FREQUENTLY ASKED QUESTIONS ON SELF-FUNDED PLANS

What is a fully insured health plan?
What is a self-funded health plan?
Why do employers self fund their health plans?
With what laws must the self-funded plan comply?
Is self-funding for everybody?
What is excess-risk (or Stop-Loss) coverage?
Do I have to redesign my existing health plan?
What about payroll deductions?
Will my life insurance coverages be affected by self-funding my health plan?
Who will take the place of the insurance company to administer the plan?
What are the advantages in using a TPA?
Do TPAs do as good a job, or a better job, than insurance companies??
Why should I self-fund my health plan?

Do I have to redesign my existing health plan?

No, not at all. Self-funding doesn't require a change in the existing group coverages you offer, unless of course you want to change them. Some employers have become comfortable with certain plan designs and decide to leave the plan as is for at least the first year of self-funding.

Other employers find that the existing plan is excessively expensive because of an overly generous design and/or difficult administrative burdens. Employers redesign these plans to save money and to simplify the plan. The choice is up to the employer. We'd be glad to help with this decision.

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