Self Funding and Insured Stop-Loss Managed Platform

Over the past few years, many companies have evaluated the increasing premium costs associated with their group medical insurance programs and have looked for ways to improve cash flow and economize on the budget for employee benefits.  This has given rise to partial self funding and insured stop-loss managed platform.  Any company with more than 100 employees that is not using this type of a plan is probably spending a great deal of money unnecessarily.

Organizations have proven that by self funding a designated portion of their medical claims and reinsuring for catastrophic claims, they are able to retain significant savings.

The concept of a partially self funded platform is to eliminate or substantially reduce some expenses – most notably the profits made by big insurance companies.  In addition, the use of a good Third Party Administrator offers solid claims processing and management of the inflationary claims experiences through proper plan design.

Under stop-loss insured platforms an employer purchases a high deductible insurance contract for the group.  Claims that do not exceed the deductible limit are paid from the fund, developed from employee and employer contributions as premiums, to fund the platform.  The stop-loss insurance carrier pays claims that exceed a pre-set limit.

If your organization is already using a partially self-funded structure The Open Solution™ will turbocharge your savings with The Open Solution™ re-pricing formula and our medical Case Management.

Why use this structure?

• Benefits are often thought of in terms of salary or wages, rather than fringe benefits
• Medical claims inflation as well as changes in benefit laws (ACA) are the most significant factors increasing the cost of medical benefits – controlling these costs pays big dividends
• There are potential cash flow advantages
• At present, under self-funding, the premium tax does not apply
• The fixed cost of administration is transparent
• Platforms are custom designed the way YOU want it – not a committee at a giant insurance company

Aren’t you ready to keep your profits for your own purposes?  Click here to access our Financial Analysis to estimate the potential savings you could have when switching to The Open Solution™.