Self-Funded & Alternative Funding
There's More Than One Way to Pay for Healthcare
Most employers assume they have to buy healthcare the way they've always bought it. A fixed monthly premium, a carrier relationship, and limited visibility into what's actually happening. That's not the only option.
WHO WE HELP
Coverage that fits your actual situation.
The individual health insurance market has changed significantly over the past decade. There are more options than ever but also more complexity. Plans vary widely in their coverage, costs, and provider networks. Choosing the wrong plan can mean unexpected expenses, limited access to your doctors, or coverage gaps you don't discover until you actually need care.
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Medicare presents its own layer of complexity. There are multiple parts, enrollment has specific windows, and the decisions you make early can be difficult to reverse later. We help you navigate all of it with clear, practical guidance.
"More options don’t make it easier. Clarity is what helps you choose the right path forward."
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Purchasing coverage for the first time
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Losing employer coverage and needing a replacement
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Self-employed and shopping on your own
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Approaching Medicare eligibility at 65
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Supporting an employee through a coverage transition
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Looking for clarity on marketplace subsidies and plan options
WHAT IT IS
Paying for actual care, not the idea of coverage.
Most employers are used to paying a fixed premium to an insurance carrier every month. Regardless of how much or how little their employees actually use the plan, the bill stays roughly the same. This is called a fully-insured model, and for a long time, it was the only option most employers knew about.
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Alternative funding models work differently. Instead of paying for the idea of coverage, you're paying for actual care being delivered. The employer takes on more of the financial responsibility for their employees' healthcare but in exchange, gains significantly more control, visibility, and the ability to benefit from a healthier or more efficient workforce.
Something that fits your life. Something that adapts as it changes. Something you can rely on at every stage.
IS IT RIGHT FOR YOU?
Honest guidance, not a sales pitch.
Self-funding works well for certain employers and isn't the right fit for others. Company size, workforce demographics, risk tolerance, and cash flow all factor into the decision. We'll tell you directly whether it makes sense for your situation.
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What we help you do is evaluate honestly, without pressure, and with a clear picture of what you'd be taking on and what you'd gain. If self-funding makes sense, we help you build the right structure. If it doesn't, we'll tell you that too.
HOW IT WORKS
The mechanics of self-funding.
In a self-funded arrangement, the employer sets aside funds to pay employee healthcare claims directly, rather than paying premiums to a carrier. A third-party administrator handles the day-to-day mechanics: processing claims, managing the plan, and keeping everything running.
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To protect against unexpectedly large claims, employers purchase stop-loss insurance. This coverage kicks in when claims exceed a certain threshold, either for a single individual or for the plan overall, limiting the employer's financial exposure.
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The result is more transparency into what's being spent and why, more flexibility to design the plan around your specific workforce, and the potential to see real financial savings when your employees are healthy and use care efficiently.