716.688.5600

Self-Funding, The Better Way

What is a Self-Funded Health Plan?

With a self-funded health insurance plan, the employer assumes the responsibility and related financial risk for paying plan participants’ health care expenses

Details of Self-Funding

  • The main change from being fully insured is the funding mechanism; a change in benefit levels or administrator is not required
  • Administrative costs are fixed and are no longer tied to premium increases
  • Your organization holds reserves and claims dollars until payments are needed

Self-Funding Highlights

  • Plan control over plan designs
  • Improved cash flow
  • Reduce health insurance costs 10-15 percent without compromising plan quality
  • Relief from most premium taxes
  • Improved access to claims data history
  • Exempt from state insurance regulations
  • Carrier profit margins are minimized
  • Non-negotiable premium increases are eliminated

What differentiates Premier in the marketplace

  • Experts in alternative funding mechanisms
  • Preferred stop loss rating as a result of our large book of business
  • Dedicated Cost Management Department that offers customized programs including:
    • Enrollment verification audits
    • High claimant medical review
    • Out-of-network discount negotiations
    • Hospital bill audits
    • Specialized wellness programs
  • Experts in analyzing medical and prescription drugs claims data and understanding how to utilize predictive modeling and gaps in care analysis
  • Experts in negotiating union health plan programs

Our team includes self-funded benefit experts who are highly skilled in both employer and employee problem resolution. Our staff has worked “on the other side of the fence” paying claims, auditing, providing case and cost management, managing provider relations and customer service. We understand how claims are adjudicated, paid and denied.

The Premier Consulting team offers the best self-funding and stop loss insurance consulting services to businesses of all sizes. The highly skilled team performs a full range of health care insurance consulting services relating to:

  • Plan design
  • Implementation
  • Employee and vendor communications
  • Recommendations regarding current stop loss
  • Future benefit plan options

Our goal is to provide you with low-maintenance, cost-effective and creative opportunities to manage your plan to meet the needs of you and your employees.

Click here to learn more about what Premier can do for you.

Association of School Business Officials New York
Society for Human Resource Management
Society of Professional Benefit Administrators
Self-Insurance Institute of America, Inc.
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1416 Sweet Home Road
Suites 5 & 6
Amherst, NY 14228

716.688.5600

News & Views

Understanding Stop Loss and Self-Funded Health Plans

There are many factors that administrators of group health plans consider when evaluating different programs or benefit packages. Each organization – a school, a municipality, a private sector employer or a not-for-profit organization – has different needs. An...