SIE’s goal is to help consultants provide for their clients a simultaneous significant reduction in plan costs and improvement in employee satisfaction and engagement. Employers need to have the data on how the plan is running today as well as a “stress test” to know the range of possible outcomes in the future. We believe that employers and plan sponsors need this level of analysis.
SIE also has a range of important resources for health plans, ASO providers, and TPAs. These resources can be used to reduce the cost of claims but also to potentially improve the plan for covered members, employers, and broker|consultants.
Many employers with fully insured plans have never considered partial self insurance; for the rest, too many of them have been willing to focus almost exclusively on the fixed costs of administration and stop-loss insurance, as if the variable claims costs cannot be affected. The adage, “The claims are the claims” does not need to be true. These employers might even have taken the advanced step of adding an on-site clinic, but if they stop there they are greatly sub-optimizing their opportunities.
The term “self-funding” can lead to unnecessary anxiety among those not familiar with the methods to control risk or are generally not familiar with the many advantages (and disadvantages) of such plans. In comparison to a traditional fully insured health plan, where for a fixed monthly premium all or most of the risk is with the health plan, in a self-funded plan, the risk is on the employer or plan sponsor (although most of the risk is laid off to separately purchased catastrophic stop-loss coverage).
SIE exists for one reason—to promote the need for employers to become engaged and optimize medical cost management. We enable companies to take advantage of the latest in cost-cutting tools, resources, and expertise. Self-funding is not a panacea and it is not right for every firm, but it does allow employers to maximize the value of those latest tools and resources. For health plans that are already self-funded, it will work to optimize the cost saving opportunities of the plans, even while helping to improve employee engagement and satisfaction with the plan.
SIE is laser-focused on all of the many numbers of self-funding in order to help consultants save their clients money, but it doesn’t stop there.
Reduce or Eliminate Unnecessary Surgeries
Find Tomorrow's Large Claimants Today
Avoid Tragic Medical Events
Save Lives Beyond What The Health Plan Offers
Customized Stress Test Report
Sometimes catastrophic, expensive claims can occur that are ongoing, year after year. What guarantees does your stop-loss coverage include for later years if no other carrier will take you? Find out how you will fare in this report– it might be eye-opening.
Understanding the cost impact of each component part of a self-funded health plan— and understanding the many options available to potentially reduce the cost of each component—can be the start to controlling overall plan costs.
Deep-Dive Health Plan Analytics
This report outlines how data analytics can help find the needle-in-the-haystack member who is not compliant or is not aware of his or her at-risk status, thus potentially saving money and improving health.
Waste in the US Health Care System
An article in the Journal of the American Medical Association(JAMA), entitled “Waste in the US Health Care System: Estimated Costs and Potential for Savings,” (October 7, 2019), included these findings: “The review yielded 71 estimates from 54 unique peer-reviewed...
Medical Utilization by Income Strata
There are countless studies about all aspects of health insurance, population health, health studies of all types, but there has not been much consideration given to how income impacts health utilization within the context of employer health plans. This abstract from...
Insurance Chic
In 1970, iconoclastic author Tom Wolfe famously wrote his essay and later book, Radical Chic. Wolfe attempted to pillory certain who, in his opinion, invited radical individuals to swank Park Avenue soirees to bolster their reputations rather than for social good....
EBA Stop Loss Plans
Bravery In The New World Order
Stop Loss Pitfalls
