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Optimize your self-funded health plan in 2 simple steps

Posted by Paula Turnquist

Companies looking to take more control over their healthcare costs may choose to adopt self-funded plans, where they trade fixed insurance rates for direct payment of claims. While employers are forced to assume more risk for occasional hefty charges, they gain flexibility and tighter control over how their healthcare dollars are used. Not only can companies avoid excess spending that would otherwise end up as profit for insurance companies, but they also qualify for lower tax rates than other health plans, saving costs across the board. 

If an organization can afford to take on the risk of paying the occasional large claim, these stripped-down plans may be the ideal cost-saving alternative. However, their inherent customizability means employees also take responsibility for crafting a plan that will best serve its workforce. Whether your company already operates under a self-funded plan or you're considering getting started, here are two tips that can help optimize your self-funded plan:

  • Engage with employees: The first step to determining how and where you'll spend your healthcare budget under a self-funded plan is to determine which services are most important to the people who will use it every day. Evaluating your employees' demographics, geography, environment and societal factors can help you better target the services you prioritize, according to Employee Benefit Advisor. 
Let us s​how you how you can save 15-30% on your company's total medical  costs. 
  • Evaluate payer models: Just because your business is self-funding doesn't mean it's working alone. Explore how Administrative Service Only companies and Third Party Health Plan Administrators might be able to help support your claims management process. Typically ACOs offer standard, packaged administrative services, while health plan administers offer a more flexible range of services, Payer Fusion reported. Or, companies can choose to make the investment to handle the claims process in-house. 

Posted by Paula Turnquist

Paula Turnquist joined Kelsey-Seybold Clinic in 2013 as sales manager of Employer Products. She is responsible for the sales of products and services ranging from employer group health plans to Executive Health and Occupational Medicine programs. Paula is originally from the Dallas-Fort Worth area and is a Nursing and Health Care Administration graduate of Texas Christian University in Fort Worth. She has worked in healthcare since 1976 serving major hospital systems, physician practices, venture capital start-ups and large insurance carriers.

Our team is committed to promptly and expertly managing all your inquiries and providing you with the exceptional service that you expect and deserve. To get started, complete a Get a Quote form. We will contact you within one business day or you can call the KelseyCare Get a Quote Line at 713-442-3456.

Topics: Health Plans, Workplace Health, Self-Fund

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