Self-Funded Plans are typically utilized by groups of 50 or more employees. However, recent changes to the self-funded marketplace, driven by increased plan costs and ACA regulations, provide opportunities for smaller groups of 10 or more employees access to these plans.
Although self-funded plans can be a great product for healthy employee groups, they don't make sense for just any group. PFSI can help you evaluate your specific group and help you understand the costs, risks, and benefits that may be available to you through self-funded plan options.
Self-funded and partially self-funded plans work by sharing the claims risk between the insurance provider and employer. For groups with low claims, the savings can be very significant compared to traditional, fully-funded insurance plans. When coupled with a stop-loss structure, even higher-than-expected claims can be covered without increasing the employer's cost above a predetermined threshold.
PFSI has offered self-funded plans for more than 10 years. There are significant differences between fully-funded insurance plans and self-funded, or partially self-funded plans to employees. We understand those difference and how to evaluate them for each employer group.
These kinds of plans are not a "one size fits all" product. Expert advice and guidance are needed to understand how your business and employees could benefit from a self-funded or partially self-funded medical plan.
Contact us today to find out how we can help you evaluate your group medical benefits and how a self-funded or partially self-funded approach may work for your business!