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Showing posts with the label Employee Medical Benefits

Employee Medical Benefits: Self-funded vs. Fully Insured

Group employee medical benefit plans typically fall into one of two categories: self-funded or fully insured. The choice of one over the other should not be made arbitrarily. Each type carries its own set of administrative rules and legal constraints.  What is self-funding?   Under an insured health benefit plan, an insurance company assumes the financial and legal risk of loss in exchange for a fixed premium paid to the carrier by the employer. Employers with self-funded (or self-insured) plans retain the risk of paying for their employees’ healthcare themselves, typically from corporate funds.   Most employers with more than 200 employees self-insure some or all their employee health benefits. Many employers with fewer than 200 employees also self-fund, but these employers require greater stop-loss insurance protection than larger employers (stop-loss insurance is discussed below). Generally, employers with fewer than 100 employees fully insure their group medical benefits. In New Yo