As health care gets more expensive, more employers are starting to look for new solutions. One such solution is self-funding, which is a logical, powerful option other than traditional insurance, and one that can be easy to implement for employers. With self-funding, employers can fund their claim costs directly, and at the same time limit the amount of risk by buying stop-loss insurance.
Traditionally, the insurance company would pay for the majority of benefits and members would pay small expenses like co-pays, coinsurance, and deductibles. In this case, the insurance company profits when claims are low. With a self-funded plan, employers pay benefits up to a higher amount, but purchase stop-loss insurance, which reimburses the plan when or if the deductible is met.
So what exactly does stop-loss insurance do? It helps protect the plan against individual catastrophic claims, or protects against total claim expenses that exceed yearly budget.. This first instance is called specific stop-loss, while the second is aggregate stop-loss. Third Party Administrators work for employers to manage, process, and pay claims on their behalf.
Self-funding is an employee health plan that really works for everyone! Employers get the benefit of choosing from an array of plans and customize-able benefits that truly fit their employees’ needs. They can also choose the payment and funding option that best works with their business plan and expenses. That’s what’s so great about self-funding: it works with you and is flexible.
With the VEBA Captive program, employers can pre-pay a specified premium equivalent, including a maximum claims fund and fixed costs. Since the employer is pre-paying, This gives clients the benefit of choosing a health plan that is not bundled.
We work with the best vendors, as well as A-rated excess insurance companies, physician networks, and wellness providers. We help you, the employer, keep costs low by paying claims directly to providers while allowing you to customize your benefits. Essentially, we reward you in a way that makes sense for businesses of all sizes. Finally, a better way to do benefits.