Self-Funded Plan

Updated: 28 November 2024

What Does Self-Funded Plan Mean?

A self-funded plan is a type of health insurance where a company directly covers the healthcare costs for its employees, rather than relying on the products and services of an insurance company. In a self-funded plan, the company essentially functions as the health insurer and is responsible for paying all claims.

Insuranceopedia Explains Self-Funded Plan

The advantage of self-funded plans is that companies can save money by avoiding the higher premiums that include profit margins typically associated with fully-funded plans or plans purchased through insurance companies.

Self-funded plans are usually adopted by larger companies.

To mitigate excessive risk, companies with self-funded plans often purchase stop-loss insurance. This coverage protects against claims that exceed a predetermined amount, ensuring financial stability in case of unusually high healthcare costs.

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