Opinion Based List:
Advantages to Employers Choosing to Self-Fund Health Plans
- Self-funded plans have lower administrative costs with better cash flow.
- Self-funded employers are afforded more flexibility in the design of their benefit plans, which helps to control cost, quality and levels of service.
- Decision making on what to include and how to adjust spending on certain aspects of the benefit plan can be directly determined by data received from utilization reports and claim information.
- Self-funded plans incur lower taxes than other health plans.
- Funds usually held by the insurance carrier in various reserves are available for use by self-funded employers and can benefit the employer financially.
- By choosing the right administrator, employers can design a service plan that meets their needs.
Notes: Employers with self-fund health plans should consider the right type of payer/administrator to suit their needs: Administrative Services Only (ASO) - Insurance company that offer packaged administrative services to self-funded employers without taking on risk There is often little flexibility to included or exclude specialty vendors to optimize the health plan performance. Self Administration - Employers take on the large investment to administer benefits and pay their own claims. Third Party Health Plan Administrator - A Third Party Health Plan Administrator offers administrative service packages ranging from complete services to customized services to suit the employer's needs. These services include claims payment, case management, provider networks, prescription coverage, and medical fraud detection.
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PayerFusion is a Health Plan Administrator that offers an extensive array of services that meet self-funded health plan payer needs. These include provider network design/support, policy design, full-service TPA, technology solutions/support and informatics.
For more information on our services please visit Our Services. If you are interested in having a service package tailored to your needs, please contact us.