Should a middle-market employer consider self-funding?
Sometimes. It depends on cash-flow tolerance, how predictable claims are, stop-loss terms and how much plan data the employer can get. We model level-funded and self-funded options against the fully insured renewal and show the downside as well as the savings.
When self-funding makes sense
Sometimes. The decision turns on cash-flow tolerance, how predictable claims are, stop-loss terms and how much plan data the employer can get from the carrier.
We model level-funded and self-funded options against the fully insured renewal and show the downside as well as the savings, so the decision is made with the risk visible.
A way to test self-funding without committing
Start by asking three questions: how predictable are your claims, how much cash-flow variation can the company absorb, and how much plan data can you obtain? If the answers are favorable, model the plan with stop-loss at several attachment points.
Compare the expected cost, the worst-case cost, and the reporting you would receive. We build that comparison against your fully insured renewal, and we show the downside as clearly as the savings.
Where to go from here
Consider level-funded and self-funded options
When a different funding arrangement is worth testing.
Plan stop-loss alongside the change
How specific and aggregating deductibles behave when a plan changes.
Send us your renewal
Share the renewal and plan documents and we will tell you what to test.
More questions on this topic
What counts as a middle-market employer?
There is no single definition.
How is the middle market different from small group?
Rating and funding rules change as a group grows.
What do you need to review a middle-market renewal?
Your renewal or rate action, current plan summaries and a census.
Do you work with employers outside Michigan?
Michigan is our home market, and our licensing follows clients beyond it.
Where these details come from.
This guide cites the federal statutes and regulations behind its compliance points. Rules vary by state and carrier, so we check them for your group.
Send us your renewal.
We’ll tell you whether it looks competitive, where we see opportunity, and the five questions we’d put to your carrier. No cost, and no obligation to move anything.
The renewal letter
Your current plan summary
Contribution split by tier
Enrolled counts by tier
Four documents — two more if your group is 50 or more. Nothing else; every extra one is a reason to postpone.