
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.

Stop-loss insurance protects self-funded employers from catastrophic claims by pooling risk with similarly sized businesses through a group captive plan.

Twenty percent of employees drive eighty percent of healthcare costs. Self-funded plans give you the data to manage chronic conditions

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

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

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 lets like-sized employers pool risk, share data, and capture savings together. It’s the structural alternative to fully

Hidden fees in employee benefits plans quietly bleed your budget. Here are the top five charges to identify and renegotiate

Telehealth coverage inspires trust because it removes friction from accessing care. Self-funded plans can prioritize and price telehealth on their

Aligning incentives between employer, employees, and providers is the foundation of a healthier, cost-effective benefits plan. Here’s how to design

Is your healthcare benefits plan sustainable? Year-over-year cost increases say otherwise. Self-funded plans give employers the levers to bend the

A group captive insurance plan involves the employer, TPA, PBM, stop loss carrier, and advisor. Here’s the who’s who and

Q&A with Roundstone founder Mike Schroeder on cost-saving measures employers can use right now to take control of their health

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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