Self-Funding is Risky

Anyone who has experienced a double digit premium increase knows that health plan prices can be volatile. Price swings can occur whether fully insured or self-funded. When self-funding with Stirling Benefits, you will have access to your full claims data and can take steps to lower your costs and still improve benefits. This is the key to understanding why self funding is NOT risky.

Insurance companies are offering “level funding” to very small groups. All level funded groups are actually self-funded with insurance company stop loss. If a level funded group gets a single digit renewal, they are a very good prospect for full self-funding. The carrier is basically signaling that group has a good risk profile. Self-funded plans with Stirling all utilize appropriate Stop Loss to limit risks and protect cash flows. And unlike carrier level funding with Stirling, the group keeps all their reserves and does not give half back to the carrier.

I’m Too Small To Self-Fund

We offer self-funding to groups with 25 or more members on their plan. The reason why self funding can work with smaller companies is due to the company’s risk profile. If the risk is not high the chances of your company becoming self funded is high. We believe that by reviewing your claims data from the previous 2 or 3 years, we will have more than enough information to provide you with a comprehensive quote that will give your employees all the benefits they need and more.

My Employees’ Health Is Outside My Control

A properly designed health plan has financial incentives for obtaining quality appropriate care. By crafting the plan to share savings with employees, the employers cost will go down. This includes eliminating high deductibles that are a barrier to care, rewarding those that take small progressive steps to improve their vitality and long term health, and lowering copays for medicines that are effective to encourage compliance.

You can positively impact the health of the families that rely on your plan. To do so, you need to design a plan that truly benefits you and them, rather than one that benefits the insurance company.

Medical Expenses Can’t Be Controlled

Medical expenses can ABSOLUTELY be controlled! There is sometimes a huge price difference between two medical providers just a few miles apart. Our plans reward employees that choose lower cost, high quality providers. For example, some of our plans eliminate a fixed co-payment for a MRI. One plan pays 80% of the cost. Members can choose a $3000 MRI and pay 20% ($600) or get a MRI at a licensed facility down the street for $800 and pay $160. Members can choose. Once members understand their costs, we find they turn into very savvy consumers. Just like getting multiple quotes from dealerships to buy a car, we know that training consumers to do the same with non-urgent services will significantly lower your health plan costs annually. The medical provider charges can’t be controlled, but helping members find a better deal on their care saves them, and the plan, money!

Additionally, it should be noted there are numerous mechanisms that Stirling Benefits has to save tens of thousands of dollars on some medications. The rebates on these drugs can account for upwards of 30% of the of the price and often go directly back to the insurance carrier. The carrier has little to no incentive to help find a lower cost drug.

With our plans, all the savings go to the plan sponsor, not the insurance company. What better reason to choose Stirling Benefits than this?

I don’t have the staff to manage a self-funded plan

It is true that self-funded plans do take more work than a fully insured program, but once it is up and running, it might be a few hours a month to manage.

For many employers, benefit plan costs are the second or third largest line item after salary. We find that many employers will spend hours negotiating a few cents off a supply item, but have never thought of using the same theory and application to healthcare! We are baffled that health care programs are only given a few hours a year at renewal presentations. There is absolutely no need to accept a standard plan chosen from a spreadsheet, especially since those spreadsheet options are canned packages not meant specifically for you or your employees! You can custom design a plan that meets your specific needs. Of course, the earlier you start, the better the plan and the better the results. Don’t wait till your renewal comes in. It takes time to save money, to talk through the options, and time to bring in a lower cost program with benefits tailored to meet your needs.

The health plan is supposed to be a benefit, not an expense. We view it as an investment in your firm’s future.

We work with select fee based advisors. If your broker has not told you about Stirling Benefits, call us. If your advisor says you are too small for self-funding, or you don’t want that, or it will take too much time, or your members are too sick, we can offer a second opinion with one of our preferred advisors.

We believe that plans can be both caring and cost effective.

Find out how with Stirling Benefits.

Click for a free consultation.