Self-funding is assuming all or part of the risk in exchange for much lower premium charges. A group can purchase two types of reinsurance:

• Specific Stop-Loss: Reinsurance carrier will pay for all claims over a designated Specific Deductible. (Employer is responsible for all amounts up to the Specific Deductible). For example:

• Aggregate Stop-Loss: Aggregate reinsurance is designed to put a cap on the total claims for the entire group (under the Specific Deductible). For example:

Why Choose Self-Funding?

Self-funding benefits employers in many ways:

• Control of plan design
• Administration tailored to the employer's needs
• Cash flow benefits - you hold your own reserves
• Return on investment for reserves
• Cost and utilization controls - access to many discount programs
• Effective claim processing
• Lower cost of operation - administrative fees are lower by nature
• Elimination of most premium tax
• Carrier profit margin & risk charge eliminated
• Mandatory benefits avoided - state mandates can be avoided as
   self-funded programs are governed by ERISA
• Risk management effectiveness through stop loss insurance - employer
   may choose the amount of risk to retain
   (Source: Stop Loss 101, Duncanson & Holt Group)

What is a TPA?

TPA stands for Third Party Administrator. A TPA is a professional organization hired to perform the administrative duties of an insurance company such as:

• Processing Claims
• Paying Providers
• Providing Benefit & Eligibility information

These are just a few of the administrative duties that a Third Party Administrator performs. If you would like to learn more about self funded or partially self funded group health plans, and how Health  Reimbursement and Flex Spending Accounts, along with Consumer Directed Benefits designs could save you up to 30%.....................

Call  1 888-456-1858 /504-456-1858  or email  info@ghpla.com.

  or...................  REQUEST  A  QUOTE !