Self-Insured

Self-Insured Group Health Plan for Your North Carolina Company

IBA_Logo_EmployeeBenefitIndependent Benefit Advisors provides the financial and technical expertise that enables our clients to successfully self-fund their health, dental and vision plans and consults on carving out the drug and stop loss benefits. We help our clients select the most cost-effective and beneficial Third Party Administrator contracts (proprietary and non-proprietary TPAs). We help our clients evaluate their organizational culture, risk tolerance, finances, and claims risk to recommend appropriate amounts and types of reinsurance and drug formularies.

As part of our comprehensive service and at no extra cost to our self-funded clients, IBA provides the following for companies in North Carolina:

  • Strategic benefit plan design
  • Premium equivalent calculations
  • Monthly loss ratio reporting and analysis

What is a Self-Funded Insurance Plan?

The cost of a self-funded plan has fixed components similar to an insurance premium, e.g., administration fees, stop-loss premium, and variable costs (the claims expense). The administrative fees, stop-loss premiums, and any other set fees charged per employee are referred to as fixed costs and are billed monthly based on plan enrollment just like an insurance premium. The employer sponsoring a self-funded plan also pays the claims costs incurred by the covered persons enrolled in the plan, and this cost varies from month to month based on healthcare use by the covered persons. Stop-loss insurance reimbursements are made if the claims costs exceed the catastrophic claims levels in the policy. Ultimately, the total cost of a self-funded plan is the fixed costs plus the claims expense less any stop-loss reimbursements.

Contact us to discuss your health insurance needs for your business in Apex, Boone, Cary, Durham, Garner, Holly Springs, Raleigh, Sanford, Wilmington, Zebulon or another North Carolina location.