Gain Control With Self-Funded Health Plans

Gain Control With Self-Funded Health Plans

With increasingly more employers looking to gain cost savings through fully self insuring or partially self insuring health plans, an even greater benefit is being realized: Control over plan design and utilization of plan data to better manage employee health and drive down claim costs.

With fully funded health plans, employers choose from largely mandated, canned plan designs and benefits. In addition, gaining access to employee health data from the insurance carriers is difficult, if next to impossible, leaving an employer with very little information to impact their health spend and implement programs to influence healthier employee choices.

A fully self-funded health plan, on the other hand, allows employers to control their health plan design and benefits. Flexibility in plan design is due to the fact that a self-funded plan is free from state-mandated benefit laws (and premium taxes), allowing an employer to design its plan without the restrictions, delays and costs involved in obtaining the approval of an insurer or regulatory agency. Employers, therefore, can make the overall compensation package more attractive, and plan design options can be tailored to the employee population and company preferences.

In addition, with self-funded plans, employers gain full data transparency. They have access to their group’s claims and utilization data to use data analysis and sound risk management principles to both help employees manage their health better and control claim costs. The data available in a self-funded plan allows employers to identify health issues and cost drivers within their own groups and put appropriate health programs, such as outcomes-based wellness programs, in place. Additionally, with access to individual employee health data, effective incentives such as premium differentials can be implemented.

Self-funded options are now available to mid-sized employers as a result of the increase in cost of health insurance and healthcare reform legislation. Caitlin Morgan offers self-insurance alternatives for employers. Among our products is a Health Select, a stop-loss captive designed to provide mid-size employers – anywhere from 25 to 500 employers – with the benefits and cost-management tools typically available to larger self-funded clients. Health Select is available in Indiana with upcoming plans to make the program available nationwide. For additional information about self-funded healthcare plans, please contact us at 877.226.1027.