer retains the financial savings. Self-funding employers also benefit from reduced premium taxes.
• Ability to Purchase Stop-Loss Insurance – your maximum exposure is capped
• Plan design flexibility and control – Employer has complete control of all aspects of the health plan and design

• Through level funding, you can enjoy the flexibility and savings of a self-funded plan while also having the stability and coverage of a fully insured program.

• Unlike a fully insured plan where the premium costs are locked in regardless of how much your group’s claims actually cost, a self-funded program provides the opportunity for a refund if claims are lower than expected in a given year. There’s also no need to worry if monthly claims costs are higher than expected because stop loss insurance coverage, which comes with all of our level funded plans, will cover the unanticipated costs. This plan design ensures that you get the opportunity for savings while only having one fixed monthly payment that’s determined upfront.