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Self-funding an employee health benefit plan is a smart long-term business strategy to save money. Self-funding can provide an excellent opportunity for a company to recognize immediate cost savings as well cost control while meeting their employees health needs. There are financial and operational advantages of self-funding. You might be a good candidate for self-funding if:

  • You’re ready to reduce cost by improving employee health.
  • You want greater control over employee benefit expenses.
  • You'd like to design an employee benefit plan that fits your employees' healthcare needs.
  • You want efficient, accurate claims administration and live, local, customer service.
  • You want access to up-to-date-data for strategic employee benefit decision making year-over-year.
     

Why consider self-funding?

You have more control, lower taxes, improved cash flow, less regulations, and plan flexibility with a self-funded plan.

Increased Financial Control

With self-funded plans, employers have the advantage of using their money for funding claims when they are due rather than funding an insurance company through advanced premium payments. You can control your funds that would otherwise be held by your insurance carrier in various reserves, such as unreported claims and pending claims.

By funding claims directly, an employer avoids the insurers’ costs of claim reserves, administrative costs, profit margin, risk charges, premium taxes, and contingency margins—basically, you're cutting out the middleman and likely saving money because of it.

Plan Flexibility

Employers have flexibility in designing their own health benefit plan. Self-funded plans are exempt from state insurance laws, which give employers more control of where their claim dollars are spent. Many benefits incorporated into your plan document are determined by your cost and strategic planning objectives.

Utilization and Plan Management

The design flexibility and ongoing expense analysis of self-funded plans allow employers to make the plan design changes they need in order to manage costs effectively. Self-funded plan designs can include strategies to monitor use and assure appropriateness of care for inpatient and outpatient services, all while utilizing discounted network partners.

Information Management

In a self-funded plan, employers have secured access to all the information needed to manage their plan effectively. Authorized individuals will have access to confidential monthly reports and benefit-related information and insured clients have access to their eligibility, claims, and reporting system through our encrypted website. This allows the clients to have greater time control and functionality for their plan data.

For more information, contact:

Lon Springer
Senior Account Executive, TPA Services
lspringer@phpni.com
1-800-551-7334

John Court
Account Executive, TPA Services
jcourt@phpni.com
1-800-982-6257, ext. 212