Self-Funded Medical Insurance

For employers seeking a more sophisticated and cost-effective approach to employee health benefits, a self-funded medical plan offers a powerful alternative to traditional, fully-insured products. By funding your own claims, you can gain greater control over your healthcare spend, increase transparency, and design a plan that truly meets the needs of your employees. At HBG Insure, we specialize in helping businesses in Eastern Pennsylvania and New Jersey transition to and manage successful self-funded and level-funded medical plans.

Our process is designed to demystify self-funding and provide you with the data and analysis you need to make an informed decision. We start with a comprehensive feasibility analysis, evaluating your claims history, risk tolerance, and employee demographics to determine if a self-funded or level-funded model is the right fit. We then design a plan that includes stop-loss insurance to protect you from catastrophic claims, and we partner with best-in-class third-party administrators (TPAs) to ensure seamless claims processing and administration. With a self-funded medical plan from HBG Insure, you can escape the rigid constraints of the fully-insured market and unlock a new level of control and cost savings.

Benefits of Self-Funded Medical Insurance

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  Cost Control: Pay only for the claims your employees actually incur, not inflated premiums based on pooled risk
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  Transparency: Gain complete visibility into your healthcare spending and utilization patterns
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  Flexibility: Design a plan that meets the specific needs of your workforce without carrier restrictions
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  Cash Flow: Retain unused premium dollars rather than paying them to an insurance carrier
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  Regulatory Advantages: Self-funded plans are governed by federal ERISA law, providing more flexibility than state-regulated fully-insured plans

Our Self-Funded Solutions

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  Traditional Self-Funded: Full control and transparency with stop-loss insurance to protect against catastrophic claims
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  Level-Funded: Predictable monthly payments with the benefits of self-funding and potential for premium refunds
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  Captive Programs: Pooled self-funded arrangements that provide additional risk protection and cost savings

Is Self-Funding Right for Your Business?

Self-funding is typically most effective for businesses with 50 or more employees, though level-funded options can work for smaller groups. The key is having a stable workforce and the financial capacity to absorb monthly claims fluctuations. Our feasibility analysis will help you determine if self-funding is the right choice for your business and provide you with a clear roadmap for implementation.