top of page
Self-Funded Plans
In 1985, nearly 15% of employees participating in employer sponsored plans were on Self-funded programs. In 2016, nearly 70%. There is a growing trend toward Self-funded programs because of the added flexibility and control it offers along with cost savings.
In partnership with Benefit Health Advisors,
Vantage Financial Solutions, Inc., can provide
you a customized quote with just the following
information:
The Solution is Easy!
Partially self-funded plans work just like fully-funded
plans, except they remove the middle
man. When comparing premiums, in a typical
scenario, it’s heads you win, tails you tie.
Together, we have successfully helped
hundreds of organizations transition from fully
to self insured plans, and we can design the
benefits plan that will best satisfy your needs.
Download our brochure to learn more about self funded plans and what we can do for you.
Self-Funded plans offer employers a more cost effective model compared to traditional fully insured plans that have high administration expenses, premium taxes and insurance carrier profit margins. The employer owns the plan and the plan data and has flexibility around plan components, plan design, etc.
Monetary/Cost Management Benefits of the Self-Funded Model:
-
If claim expenses don’t reach an anticipated level, the employer retains the unused claims funds.
-
Cash flow is improved when money formerly held by the insurance carrier in the form of reserves for unreported and pending claims is freed for use by the employer.
-
Self-funded plans typically enjoy lower administration costs and overhead. The profit margin and administrative expenses are eliminated for the bulk of the plan.
-
Fully-Insured plans see approximately 30% of expenses go toward taxes, commissions, reserves, administration, and profit. Self-funded plans see approximately 10% of expenses go toward these same things.
-
The Self-Funded model is financially more sustainable over time, due to the modular model that adds an element of competition each year without causing disruption to plan participants if a carrier change is made.
-
Fully insured plans offer little transparency into annual rate increases.
Employer Control with the Self-Funded Model:
-
Complete program transparency, allow employers to access and own their data.
-
Utilization reviews are performed regularly through the year including quarterly reporting of costs, benchmarks, and lag reports.
-
Customized medical plan according to their cost and service preferences around: network, pharmacy, wellness, reinsurance/stop loss, claims processing, plan design, care management.
-
Utilization care management options including large case and disease management to help provide for the employee population the best and most cost-effective care possible.
-
Wellness programs that actually help plan participants live healthy lives, improving productivity and minimizing medical claims/costs.
-
Flexibility and control over your plan, with the ability to redesign or make changes to individual components, ultimately managing costs without disruption.
Stop-Loss
We provide expert help and the depth of experience to assist you in purchasing the right stop-loss coverage. At Vantage Financial Solutions, we pride ourselves in always negotiating the best possible rates for our clients and finding creative solutions that work for you.
Prescription Drug Card
Due to the escalating costs of prescription drug plans, it is imperative that medical plan sponsors implement effective strategies to reduce prescription drug costs. We will help you to structure innovative plan design and has negotiated deep discounts with Prescription Benefit Managers to reduce prescription costs within client medical plans.
Reporting and Monitoring
We will continuously monitor your plan and use claims data to provide recommendations and consulting at quarterly reviews. Customized reporting allows our clients to stay aware of plan utilization throughout the year.
bottom of page