As the number of stop loss insurance products offering quick reimbursement of large claims continues to increase, more and more small groups (those with 50 to 150 employees) continue to transition to partial self-funding. The ability to identify how claim funds are being spent is one important reason. Claims data, seldom made available to small groups in a fully insured environment, can help pinpoint where health care dollars are going and the impact of strategies such as disease management, care management or wellness programs.
Greater transparency and flexibility give self-funded employers the ability to track plan performance on an on-going basis and make changes as needed. While it is not unusual for insurers to wait until 60 or even 30 days prior to renewal before delivering a fully insured proposal, self-funding gives the employer the opportunity to see how their plan is performing throughout the year and be better positioned to make plan design changes as needed.
While state and federal governments continue to pursue the establishment of minimum specific attachment points that could restrict smaller employers from utilizing stop-loss insurance, partial self-funding has proven to be a very viable and effective option for many smaller groups. We will keep you informed on these developments and the availability of flexible, competitively priced stop loss insurance coverage.
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In cooperation with NAEBA