Making the Switch from Fully Insured to Self-funded

The Baldwin Group

Employers are under an ever-increasing strain to offer competitive benefit packages designed to both attract and retain employees, all the while prudently managing the outlay of the employer’s financial assets to further the total compensation philosophy of the organization. However, the cost of total rewards offerings are ever-increasing, and oftentimes, employers seeking alternatives to the fully-insured equation look to level and/or self-funding as a calculated gamble.
Employers should consider a variety of factors when selecting a funding approach for their health plan, including the compliance requirements for each option. In this hour-long presentation, we will examine some of the major differences of government regulation regarding insured and self-insured plans and the challenges those regulatory differences create, such as the following:

• Self-funded regulatory and legal compliance mandates arising under HIPAA, MHPAEA, the ACA, COBRA, and others;
• Comparison and contrasting of stop-loss benefits, requirements, and limits;
• The interplay of state-level insurance regulation into the equation of plan-level funding, and others.

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