
How Self Funded Health Insurance Works
Self-funded health insurance lets employers pay claims directly, capture savings when employees stay healthy, and see exactly where every dollar of spend goes.
Explore our blog resources to help employers and advisors understand the value of captive insurance.

Self-funded health insurance lets employers pay claims directly, capture savings when employees stay healthy, and see exactly where every dollar of spend goes.

Per-employee-per-year (PEPY) cost is the truest benchmark for whether your health plan is competitive. Here’s how to use it to drive decisions.

Specialty drugs are the fastest-growing line item in employee benefits. A self-funded plan gives you the visibility and levers to manage the spend.

Budgeting a self-funded health plan means understanding fixed and variable costs. Here’s how to plan spend and unlock savings through a group captive.

Lowering prescription drug prices takes more than negotiating with PBMs. Self-funded employers can stack DPC, transparency, and direct contracting to control total spend.

Your pharmacy benefit manager makes or breaks drug spend. Here’s how self-funded employers choose a PBM aligned with their interests, not the PBM’s.

A self-funded health plan can free up cash flow you didn’t know you had. Here’s how the model shifts working

The most popular group health insurance program might surprise you. Self-funded and group captive plans now drive more mid-market employer

Consumerism in healthcare means giving employees the tools and incentives to act like consumers. Here’s how self-funded plans build that

Employee benefit advisors grow and retain business by leading with cost containment. Here are four strategies that win renewals and

Self-funded health plans are a safer bet than employers expect. Stop loss, captive structure, and claims transparency reduce risk while

Roundstone unveiled a new enhanced website built to help employers and advisors explore self-funded health insurance, captives, and cost containment

Provider network choice shapes employee care, plan costs, and out-of-pocket spend. Here’s how self-funded employers pick the right one.

Pharmacy costs are rising faster than any line item in your health plan. Here’s how to choose a PBM that

Per-employee-per-year (PEPY) cost is the truest benchmark for whether your health plan is competitive. Here’s how to use it to

Your pharmacy benefit manager makes or breaks drug spend. Here’s how self-funded employers choose a PBM aligned with their interests,

A third-party administrator (TPA) is the backbone of any self-funded plan. Here’s how a TPA processes claims, manages eligibility, and

Finding the right TPA shapes claims accuracy, employee experience, and total spend. Here are 8 secrets self-funded employers use to

You don’t always get what you pay for in healthcare. Bob Chrobak shows how higher cost doesn’t always mean better

Roundstone’s Cost Savings Investigators (CSI) team digs into claims data to find waste, billing errors, and overcharges. Real dollars stay

Late-stage cancer diagnoses are among the most expensive claims employers face. Here’s how early detection and plan design lower the

High-cost specialty drugs are reshaping employer pharmacy spend. Here are the ways self-funded employers save without restricting clinical access for

If renewal season has you bracing for a double-digit increase, it’s time to look at self-funding. Here’s how the model

Renewal season is the moment benefit advisors prove their value. Here’s how to prepare with claims data, scenario modeling, and

Strategic incentives, education, and communication can increase wellness program engagement by 40-60%. Here’s how self-funded employers design programs that actually

Employee healthcare is the largest controllable line item on most P&Ls. Self-funded plans give you the data to manage spend

The best health insurance for employees isn’t always the lowest sticker price. Self-funding aligns cost, coverage, and care for long-term

Culturally competent healthcare improves outcomes and reduces preventable claims. Self-funded employers can choose vendors and programs that actually serve their

Five recommended reads on workplace wellness, from behavioral health to chronic disease management, for HR leaders building healthier, more engaged

Customer experience at Roundstone is anchored in responsive service, proactive claims navigation, and the team that supports employers through every
Self-funding means an employer pays for their employees’ healthcare claims directly instead of paying fixed premiums to an insurance carrier.
A medical group captive is a self-funded model where small and mid-sized employers join together to access financial advantages, share risk and gain greater stability.
Stop-loss insurance protects self-funded employers from large or unexpected claims. It caps financial risk so one high-cost event doesn’t significantly impact your overall healthcare spend.
Health insurance costs rise due to increasing healthcare prices, higher utilization, and lack of transparency in traditional models. Learn how self- funding through a captive can help offset these trends.
Cost containment includes strategies that reduce unnecessary healthcare spending while maintaining quality care. Read how tactics like claims analysis, preventative care, and pharmacy cost management can reduce spend.
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