For companies who want to self-fund their health insurance, we offer several plans based on the size of your business. We include a broad provider network with substantial discounts and outstanding customer service.
New product: Self-funded Administrative Service Option
Our newest self-funded product lets you choose the administrative services that fit your organization’s needs and budget. It features:
- Lower base per employee per month (PEPM) fee for core services
- Buy-up and formulary options
- Operational flexibility and choice
What to consider
- The business is the plan sponsor. While most of the plan functions may be assumed by the administrator, it is the company’s plan and, therefore, the business must comply with all regulations that fall under ERISA (The Employee Retirement Income Security Act of 1974).
- If the business chooses to change to a fully-insured arrangement, it will be responsible for claims runout from the self-funded plan — i.e., it has the responsibility of paying for claims incurred but not paid prior to the termination of the self-funded contract. Those claims will be paid in addition to the fully-insured premium.
Self-funding is a financial arrangement where the business assumes the risk of providing healthcare benefits to its employees instead of purchasing a fully-insured plan through an insurance carrier and paying the associated premiums.
The business chooses to pay its own claims through a third-party administrator (TPA) such as Geisinger Health Plan.
Most companies also purchase a stop-loss policy to protect itself from catastrophic losses. Get answers to your questions about self-funding
Advantages of self-funded plans
- Flexible options: Mid to large businesses can design a benefit plan that addresses the needs of their employees. Smaller businesses can choose from over 40 plan designs.
- Portability from one stop-loss carrier to another: The employer maintains the “look and feel” of the benefit plan and simply chooses the best financial arrangement to meet its needs. This process is seamless to employees — there’s no disruption as a result of changing benefit design, or networks.
- Avoidance of most premium taxes: The only premium tax a business pays on a self-funded arrangement is on stop-loss protection, and that premium is significantly less than a fully-insured premium.
- Potential for financial gain: The self-funded employer has the potential for financial gain resulting from a better-than-expected claims experience.
Learn more about Geisinger Health Plan.
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