Controlling Health Care Costs With Self-Funded Plan Options

Lorman Education Services

Are self-funded plans the right option? Find out all you need to know to make the right decision for your organization.

The Patient Protection and Affordable Care Act creates incentives for certain employers to self-insure health care coverage. For example, self-insured plans are not subject to the small-group rating regulations, risk adjustment policies, and essential health benefits provisions newly imposed by PPACA. Self-insured businesses are also exempt from many state insurance regulations. This topic examines the factors that may motivate employers to self-insure, and the ways incentives to self-insure might change after PPACA becomes effective. The topic also will discuss how self-insurance influences benefit design, benefit claims decisions, and financial exposure. Finally, the program will offer practical tips to employers facing this certain uncertainty in the group health care context.

Learning Objectives

• You will be able to describe PPACA's impact on self-funded plans.
  
• You will be able to identify factors impacting decisions to self-fund.
  
• You will be able to discuss cost containment strategies for self-funded plans.
  
• You will be able to recognize and dispel myths.

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