Find answers to questions we get asked the most often.
Self-Funded Health Benefits are a cost-effective alternative to traditional health insurance. You, the employer, own and control your health benefits for your employees. By controlling the plan, you can see significant savings over traditional health insurance. There are two types of Self-Funding, please click the links to learn more.
Self-Funded works by you, the employer, obtaining an Excess Stop-Loss policy to help protect against eligible claims above the pre-determined claims cost you are willing to fund out-of-pocket. You select which plans to offer your employees and the benefits you choose work just like traditional insurance with a PPO network, prescription copays, max out-of-pocket expenses the only difference is YOU own the plan, not the insurance company.
Simply stated, you can receive significant savings with Self-Funded. When a company has Traditional insurance, if the amount of money paid to claims are less than the amount of premium the insurance carrier collected, they make a profit. With you owning the plan, if the plan experiences lower claims costs than what you have funded, the plan sees significant savings that otherwise would be profit for the insurance carrier.
With Traditional Self-Funded plans, the monthly amount can change based on claims, for this reason we recommend companies of at least 125 employers consider Traditional Self-Funding due to the inconsistency in monthly contributions.
Paramount Consulting offers Self-Funded health benefits with Level-Funding. This options allows you to pre-fund the amount of claims you are willing to pay out-of-pocket. This means that you are paying the same amount each month for each employee for your health benefits.
Paramount Consulting Group has aligned with Cigna to utilize their nationwide PPO and Pharmacy Benefit Management network to provide our clients with services and access to doctors across the United States. With the PPO network, our clients save money on medical costs due to a pre-negotiated discount with service providers for being part of the network.
There is always risk when owning your own benefits program but with Paramount Consulting Group we have limited your exposure risk by helping you purchase an Excess Stop-Loss Policy and aligning you with a Third-Party Administrator to assist in keeping you compliant as well as provide administration of your Health Benefits plan.
There are only positives with our program!!! Self-Funded health benefits “act the same” as fully-insured products. We contracted with Cigna to bring you a large physician network that is available across the entire United States.
PCG entered the Self-Funded market because we saw a need in the marketplace – employers were struggling to offer affordable healthcare coverage for their workforce. We joined forces with the best and brightest minds in the industry, and our team today offers 75 years of combined industry experience in every facet of healthcare—from working with major carriers to owning carriers themselves.
PCG has remained at the forefront of the Self-Funded marketplace, developing advanced technology that is changing the face of the Self-Funded benefits industry, and working with some of the most prestigious partners in the country.
- for Self-Funded health benefits with Level funding, we can write groups as small as 5 employees;
- for traditional Self-Funded health benefits, we recommend the group have at least 125 Employees.
Self-Funding is a great fit for most companies wanting to curb premium increases each year and wants to Control their own health benefits plan.
Absolutely!! When a company has a healthier workforce due to wellness programs and healthy choices, claims should be reduced. If a company sees a reduction in claims costs, more money is left in the Claims fund to be retained at the end of the program term. Also, if an employee decides to go to a family practitioner for a cold versus the emergency room, the entire benefits program will profit because of the lower claims cost.