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A Proactive Approach to Plan Data Lowers Number of ER Visits

Nov 14, 2018|0 Comments

Having access to plan data is a unique advantage in self-funding that gives employers the ability to identify cost-driving trends and make the necessary adjustments to address them. Nova Healthcare Administrators, Inc., shares an example of how this diligent data monitoring led one client to READ MORE>

Success in Self-Funding

What’s Actually Working for Employers in Controlling Health Plan Costs

Today’s health benefits landscape is more challenging for employers to navigate than ever before. Yet, there’s a reason why nearly 70% of employees who have health coverage in the U.S. are now enrolled in some sort of self-funded plan and why that number is growing – they work. It’s that simple. Companies of all sizes and types, including public entities, are finding this to be true as they make the switch from the more limited fully-insured plans to the added flexibility and customizable health benefit options self-funding offers. The goal of this website? To showcase success stories from the employer-entrepreneurs who are experiencing the savings because of their self-funding efforts and from the SPBA-member third party administrators (TPAs) who are the facilitators in making these success stories happen.

NEW to the concept of self-funding?

Here’s a quick introduction:

Self-Funding 101

Recently Submitted Articles:

The most recently posted real success stories about self-funded plans and how they’re working, as shared by the third party administrators (TPAs) who manage them.

Thorough Claim Review Leads to At-Home Treatment Solution that Saves Nearly $100K Per Year for Individual Member

Nov 30, 2017|0 Comments

One thing that’s often a real difference maker for self-funded clients is the emphasis that’s placed on health claim review. As third party administrator (TPA) MedBen noted in a recent blog post, the savings opportunities identified can be quite substantial – even on an individual READ MORE>

Forward-Thinking Employee Benefits Lead to More than $2 Million in Savings and Healthy Outcomes for Plan Members

Sep 20, 2017|0 Comments

When offering health benefits to employees, employers face the risk of experiencing high-cost claims if plan participants are diagnosed with a serious illness or disease. Self-funding allows the flexibility to plan for these situations … proactively. In this example, Tom Doney of Cypress Benefit Administrators READ MORE>

Read more of our articles: Self-Funding in Action …

In The Industry:

A sampling of employee health benefits industry articles, with an emphasis on self-funding-related topics and perspectives.

A Tough Negotiator Proves Employers Can Bargain Down Health Care Prices

Nov 12, 2018|0 Comments

Marilyn Bartlett took a deep breath, drew herself up to her full 5 feet and a smidge, and told the assembled handful of Montana officials that she had a radical strategy to bail out the state’s foundering benefit plan for its 30,000 employees and their families. The officials were listening. Their health plan was going broke…. Bartlett came with some unique qualifications. She had just spent 13 years on the insurance industry side…. Most importantly, Bartlett understood something the state officials didn’t: the side deals, kickbacks and lucrative clauses that …. [help] explain why Americans pay the highest health care costs in the world — and why the tab continues to increase, year after year…. And so Bartlett pitched a bold strategy…  READ MORE

The Remedy for Surprise Medical Bills May Lie in Stitching Up Federal Law

Oct 18, 2018|0 Comments

Drew Calver, a high school history teacher and swim coach in Austin, Texas, had a heart attack at his home on April 2, 2017. A neighbor rushed him to the nearby emergency room … which was out-of-network on his school district health plan. …his health plan paid nearly $56,000 …. but the hospital charged Calver another $108,951. That sum – a so-called balance bill – was the difference between what the hospital and his insurer thought his care was worth…. READ MORE

Read more of our Industry Articles …