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Funding Arrangements
Some organizations with significant levels of cash reserves can reduce costs by self-funding their health plans or assuming more risk. But before doing this, you must carefully consider the ramifications and protect the plan against ordinary or catastrophic risks.
Sibson Consulting can help you determine if self-insuring or other cost-saving funding arrangements are right for your organization. We can also help plans that are already self-insured evaluate whether self-insuring is still the best choice.
Stop-Loss insurance
Self-insured organizations can protect themselves against large claims or fluctuations in claims by purchasing stop-loss insurance, which sets a limit on how much the plan will have to pay for individual or aggregate claims. Sibson can help employers with:
- Determining the level of stop-loss insurance the organization should buy
- Evaluating whether the plan needs specific or aggregate insurance, or both
- Deciding whether to include prescription benefits in the policy
- Developing an RFP and preparing documentation
- Negotiating policy provisions with the insurer
- Addressing coverage gaps
- Monitoring stop-loss market conditions to take advantage of increased competition
- Negotiating renewals
- Settling claims disputes