Self-insurance allows employers to better
customize benefit plans. Self-funded plans allow employers to specifically
offer benefits that fit the needs of their employees and meet employer
financial and human resource goals.
Self-insurance allows employers to benefit
from the unbundling of services. Major services such as reinsurance
and third party administration (TPA) can be obtained from separate
vendors at better prices and better service.
Self-insurance allows employers to benefit
immediately from favorable claims experience. An employer who self-insures
only pays benefits applicable to their group’s claims history.
Claims are not pooled with the claims experience of other groups their
size. Should an employer experience a favorable claims experience
to premium paid under fully insured, it is very unlikely the employer
would have their premium lowered.
Self-insurance allows employers greater financial
control over how the plan is funded. Funding is more flexible in self-insurance
than in a fully insured scenario, possibly improving an employer’s
cash flow.
Self-insurance allows employers more flexibility
in the manner in which claims are paid. Appeals and exceptions can
be handled with greater flexibility and ultimately the employer can
make the exception if desired.
Self-insurance allows employers more control
in the approach to some federal and most state legislative benefit
mandates. Employers can decide whether or not to offer these benefits
in many cases.
Self-insurance allows an employer more flexibility
in the designing and contracting of managed care networks.
Self-insurance allows an employer to hold their
own claims reserves. The employer can earn interest on plan reserves
and assets.
Employers who self-insure do not have to pay
the full amount of premium taxes. State taxes on a self-funded plan
are a fraction of those in a fully insured plan