Self-Funded Health Plans
Greater control over your health plan and healthcare spending.
With a self-funded plan, the employer funds covered medical claims. An administrator can manage claims and plan operations, while stop-loss insurance can protect against specified high-cost exposure.
Specific products and availability are subject to confirmation.
Why employers consider it
For employers prepared to retain claims risk, self-funding can offer greater plan-design flexibility, more spending visibility and a direct financial benefit when claims are lower.
- Plan design can be tailored rather than selected from fixed carrier products.
- Administration, reporting, network access and member support are arranged through service partners. Delivery arrangements are subject to confirmation.
- The employer carries funding responsibility for covered claims within the retained layer.
Claims administration, reporting, network access and member support are delivered through service partners. We will describe them as our own services only once the delivery arrangements are confirmed.
Important consideration
Claims costs can fluctuate. The employer retains funding and plan responsibilities, and stop-loss protection is subject to its terms.
Benefit design sits alongside funding
Self-funded plan designs can range from broad major-medical benefits to designs with specified limits on certain services, including limited-day options. The funding decision does not settle what care is covered.
Keep in mind
A lower-cost design usually covers less care. Compare the covered benefits, not only the monthly funding figure.