Self Funded Medical Claims

A self-insured healthcare plan, sometimes referred to as a partially self funded healthcare plan or partial self funding your healthcare plan, is a healthcare plan in which the employer assumes partial financial risk for providing health care benefits to its employees. 

• Everything that is provided in a conventionally fully insured program is duplicated in the partially self funded health plan. 
• The employer can duplicate it’s current fully insured benefit plan or it can “redesign” and tailor the benefits to meet the specific needs of the employer. 
• Since Self funded healthcare plans are governed by ERISA, they follow Federal law, and are not required to cover “State-Mandated” benefits, which can be expensive and unnecessary.
• The employer only pays for their own claims. With a fully insured plan, the premium is paid every month regardless of where there are claims or not.