Group size, claims history, cash and appetite for risk decide what fits.
For some groups the right answer is staying fully insured, and we say so.
What decides it.
Three of the inputs.
Group Size
Larger groups have steadier claims. Smaller groups see bigger swings.
Claims History
What you have paid in past years shapes what is realistic.
Cash Position
Whether the business can absorb a high-claims month.
Matching group to structure.
Honest about the limits.
Stay Fully Insured
Right when predictability matters most or the data does not support more risk.
Level-Funded
A middle path for groups that want some upside with a cap on the downside.
Self-Funded
For groups with the size, data and appetite to carry the volatility.
How we decide with you.
Not a pitch.
Review the Data
We look at claims and enrollment.
Model the Options
Each option is priced with its risk.
Revisit Yearly
Fit changes, so we re-check at each renewal.
Questions Employers Ask About This
Can we switch back?
Often yes, though timing and carrier rules apply. We check before you move.
Does staying fully insured mean we lost?
No. Sometimes it is the best result.
What data do we need?
Claims reports, the census and current plan documents. We tell you what we need.
Related guides.
From Renewals to Results: The Broker Playbook
The full playbook.
Fully Insured, Level-Funded and Self-Funded Plans Compared
Three funding structures.
Stop-Loss and Claims Risk Before Projected Savings
Risk before savings.
Want this applied to your renewal?
Send us the renewal and we will run it through DATUM and show you where the number comes from.
Your renewal letter
Your census
Your current plan documents
Your renewal date
Rough answers are fine. We build the numbers from there.
Laws and rules referenced
Employee Benefit News: Renewals to Results — Opinion piece on brokers moving from plan shopping to data-driven advisory work.
An independent employee benefits consulting firm. We look at the entire benefits program — cost, plan performance, risk and administration.
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