SELF-FUNDING HEALTH BENEFITS

1. SELF-FUNDING HEALTH BENEFITS

2. Two ways to illustrate Self-Funding • A. Follow the money • Fully Insured • Self-Funded • B. The Extra “0” Plan • What is an HRA

3. Why it works • An illustration comparing Fully Insured to Self-Funding • Industry-wide stats on health and utilization • Grid comparing Fully Insured to Self-Funding • Who is a good candidate? • Case Study

4. Stop Loss A. What it is B. Contract Types

5. Two ways to implement Self-Funding • Baby Stops • The Big Bang (for your buck)

6. Evaluating & Purchasing Stop Loss Insurance • Terminal Liability Option (TLO) • Monthly Aggregate Accommodation • Specific Advance Funding • Rate Caps • Aggregating Specific • Options for Groups Under 100 ee’s

7. Myths & Misperceptions • Busy, Busy Bee • Lasers – the boogeyman in the closet • The monster under your bed – looming large claimant • Run-Out – the Grasshopper & The Ant

8. Maximum Liability – chicken little syndrome • No Guaranteed Renewal – too many fish in the sea • The Ugly Step-Sister – ugly renewals

9. How Self-Funding works with a TPA • The key elements • Pharmacy Benefits • PPOs • Maximum cost containment is more than a PPO discount • Minimizing Future Risks • Administrative Services Only (Carrier) vs. TPA Grid

10. Questions & Answers