Paying health and dental insurance premiums are a real pain. Every year at renewal the insurance company tells you it will cost more. And have you ever tried to read a renewal report?! The jargon and complicated ratios in those things are enough to make your head spin.

Thankfully, there’s a way to take control of your health and dental benefits costs, while still supporting your team by giving them the coverage they expect. It’s called a self-funded plan, and it’s as easy as pie to set up.

What is a self-funded group benefits plan?

A self-funded plan is a fancy way of saying that instead of paying health and dental insurance premiums as a plan sponsor you’ll reimburse claims yourself (with a little admin help from a benefits provider of course).

These plans can be called self-funded, employer-funded, self-insured, or Administrative Services Only (ASO), but they all mean the same thing:

  • The plan sponsor designs their plan with help from the benefits provider
  • Plan members submit claims to the benefits provider
  • The benefits provider adjudicates and pays the claims
  • The benefits provider sends the monthly bill for claims paid to the plan sponsor

The best part is you’re in complete control!

You know what you’re paying on a monthly basis, you can make changes as needed, and there are no surprise cost increases at renewal.

Why should we choose a self-funded group benefits plan?

If you’re considering a self-funded group benefits plan, ask yourself a few questions:

  • Do you want coverage similar to an insured health and dental plan?
  • Are you sick of seeing your health and dental premiums increase every year?
  • Do you want to get in the driver’s seat and take control of your costs?
  • Are you comfortable with variable costs each month?

If you answered “yes” then a self-funded plan is for you!

Familiar coverage

Self-funded group benefits plans are set up just like insured health and dental benefits, except you make the decisions, not the insurance company. You can use limits, maximums, and co-pays to help control your costs, and give plan members the peace of mind that their healthcare costs will be covered. You’re creating less flexibility for plan members than a Health Spending Account, but potentially greater coverage.

No surprises

It also means you get to quit paying health and dental insurance premiums and trying to figure out if you’re getting a good deal from the insurance company (you’re not). Your cost for benefits becomes transparent - the cost of claims, plus an admin fee.

Cost control

Taking care of benefits this way puts you back in control. You can choose how to design your benefits plan based on what you want to cover. By working with a benefits expert you can create categories, maximums, and limits that will control your costs while giving your plan members the coverage they expect. Need help budgeting in preparation for the big switch? Look no further than one of our blogs!

Pay claims as incurred

Budgeting for a self-funded group benefits plan is variable in nature. One month may be quiet and you’ll save money. The next month everyone may fill their prescriptions and you’ll have to pay more. As long as you’re comfortable with this variability, it will save you money in the long run (and if you want something more predictable, check out an HSA!).

Blendable Enhanced Health Blends – our self-funded benefits option

At Blendable, our self-funded plan is called our Enhanced Health Blends. You get the affordability, flexibility, and simplicity described above, plus the bonus of working with our super-helpful team of Blendarinos!

Like all blended benefits plans, we can blend in features like Life Insurance, Disability Insurance, Group Travel, or an Employee and Family Assistance Program to help you create the plan of your dreams.

Our Growth Team is standing by to help you design an Enhanced Health Blend tailored for your business. We’ll sit down with you and get to know your specific needs and wants, then build a plan that works for you.

Ready to start saving money with self-funded group benefits? Get in touch to get benefits that are made for you!

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