Self-Insured healthcare plans are increasing in popularity because self-insured employers can pay for claims out-of-pocket as they are presented, instead of paying a predetermined premium to an insurance carrier for a Fully Insured plan. Businesses are able to better negotiate administrative services and reinsurance as effectively as that of a larger, single employer. 



Facts about Fully-Insured Plans

  • Lack of transparency
  • Retrospective rating
  • Volatile rate cycle
  • Carrier shopping (switching different carriers every year, new cards, etc.)
  • No direct savings from wellness initiatives 


Facts about Self-Insured Plans:


  • Available to small employers. Companies must have a minimum of 20 employees covered on their medical plan.
  • Full transparency
    • Monthly reports detail where every dollar is spent for claims, administration and insurance protection.
    • You are fully aware of rate development for their next renewal cycle.
  • Total Control
    • You have collective purchase power of stop-loss insurance.
    • Specific claim utilization history allows you to make design changes to benefits both employees and your business. 
  • Stability
    • You have real-time data throughout the plan year, which creates a more predictable healthcare line item. 
    • It allows a safety net for protection in both good and bad claim years. 


Learn more about our Genesis Healthcare Consortium, one of our self-funding consortiums. We would love to set up a meeting to talk about if your company would benefit from a self-insured market. 



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