How Self-funding Works

1
How Self-funding Works
2

• Fully Insured

• Partial Self-funding

Administration
100 Non-refundable Premium
Stop Loss Premiums
Potential Claims (Opportunity to Save)
3

• Claims treated as expenses
• Potential for savings
• Most premium taxes avoided
• Avoid certain coverage levels
• We manage self-funding
• Specific stop loss
• Aggregate stop loss

4
Stop Loss limits your liability

• Specific stop loss limit 40,000
• Individual catastrophic claims 50,000
• Amount paid by insurer 10,000

5
Stop Loss limits your liability

• 400,000 x 125 500,000
• 500,000 Attachment Point

6
Maximum funding recommended

• Fully Insured

Maximum Cost Total of all premiums paid
100 Non-refundable Premium
7
Maximum funding recommended

• Partial Self-funding

Administrative Expenses Stop Loss
Premiums Maximum Claims
Administration
Stop Loss Premiums
Potential Claims (Opportunity to Save)
8
Example
Covered Employees 65 Annual Premiums
450,000 Monthly Payment 37,500 Claim
Payments 170,000 Annual Premiums
450,000 Claim Payments -170,000 Carrier
Profit 280,000 Claim Reserve 60,000
Administration 20,000
Stop Loss Premiums 130,000
100 Non-refundable Premium 450,000
Actual Aggregate Claims 170,000
Actual Savings 130,000
9
Example
20,000 130,000 150,000 12,500
per month Claims paid 170,000 Savings
130,000
Administration 20,000
Stop Loss Premiums 130,000
100 Non-refundable Premium 450,000
Actual Aggregate Claims 170,000
Actual Savings 130,000
10
In Summary

• Funds belong to your company
• Flexible plan design
• Compare at no cost or obligation
• Accurate claim settlement
• Greater financial control
• Access plan information 24/7

• Decision making
• Monthly management reports
• Plan for the future
• Adapt to change
• Meet employee needs