Self-Funded Insurance

business professionals looking at laptop computer

What if there was a way to save money on insurance premiums while still offering the same or even better coverage to your employees? Self-funding can be the solution to growing insurance costs.

  • 47% of employees in firms with 200-999 workers are self-funded according to the 2011 Kaiser Family Foundation Survey of Employer-Sponsored Health Plans.
  • Self-funded insurance plans are the solution to almost half of large employers’ problems.
  • The same Kaiser Survey reports 58% of workers with a self-funded plan are also covered by stop-loss insurance.

Self-funded insurance is an arrangement where an employer provides health care or disability benefits to employees with his or her own money. Even though these plans are called “self-funded” the employer does not usually assume 100% of the risk. Extreme claims like transplants, leukemia or premature births can be covered by a type of insurance called stop-loss or excess-loss which covers the employer for claims above a predetermined price. In other words, the employer accepts most of the risk, but controls that risk with a stop-loss plan.

Sometimes most of your employees are young and healthy which means it doesn’t make sense to pay a one size fits all premium. In many cases, self-funding will not only save you money, but it will attract the best employees.

Changing from an insurance program that is the same for every employee to a self-funded plan can make a big difference. Joseph Berardo, Jr., CEO of MagnaCare said in an interview with Inc Magazine, "Savings can be in the range of 10 to 20 percent.”

The Pros of Self Funding Are Clear

Self-funding allows the employer the flexibility to customize insurance plans for everything from employee eligibility to cost-sharing to retiree benefits.

  • Self-funding gives the employer better data because the employer will have greater access to employee health claims.
  • Another benefit is more cash flow. You know how to use your money better than an insurance company.
  • Self-funded coverage is not prepaid which means you will have more cash on hand to invest in other areas of your business.
  • Self-funding allows that flexibility. Your employees will also be happy because their premiums will be lower.

Many large and small companies are switching to self-funded insurance programs because it saves them money and allows them to create customized plans. It just makes sense. For more information on how Valued Health Partners can help you save money on your employee benefits, and to see if self funding is right for you, call us today at 1-855-847-5550.

Sources:
http://www.physicianscare.com/content/public/default.aspx?id=330
http://www.shrm.org/hrdisciplines/benefits/Articles/Pages/SelfFunded.aspx
http://ehbs.kff.org/

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...with powerful health care and claims management systems to save them money.
We believe your investment in a health plan should be treated like any other aspect of your business, with upfront knowledge of the costs and all attempts to weed out waste. MBA saves employers more than nickels and dimes with many methods of management, including: Metrics Based Pricing: Why rejoice over a 30% discount on a claim that is 1000% too high? Metrics Based Pricing reduces claims to a “cost of service + reasonable margin” level by auditing claims for unfair markups and inaccurate or fraudulent billing. This results in an average $1500 per employee savings – AND WE DO IT WITHOUT RESTRICTIVE NETWORKS! Medical Management Services: Proven to reduce hospital admissions and the average length of stay. HealthSteps™: Wellness plans and initiatives that do make a difference in the overall health of your workforce and drive down health claims. Prescription Benefit Management: With an average reduction of 9.4%. Internet Prescription Bidding: Allowing employees to save up to 87%. Actuarial Projecting: The projection of benefit costs and savings is one of our underwriting core competencies. Go ahead – suggest benefit changes, add or drop a plan component, change eligibility: MBA will accurately determine the financial impact on the plan and offer suggestions to tweak the benefits to suit your objectives. We offer the facts then you call the shots.
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Where else can you get a direct line to a claims adjudicator, plan manager or even the President of the company? Only at MBA Benefit Administrators. We’re the big third party administrator for health plans with personal service that you can only wish others would provide. Like talking to a friend over a fence, we have that neighborly feel…but we provide world class advantages.
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With “outside the box” flexibility in health plan administration…
Since 1987 MBA Benefit Administrators has successfully served large and small employers, public entities, associations, tribal nations, school districts, non-profit organizations and insurers. We have the capability to administer anything from single-plan 25-life groups to complex employee organizations with multiple medical, dental and vision benefits or employees in multiple states. We also provide a wide array of ancillary services such as COBRA and HIPAA administration and HSAs. When you discover:

  • The depth of our experience
  • The flexibility we offer in benefit design
  • Our commitment to technology to make your life easier
  • Our can-do attitude toward service

 

…we’re confident you too will see why MBA is a national leader in third party administrative healthcare benefits.

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…and we prove real solutions do exist for escalating healthcare costs.
We’ve received national kudos for our multiple, proven strategies which reduce claims and plan costs without harmful benefit reductions for our clients’ employees. Proof of MBA’s effectiveness in this is in the numbers. Our clients see:

  • An immediate average reduction of up to 25% in maximum health plan costs the first year,
  • Flat renewals after that, and because of this and our commitment to impeccable service…
  • Our clients remain with us an average of 12 years…an unheard of accomplishment in the health insurance industry.
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…and state-of-the-art technology for painless administration and integration of services, we make your life easier.
No one thinks about making your life easier and more efficient than MBA Benefit Administrators. Our technological investments are totally integrated across services so that employees and employers – with HIPAA-compliant and appropriate need-to-know safeguards – can view at a glance their standing for benefits, claims, plan reporting and other services. These advancements provide:

A Comprehensive On-Line Enrollment Wizard: Employee self-enrollment or HR department enrollment methods, including ancillary program enrollments and billings.

HR On-line Capabilities: View, adjust and approve on-line employee eligibilities; check claims status, print reports and plan documents all from one place.

Multiple Employee Access Channels: Employees can view on-line their claims status, eligibility and account balances of reimbursement plans such as HRA, HSA, Flex and Executive Reimbursement plans. In addition, we offer all employees our MBA App, where they can:

  • Carry a virtual ID card,
  • Check on the status of a claim,
  • Submit secure documentation to MBA,
  • Contact our support team,
  • …and more!

On-line Document Management: In one place view specific documents such as:

  • Plan Documents
  • Temporary ID Cards, and
  • Employee Communications and Forms

HSA Services Integration: MBA seamlessly integrates HSA plans with HealthEquity Services. Claims information is electronically transferred from MBA’s claims system to HealthEquity employee accounts. There is no need for paper claim filing or second-guessing the eligibility of expenses. Even employee eligibility is updated through MBA data feeds.

HRA Reimbursement Plans: MBA’s administration processes allow clients and their participants to rely on accurate and timely processing of reimbursements. Eligibility, billing and remittance of claims, integrated scanning and storage allow for real-time remote access.

Section 125 Flexible Spending Plans: MBA Benefit Administrators coordinates with employers to offer Section 125 Flexible Spending administration and help employees save money on medical expenses. Providing this benefit for your employees is like getting a 30% discount on Medical Premiums, uncovered medical expenses and dependent care.

COBRA Administration: MBA Benefit Administrators can handle all of your COBRA requirements. We will mail and track notifications, coordinate COBRA payments, receipts and reporting and ensure claims match “paid through” dates, plus give you on-line access to all activities.

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At MBA employers are cared for too…
MBA goes the extra mile to ensure that as an employer your health plan does not complicate your life. We give you things like:

  • Business intelligence for advanced reporting and critical analysis of your plan’s performance, costs, payouts, claims analysis and large claims submitted for insurance.
  • Billing and Funding services integrated with enrollment, customized to your specifications and handled electronically.
  • Account balancing systems produce cost accounting reports and perform bank reconciliation activities, available for review at any time.
  • And the ability to review multiple reports regarding your plan; check registers, active employee reports, YTD recaps, claims reviews and lots more.
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