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  • Self-Funded Plans

    Self-funded plans are a viable alternative to traditional plans for employers who are interested in taking control of their health care options to reduce premium and administrative costs can be reduced. If you decide that self-funding is right for your company, HealthPlus Options, Inc. is a licensed third party administrator who can deliver a full-range of services to complement your unique approach to employee benefits.

    We provide access to hospitals and health care professionals, process claims, issue ID cards, manage employee questions, prepare reports and offer cost-containment initiatives such as wellness programs and care management.

    Is Self-Funding Right for Your Company?

    Self-Funded Key Players
     

    Profiles of a Self-Funded Employer

    • Relatively stable with less than 15 percent annual turnover
    • History of healthy workforce
    • Financially secure and able to assume risk
    • Large group employers and in many cases, smaller employers who have been hesitant to self-fund because they thought it was for large companies
     

    To learn more about HealthPlus Large Group plans,
    call 1-800-530-9071 or contact your insurance agent.

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  • How It Works

    With a self-funded health plan, an employer puts aside funds to pay for anticipated health insurance claims for employees instead of paying a premium to a health insurance carrier. In this respect, the employer is the insurer and carries the risk associated with high insurance claims.

    A licensed third-party administrator, like HealthPlus Options, provides access to hospitals and health care professionals, processes claims, issues ID cards, manages employee questions, prepares reports and offers cost-containment initiatives such as wellness programs and care management. HealthPlus also has stop-loss solutions that protect the employer from individual catastrophic claims or higher than expected total expenses.

    Advantages of Self-Funding

    Self-funding is an option to consider for employers exhibiting the following characteristics:

    • Increased Financial Control — Fund claims as they come due, rather than in advance premium payments.
    • Lower Operating Costs — Funding claims directly reduces the administrative costs typically associated with an insurance carrier.
    • Flexibility — Design a health benefit plan that addresses both specific employee needs and company objectives.
    • Access to Data — Claims reports provide insight for employee engagement and care management planning.
     

    HealthPlus As Your Third Party Administrator

    HealthPlus is the partner that seamlessly administers your health benefit plan. What's more, HealthPlus delivers a full-range of services to complement your unique approach to this employee benefit:

    • Account Services — Oversight, consulting, stop-loss quotes, utilization review and reporting, anti-fraud and HIPAA support
    • Provider Network — State- and nation-wide with global emergency care
    • Member Services — ID cards, customer service, employee communications
    • Financial Services — Claims payment, underwriting
    • Cost Containment — Disease and care management, health and wellness programs