Top 3 Questions to Ask when Considering a Self-Insured Health Benefits Model

Self-insured models in businesses of all sizes are on the rise and with good reason. Many companies find this type of health insurance model provides the flexibility and resource control that is best for them and their employees. But there are important factors to consider before your company makes the jump from fully-insured to self-insured. If you are wondering whether this move could be right for your organization, here are the top 3 questions to consider.

1. Do you currently feel like you have control over your company’s healthcare spend to control year-over-year trend?

Many companies who have fully-insured health plans feel they have no control when it comes to managing their healthcare costs. They also feel the information they get regarding claims and trends is very limited.

2. Do you feel Risk Management is being utilized with your health insurance plan?

Risk management is utilized in Workers Compensation claims management. However, the lack of transparency and information in fully-insured models makes it hard for companies to manage their risk. Self-insured companies are able to get more in-depth claims reporting. This allows Benefit Consultants to drive down costs by managing a company’s healthcare risk.

3. Do you see prescription trends rising – specifically in Specialty Medications – and have you been able to mitigate that increased risk?

Prescription costs are on the rise and the utilization and cost of Specialty Medication is the biggest driver. Self-insured models provide companies with more control over the risk and claims spend in this area.

There are a number of other factors that are important to consider when determining if a self-insured plan can work for your organization. If you are ready to consider this option, Equinox’s in-house Underwriting Team can execute a FREE, Self-Insured Feasibility Analysis to help guide your decision-making. Fill out the short form and one of our specialists will contact you to get the process started.

*Are you already self-funded and not realizing savings? Equinox can review your information to maximize the savings from self-funding with our cost-containment strategies.