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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
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- Discounts
- Tiered options
- TPA fees
- COBRA fees
- Per head fees
- Commissions
- Reports changes
- Renewal costs
- Funding levels
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