Self-Funded Medical Insurance
For employers seeking a more sophisticated and cost-effective approach to employee health benefits, a self-funded medical plan offers a powerful alternative to traditional, fully-insured products. By funding your own claims, you can gain greater control over your healthcare spend, increase transparency, and design a plan that truly meets the needs of your employees. At HBG Insure, we specialize in helping businesses in Eastern Pennsylvania and New Jersey transition to and manage successful self-funded and level-funded medical plans.
Our process is designed to demystify self-funding and provide you with the data and analysis you need to make an informed decision. We start with a comprehensive feasibility analysis, evaluating your claims history, risk tolerance, and employee demographics to determine if a self-funded or level-funded model is the right fit. We then design a plan that includes stop-loss insurance to protect you from catastrophic claims, and we partner with best-in-class third-party administrators (TPAs) to ensure seamless claims processing and administration. With a self-funded medical plan from HBG Insure, you can escape the rigid constraints of the fully-insured market and unlock a new level of control and cost savings.
Benefits of Self-Funded Medical Insurance
✓ Cost Control: Pay only for the claims your employees actually incur, not inflated premiums based on pooled risk
✓ Transparency: Gain complete visibility into your healthcare spending and utilization patterns
✓ Flexibility: Design a plan that meets the specific needs of your workforce without carrier restrictions
✓ Cash Flow: Retain unused premium dollars rather than paying them to an insurance carrier
✓ Regulatory Advantages: Self-funded plans are governed by federal ERISA law, providing more flexibility than state-regulated fully-insured plans
Our Self-Funded Solutions
✓ Traditional Self-Funded: Full control and transparency with stop-loss insurance to protect against catastrophic claims
✓ Level-Funded: Predictable monthly payments with the benefits of self-funding and potential for premium refunds
✓ Captive Programs: Pooled self-funded arrangements that provide additional risk protection and cost savings
Is Self-Funding Right for Your Business?
Self-funding is typically most effective for businesses with 50 or more employees, though level-funded options can work for smaller groups. The key is having a stable workforce and the financial capacity to absorb monthly claims fluctuations. Our feasibility analysis will help you determine if self-funding is the right choice for your business and provide you with a clear roadmap for implementation.
Ready to Request a Plan Design Audit?
Contact HBG Insure today to learn how our Plan Design Audit can help you control costs and improve coverage.
These satisfied clients started with a simple,
no-obligation Plan Design Audit...
These satisfied clients started with a simple,
no-obligation Plan Design Audit...
What makes Horizon Insure Business Group different from other insurance brokers?
Most insurance brokers focus on shopping rates at renewal. Horizon Insure Business Group takes a plan design approach—reviewing how your current insurance and benefits are structured to identify smarter ways to control costs and improve coverage before renewal decisions are made.
Do you only work with businesses in Pennsylvania and New Jersey?
Our primary focus is serving employers in Pennsylvania and New Jersey. This local focus allows us to provide more tailored guidance and hands-on support for regional regulations, carriers, and employer needs.
What is a Plan Design Audit?
A Plan Design Audit is a structured review of your current insurance and employee benefits program. It identifies cost drivers, coverage gaps, and design opportunities so you can make informed decisions before renewal—without pressure to change brokers.
What size businesses do you typically work with?
No. The Plan Design Audit is informational and educational. Many employers use it to understand their options before deciding whether any changes are needed.
Do I have to switch brokers to get a Plan Design Audit?
We primarily work with small to mid-sized employers, typically ranging from 25 to 250 employees, who want more control over insurance costs and benefits strategy.