Traditional Self-Funded Plans
A self-funded health plan can lower your costs and grow your long term savings.
When working with a TPA, self-funded benefit plans give employers the ability to cut employee benefit costs and manage risk associated with high cost claims.
Because the employer only pays for claims out-of-pocket, they’ll only pay for claims if they’re incurred. If benefits are not used, healthcare spending will be low as well.
Any self-funded plan savings are kept by the employer and will be applied to next year’s claims.
All this adds up to substantial cost savings as well as a growing accumulation of funds to pay for future healthcare expenses.
Why a Self-funded Plan?
Self-funding prevents insurance companies from passing on the full costs of increasing healthcare prices by removing your group from the large insurance pool, thus potentially creating large cost savings.
Employers of any size can use level-funded plans to build up cash reserves that act as a bridge to a fully self-funded plan.
Control plan design and benefits offered
Promote culture of investing in employee’s health
Ability to build claim reserves
Collection of health plan data
Reduced premium tax and avoidance of Health Insurance Industry tax
Custom Plan Design
Because plans are custom designed, the employer doesn’t pay for coverage that isn’t relevant to their employee base, which increases benefit utilization. We collaborate with each employer to design benefit plans that address the unique health needs and risk factors for their employee base.
The employer is protected by stop-loss insurance in the event a specific claimant or the entire group’s healthcare claims exceed a certain level.
These combined methods empower the employer in managing current risk, mitigating potential risk, and focusing future cost management efforts in a targeted, meaningful way.
Employers maintain complete control of the Plan Document, Summary Plan Description and the Schedule of Benefits. They also have 24/7 access to all reports and plan details, enabling them to make informed decisions regarding all aspects of the plan.
Differences Between Traditional Fully Insurance Plans and Self-Funded Insurance Plans
How a Third Party Benefits Administrator Makes Self-Funded Plans Easy
The employer may handle administration in-house, however, majority hire a third party administrator (TPA) or work with an insurance carrier on an ASO basis.
When an employer works with a third-party administrator (TPA), self-funded plan management and compliance is an easy process. The TPA does the heavy lifting for the employer, from plan design, to processing of claims, to customer service, to maintaining compliance with federal and state laws. The TPA also helps the employer effectively manage the cost of healthcare by providing transparency about the cost of claims, the key cost drivers, and solutions for reducing the costliest claims.
How BMA Excels at Self-Funded Plan Management
BMA provides efficient claims management services achieved through superior processing accuracy and claim turnaround services. We work with a variety of self-funded medical benefit plans including Health Reimbursement Arrangements (HRA), PPO plans, HMO plans and Medical Reimbursement plans. Our tailored administration services provide our clients with flexibility and control.
Benefit Management Administrators' self-funded plan options put the control of Employee Benefits back in the hands of the employer. Clients pay only for what they use and they have access to utilization reports, at no risk.
Our services include:
- Aggregate & Integrated Stop Loss
- Dedicated Account Manager
- 24/7 Online Report Access
- Online Enrollment Services and Eligibility Management
- Disease Management Interface
- Lower premiums
- Ability to set co-pay plan options
- Freedom of dentist choice
- Multiple available networks
- Reduced overhead
- Cost savings visible in first year
- Compatibility with Section 125 plans
BMA’s self-funded short-term disability plan includes income protection for employees who can’t work, incentives for employees to return to work, and a
smooth transition to long-term disability.
By self-funding a short-term disability plan with BMA, members will benefit from fast and hassle-free claim service.
An FSA is a tax-advanced financial account, set up through a cafeteria plan and can be added to a self-funded plan. This allows employees to contribute a certain amount of pre-taxed earnings to the account and apply it to IRS eligible expenses.
Dependent Care FSAs are a great way for your employees to pay for qualified child and dependent care expenses while lowering their taxable income. This plan allows employees to use pre-tax dollars to pay for eligible dependent care services, such as child or elder daycare, preschool, before and after school programs and summer day camp. Opening and funding a DCA can help employees plan and pay for the care they need on an individual case basis.
Employee contributions to the DCA are deducted from their paycheck on a pre-tax basis, reducing their taxable income.