Take greater control of your healthcare costs with a self-funded health plan.
Smarter Benefit Plans with Self-Funding
Traditional or Captive Self-Funded Plans with IRM Benefits
Self-funded employee benefits plans are becoming a smarter alternative to traditional fully insured programs for employers looking to gain more control over healthcare costs. By paying for actual claims rather than fixed insurance premiums, businesses can improve cash flow, increase transparency, and customize plan designs to better meet the needs of their workforce. When paired with effective risk management strategies and stop-loss protection, self-funding can provide opportunities for long-term savings while maintaining quality benefits for employees. Learn more about how a modified approach to employee benefits can help your organization reduce costs and improve outcomes.
A successful self-funded plan begins with the right stop-loss strategy. Employers can choose from specific stop-loss coverage, which protects against large claims from an individual participant, and aggregate stop-loss coverage, which limits overall plan liability when total claims exceed expected levels. Organizations seeking improved cash flow and protection against large monthly fluctuations may also benefit from monthly aggregate accommodation, which allows for partial payments under aggregate stop-loss coverage throughout the plan year rather than requiring employers to wait until year-end.
Depending on an employer’s size, risk tolerance, and financial objectives, these protections can be structured through traditional stop-loss carriers or through group captive programs, which allow employers to share risk with like-minded organizations while potentially benefiting from favorable underwriting results and significant long-term savings.
Maximizing the value of a self-funded health plan also requires effective vendor management. Selecting and overseeing the right Third-Party Administrator (TPA), Pharmacy Benefit Manager (PBM), and specialized point-solution providers can have a significant impact on plan performance, member experience, and overall cost containment. A coordinated vendor strategy helps ensure transparency, accountability, and alignment across all service partners while leveraging data to identify cost drivers and opportunities for improvement.
By regularly evaluating vendor performance, negotiating favorable contract terms, and integrating appropriate solutions, employers can create a more efficient benefits ecosystem that delivers better outcomes for both the organization and its employees.
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