Considering Self-Funding — Employer Benefits Decision Journey
We're thinking about self-funding.
Self-funding is the most powerful cost-containment strategy available to employers — but it requires the right structure, the right partners, and the right timing. This journey walks you through every decision.
The problem
Most employers overpay for health benefits because they're fully insured — paying a carrier to take on risk they could manage themselves. The carrier's administrative load (typically 15–20% of premium) is pure overhead.
The outcome
A clear go/no-go decision on self-funding, a sized stop-loss structure, a shortlist of TPA and stop-loss vendors, and a transition timeline — all based on your specific numbers.
8 steps · Free · No login required to start
Your step-by-step plan
Self-Funding 101
Before you evaluate vendors or run numbers, make sure you understand the fundamentals: how self-funding works, what stop-loss does, and what questions to ask your broker.
Already familiar with self-funding basics? Skip to step 2.
Self-Funding Readiness™
A 15-question assessment evaluating your financial capacity, risk tolerance, and administrative readiness. Gives you a readiness score and a specific list of gaps to address.
Fully-Insured vs. Self-Funded Analysis
Run the numbers side by side. The Renewal Impact Calculator shows exactly how much your fully-insured premiums will cost over 5 years — and what you could recover by self-funding.
Stop-Loss Education
Stop-loss is your financial safety net in a self-funded plan. Understand specific vs. aggregate coverage, attachment points, and the key contract terms that protect you.
Size Your Stop-Loss Coverage
Determine the right specific and aggregate deductibles for your employee population. Getting this wrong is the most common and costly mistake in self-funding transitions.
Compare TPA Vendors
Your TPA is the operational backbone of your self-funded plan. Compare vendors on network access, claims processing, reporting, and cost containment programs.
Compare Stop-Loss Carriers
Stop-loss is your financial safety net. Compare carriers on specific deductible, aggregate, laser provisions, and run-out terms — not just premium.
Explore Medical Captives
If you're a good self-funding candidate, a medical captive may offer even better economics. Compare captive programs and assess your readiness.
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