Self-Funding, The Better Way
What differentiates Premier in the marketplace?
- Experts in alternative funding mechanisms
- Preferred stop loss rating as a result of our large book of business
- Dedicated Cost Management Department that offers customized programs including:
- Enrollment verification audits
- High Claimant medical review
- Out-of-network discount negotiations
- Hospital bill audits
- Specialized wellness programs
- Experts in analyzing medical and prescription drugs claims data and understanding how to utilize predictive modeling and gaps in care analysis
- Experts in negotiating union health plan programs
Our team is highly skilled in both employer and employee problem resolution. Our staff has worked “on the other side of the fence” paying claims, auditing, providing case and cost management, managing provider relations and customer service. We understand how claims are adjudicated, paid and denied.
The Premier Consulting team will perform a full range of consulting services relating to:
- Plan design
- Employee and vendor communications
- Recommendations regarding current stop loss
- Future benefit plan options
Our goal is to provide you with low-maintenance, cost-effective and creative opportunities to manage your plan, which will result in satisfying both you and your employees.
Click below to learn more about the services Premier offers that are designed specifically for a self-funded employer.
Data Analytics and Reporting
Wellness and Disease Management
Cost Management Services
Click here to learn more about what Premier can do for you self-funded health plan.
What is a Self-Funded Health Plan?
- A health plan under which an employer assumes the responsibility and related financial risk for paying plan participants’ health care expenses
Details of Self-Funding
- The main change from being fully insured is the funding mechanism; a change in benefit levels or administrator is not required
- Administrative costs are fixed and are no longer tied to premium increases
- Your organization holds reserves and claims dollars until payments are needed
- Plan control over plan designs
- Improved cash flow
- Reduce health insurance costs 10% to 15% without compromising plan quality
- Relief from most premium taxes
- Improved access to claims data history
- Exempt from state insurance regulations
- Carrier profit margins are minimized
- Non-negotiable premium increases are eliminated