
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.

Group captive insurance was built as a structural alternative to fully insured health plans. Here’s how it gives mid-market employers

Small business health insurance doesn’t have to mean fixed plans and surprise renewals. Group captive self-funding makes the model accessible

Customer success in a self-funded plan means proactive claims management, employee navigation, and quarterly business reviews that turn data into

Mental health is the fastest-growing claims category for most employers. Self-funded plans give you the visibility to address behavioral health

Behavioral and mental health costs are climbing fast. Here’s how self-insured employers use plan design and clinical care to control

Why self-funding? Claims transparency, vendor flexibility, surplus return, and structural protection against the volatility that fully insured plans actively hide.

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

Cost containment in healthcare is the practice of cutting waste, not coverage. Self-funded plans give employers the data and tools

Rising health insurance costs are driven by medical inflation, prescription drug spend, and chronic disease. Self-funding gives employers the tools

Cost containment in healthcare is the discipline of cutting waste without cutting care. Self-funded employers have the data and levers

Emerging trends in prescription costs, GLP-1s, specialty biologics, and PBM consolidation, are reshaping how self-funded employers budget for pharmacy spend.

Hospital costs are the biggest driver of healthcare spend. Here’s why prices keep climbing and how self-funded employers fight back

Cost-effective healthcare for employers comes from claims transparency, vendor flexibility, and partner alignment, not just lower premium prices at renewal.

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.
Join us live or watch pre-recorded discussions, expert panels, and educational sessions designed for employers and advisors.
Hear candid conversations and real-world insights from industry experts shaping the future of healthcare funding.
Explore in-depth guides covering captive insurance, healthcare costs, and strategies for long-term savings.
Stay informed with monthly insights on captive insurance, cost control, and smarter benefit strategies.