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Good Candidates for Self-Funding Health Plans

If you are considering self-funding your health plan, my advice is talk to an expert because the path isn't always crystal clear.

You may think you are a terrible candidate for self-funding but you are perfect for it. The opposite is equally as true.

If you want to understand the types of things an expert would consider when evaluating self-funding, watch this short video.

Transcript
Here today's topic is am I a good candidate for self-funding? If you want an answer that question you really need to find a self-funded expert they're going to evaluate self-funding on a number of different factors. Here are some of the things an expert would consider number one the number of employees enrolled in the health plan. Size does matter for example in certain States? They're going to have different requirements on how many employees you must have before you can actually self Fund in the state of Illinois. It's 10 in addition to that stop loss carriers may only under write down to a certain number of employees very common for 50 or 100 but there are plenty that go below that number two is data in the absence of data and insurance carrier is simply going to add margin or decline to quote access to data is key in determining if self-funding is viable for you. Don't worry if you think you can't get access to your data because there are creative ways to get it that you probably haven't heard of the third is cash flow an employer must have some level of tolerance for month to month cash flow variations if they are considering being self-funded. That tolerance is employers specific but can be significantly mitigated if set up the right way from the start the fourth is tolerance for change. Lawrence for change is directly tied to how much you can control your risk as an employer the higher tolerance for change the more you can control your risk. Don't be fooled though change does not always mean something negative. There are plenty of things you can do in a self-funded environment that are a positive change for members. My advice to you is if you're considering self funding find yourself an expert and if the only answer you're getting right now is you are too small to self fun. You probably do not have an expert.

About the Author

Mike Kroupa, Self-Funding Insurance Expert

I grew up in a house that was constantly under construction and the experience helped me uncover one of my passions, remodeling. After running a successful remodeling business with my brother during college, I decided I wanted to keep this as a hobby. Instead, I took my advisor’s recommendation and started down the actuarial path, which ultimately led me to insurance.
 
Since then, I have focused my career teaching employers how to better manage their health insurance plans. I found myself frustrated year after year of doing the same thing because it didn’t feel like I was making an impact. Healthcare costs were continuing to increase, and it felt like the only options employers were left with was increasing deductibles, increasing contributions, and switching carriers.

There was a turning point for me in 2020 as I found Health Rosetta, an ecosystem for scaling adoption of practical fixes to our health care system. As my clients started adopting these fixes, I found myself getting passionate about what I was doing for the first time. Then I realized my hobby of remodeling was driving the passion because I was remodeling health plans. Even better, I was having an impact because patients (employees, spouses and children) were getting the best care they ever have and saving a lot of money in the process.

Get in contact with Mike: 

Phone: 630.738.1835     Email: mkroupa@gocgo.com     LinkedIn: Mike Kroupa

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