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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>

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.

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>

TPA Controls High Claimant Costs through Claims Management, Early Detection

Mar 17, 2017|0 Comments

A study shows that claimants who accumulate $50,000 or more in annual benefit costs represent nearly a third of total spending as it relates to employers’ health plans. What can be done to help contain these high costs? Third party administrator (TPA) MedBen explains how 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.

Air Ambulances Are Flying More Patients Than Ever, and Leaving Massive Bills Behind

Jun 27, 2018|0 Comments

Rising prices, billing disputes, and a quirk in federal law are creating a new health-care headache — When three-year-old West Cox’s fever hit 107 degrees, doctors called a helicopter…. Flying would cut a 90-minute drive in half…. Three years later, his parents are still reckoning with the aftermath of his 76-mile flight: a bill for $45,930 from for-profit helicopter operator Air Methods. At the heart of the dispute is a gap between what insurance will pay for the flight and what Air Methods says it must charge to keep flying…. when health plans balk, patients get stuck with the tab…. READ MORE

Shifting Models Could Advance Captives’ Role in Health Care

Apr 3, 2018|0 Comments

Rising health care costs, shifting care delivery models, escalating mergers and acquisitions activity and a potential new megaplayer are all complicating the health care landscape, but could also boost the use of captive insurers to cover health care risks, particularly group captives…. Stop-loss captives can be a valuable tool for employers navigating the evolving health care landscape because they enable employers to share risk with a larger population…. READ MORE

Read more of our Industry Articles …