What Is Self Funded Insurance
What is self-funded health insurance? A model where the employer pays claims directly, captures savings when employees stay healthy, and controls every dollar spent.
What is self-funded health insurance? A model where the employer pays claims directly, captures savings when employees stay healthy, and controls every dollar spent.
Is my company a good candidate for self-insurance? Use this checklist to evaluate workforce, claims, cash flow, and partner alignment before making the switch.
Benefits advisors are critical to self-funded employer health insurance. Here’s how to tell a good advisor from a great one and what to expect at renewal.
Group captive health insurance costs split into fixed and variable components. Here’s how to think about both when budgeting and explaining the model to leadership.
Clinical care management lowers healthcare costs by guiding employees through complex care, catching issues early, and steering them to higher-quality providers.
A group captive insurance plan involves the employer, TPA, PBM, stop loss carrier, and advisor. Here’s the who’s who and what each partner actually does.
A medical group captive is a self-funded health insurance model where employers share risk to gain stability, transparency, and buying power.
Employers using fully-insured pay a fixed premium for the carrier to take 100% of the risk and keep any profits. Captives allow employers to band together to control costs and receive refunds for better-than-expected claims.
Employers using level-funded pay a fixed monthly fee to cover administrative, claims, and stop-loss insurance expenses. Any surplus may be partially refunded at the carrier’s direction. With captives, you gain control—full data ownership, plan flexibility, and the ability to keep any savings.
Roundstone works with employers ranging in size from 25 to 1,000+ eligible employees.
Yes, with the right partners, transitioning to self-funding is easy. Roundstone assigns a dedicated Customer Outcomes Manager to guide clients through the process. Your third party administrator (TPA) then handles day-to-day administration and claims.
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