Speciality
Self Insurance & Medical Stop Loss
Self-funded plan strategies with stop-loss protection for employers ready to take more control of their healthcare costs.
Why It Matters
Take Control of Your Healthcare Costs
Self-funded health plans have long been associated with large corporations — but modern stop-loss products and sophisticated third-party administrators have made self-funding a viable option for employers with as few as 25 employees.
In a self-funded arrangement, the employer assumes the financial risk for employee health claims, paying them directly as they occur. To manage the risk of catastrophic claims, employers purchase stop-loss insurance that provides reimbursement when claims exceed defined thresholds.
Employers gain full transparency into their claims data, retain any surplus if claims come in below projections, and gain the flexibility to customize their plan design in ways that fully-insured plans don't allow.
Key Features
What's Included
Specific Stop-Loss Coverage
Caps the employer's liability for any single claimant's claims in a plan year, protecting against catastrophic individual claims.
Aggregate Stop-Loss Coverage
Caps total plan liability across all claimants, protecting against an unexpectedly bad claims year.
Level-Funded Plans
A hybrid approach that combines self-funding's cost control with fixed monthly payments for easier cash flow management.
Third-Party Administration (TPA)
Independent administrators handle claims processing, member services, and plan management on the employer's behalf.
Claims Data Access
Full transparency into your claims data — enabling smarter plan design decisions and cost management strategies.
Custom Plan Design
Greater flexibility to design a plan that fits your workforce's specific needs, rather than accepting a carrier's standard offering.
Is self-funding right for your business?
We'll help you evaluate whether a self-funded or level-funded plan makes sense for your group.