Self-funding is only for the largest employers.
Not true! We routinely write health benefit plans for groups for 50 employees or more.
Self-funding seems complicated.
In reality it isn’t, it’s just that a self-funded plan breaks out and lets you see all of the things that are bundled together in a fully insured plan, such as the percentage of your budget that goes for pure catastrophic insurance, administrative services and claims. This gives you the opportunity for greater control over costs and more flexibility in benefits design. And of course, MBA is here to guide you every step of the way.
"Self-funding" is just another way of saying "self-insured"
No...there is a difference. "Self-insured" is only for the largest employers, such as the Fortune 1000, who find it cheaper to pay all of their own health claims and administer their own plans. MBA offers partially self-funded plans, which are a mix of employer-paid claims (within limits) and health insurance coverage. This limits the employer’s liability while saving premium dollars, and the mix is less than traditional fully insured costs.
Self-funding is a blank check for large claims, and I could lose my shirt.
With a plan from MBA you have two levels of protection: 1) "Specific" protection limits claims liability for any individual covered. 2) “Aggregate” protection limits claims liability for the entire group. The limits of both are balanced for both the size of your group and optimal premium savings.
Self-funding is a short-term gimmick. In the end I’ll be right back to where I am now with a rapidly rising, fully insured benefit package.
That is not the experience of many employers. In fact, while most employers review and move fully insured plans on a yearly basis while looking for the lowest rates, employers who choose MBA remain self-funded and with us for an average of 12 years! That’s possible because of our unique approach to claims management and our ability to shop aggregate and specific coverage for them; things which typically keep renewal rates flat. The “unknown” of rising rates is virtually eliminated.
Smaller employers do not have the advantage of big-group buying power, therefore a discount offered by healthcare networks on traditional insurance is the only way to save money on claims.
In many cases, advertised discounts offered by networks actually hurt you. Discounts merely provide a price reduction across the board. They do not look at itemized charges. Therefore, a gross overcharge is still a gross overcharge merely reduced by a stated percentage. For example, a charge of $1000 for a service that should cost only $100, even reduced by 30%, is still too high.
Unfortunately, the above example happens a lot. But MBA’s claims process looks at each item of a healthcare claim. Through our partnership with ELAP and AMPs, overcharge claims are repriced to a reasonable price. This saves you vastly more than simple discounts. We magnify your buying power.
I have employees in multiple locations across multiple states. I’m told having numerous fully insured plans is the best way to cover all of them.
Having employees in multiple states is one area where partially self-funded plans really help employers! Partially self-funded plans are governed by ERISA, a federal law, which supersedes individual state insurance commissions and regulations. This means you can have one plan for all employees covering multiple states and avoid the duplicate administrative costs and hassles associated with numerous fully insured plans.
I’m told that I cannot predict my costs with a self-funded plan.
That is not true at all. Your budget will be basically made up of three things; premium insurance against high claims, a small administrative fee and a budgeted amount for claims. The total of all three equals your maximum liability for the year. Employers will use this method experience and average reduction of up to 25% in overall plan costs.