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Self Insurance

Self-insuring may be a viable option for larger employers. When a company decides to self-insure, it assumes all the responsibilities of offering a plan to the employees. Trustees are appointed and they assume the fiduciary responsibilities for the plan, its assets and compliance with all federal and state laws, rules and regulations.

A Third Party Administrator is usually hired and re-insurer is contracted.

You, the committee and the advisors develop the insurance plan. You have absolute control over all the benefits and percentage of payments.

Self-insuring gives the employer control of all the options. It also gives the employer all the risks. The decision to self-insure is a five to seven year commitment. No plan be successful every year. Four out of five, or five out of seven is average. The other years will be a loss for the plan.

The elements of self-insurance include:

  • Reinsurance contracts
  • Specific loss
  • Aggregate loss
  • Aggregate deductible (% as quoted)
  • Enrollment 24/12, 12/12, 15/12 run out
  • Rx rebate
  • Networks
  • Entry fees
  • Access fees
  • Discounts
  • Tiered options
  • TPA fees
  • COBRA fees
  • Per head fees
  • Commissions
  • Reports changes
  • Renewal costs
  • Funding levels
 
self insurance