For many business-owners self funding can be difficult to understand. It can feel intimidating and even risky. But here’s the reality: unless your deductible is 0, you are technically self-funding. The difference is you can pay more for the “ease” that comes with a fully insured plan.
Keep it simple.
Not ready for self-funded programs right away? Start small. Transitioning from a fully insured plan to a self-funded one will take time and commitment, but when you make minor changes to start, you can begin to gain control and utilize the flexibility a self-funded plan offers in a more confident way.
When you approach self-funding this way, you can begin to lower your costs. At the same time you can provide better service with the same, or better, care for your employees. And by giving your people an improved experience that also meets their unique needs, you can produce a healthier, happier workforce.
Where to make changes.
Using a transparent Pharmacy Benefits Manager, which is a small and manageable change, could be the best place for you to start. Capturing the overspend created in pharmacy is an easy, relatively painless first step to move into self-funding. A PBM is not disruptive and won’t create conflicts, it can even lower costs for everyone across the board.
As an advocate in the health care system, a PBM works to lower your prescription drug costs by negotiating with drug companies and securing discounts that can save you money and reduce your cost. Read more about how a pharmacy benefits manager can be a great addition to your health insurance plan here.
You can do something similar with diagnosis tests such as MRI’s, X-rays, bloodwork, and in some cases — surgery bundles, by working with Preferred Provider Organizations. This can allow you to negotiate direct agreements that ultimately cost you less. Essentially, you get better rates for these services.
This change can give your employees more flexibility and options, allowing them to see any doctor, even some specialists, without going through the primary care doctor. This flexibility is often seen as a significant perk for many employees because they are not limited to just one doctor or hospital, allowing more freedom to control their healthcare decisions.
These are all options you can implement without abandoning your traditional plan.
Yet education and awareness for these options is intentionally limited by carriers for several reasons. One of which is hidden incentives for brokers to recommend traditional options. These incentives can make the cost saving options seem more complicated when they don’t have to be, creating muddy waters.
Clear the water.
If you work with the right broker and advisor, these solutions can be implemented in a successful way, one that allows you to control costs without disrupting the current plan or sacrificing employee’s health coverage.
Making adjustments to your insurance plan can be intimidating, however with the right advisors and the right options, you can be on your way to a cost saving self-funded plan, one that your employees can use with confidence and ease.
Cost saving and employee satisfaction. Connect those two and make the magic happen!
