Advantages and Disadvantages of Self-Funded Medical Insurance

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Advantages of self-funded medical insurance include:

  • Cost Control: With self-funded plans, you have the opportunity to control healthcare costs by implementing wellness programs, disease management initiatives, and preventive care strategies.
  • Cash Flow: Self-funded plans provide businesses with improved cash flow by eliminating monthly premium payments.
  • Customization: You have the ability to tailor benefit packages to meet the specific needs of your employees, resulting in higher employee satisfaction and retention.
  • Access to Data: Self-funded plans offer access to valuable healthcare data, which can help you identify cost drivers and make informed decisions regarding benefit design and management.
  • Regulatory Flexibility: Self-funded plans are subject to federal regulations, but they allow for greater flexibility in state mandates, providing additional options and cost-saving opportunities.

However, it's essential to be aware of the disadvantages of self-funded medical insurance as well. These can include:

  • Financial Risk: In self-funded plans, the business assumes the financial risk for employee healthcare costs, especially in cases of unexpectedly high claims.
  • Administrative Complexity: Self-funded plans require ongoing administrative tasks, such as claims processing and compliance, which can be time-consuming and require expertise.
  • Stop-Loss Coverage: Businesses need to consider purchasing stop-loss coverage to protect against catastrophic claim expenses.
  • Limited Pooling of Risk: Self-funded plans may lack the pooling of risk that occurs in fully insured plans, potentially resulting in higher costs for small businesses with sicker employees.

In conclusion, self-funded medical insurance offers several advantages and disadvantages for business owners. By carefully evaluating your company's needs and resources, you can determine if self-funded medical insurance is the right choice for your business. Consult with insurance professionals to ensure you make an informed decision that aligns with your company's goals and values.

Practice Leader(s)

Max Jong
Max Jong

Captive Practice Leader, Managing Director

Max Jong

Max Jong

Captive Practice Leader, Managing Director

Max Jong is the Captive Practice Leader and Managing Director at Risk Management Advisors, an alternative risk and captive management firm.  Max began his career at Northwestern Mutual in 1994 after graduating from UCLA.  Over 12 years, he built a successful financial services practice while heading up an office overseeing 50 professionals in Los Angeles and Irvine, California.  The office was perennially one of the top producing organizations in the Northwestern Mutual system.

Max joined his partners at Risk Management Advisors in 2007 as he began to work with more sophisticated mid-market business owners.  RMA specializes in the design, formation and management of captive insurance companies.  There’s also an emphasis on self-funded group benefits as well as other creative alternative risk management strategies.  The firm assists businessowners in better managing their risks without jeopardizing their balance sheet.   In 2019, he headed up a merger with Risk Strategies, a Top 10 private national specialty insurance brokerage and consulting firm.  Since then, he was appointed as the Captive Practice Leader to oversee the growth and development of the organization.

For 5 years, Max served as an Independent Director for Fiat Lux Risk and Insurance Company, one of the largest and most sophisticated captive insurance companies.  Fiat Lux was established by The University of California Regents to better manage the broad risks of the University of California system.

Max has also been a life-long supporter of Big Brothers Big Sisters of Greater Los Angeles.  He initially volunteered to be a mentor in 1995 and is currently mentoring his second "Little".  Max was asked to join the Board of Directors in 2000 and eventually serving as their Board Chair.  After 20+ years as an active board member, he continues to support the organization by serving as a Trustee.

He is married to Alice and they’re raising two young children, Hunter and Hayden. Max and Alice are happily married despite her irreparable mistake of having gone to USC.  He loves to travel, loves to golf and a hopeful Lakers fan.

Mike DiMayo
Mike DiMayo

ACI, CFP, CLU, ChFC
Managing Director- Oxford Risk Management Group

Jarid Beck
Jarid Beck
Managing Director
Jarid Beck

Jarid Beck

Managing Director

Jarid Beck is a Managing Director at Risk Management Advisors. He is a career specialist in the design, implementation, and management of alternative risk management (ARM) strategies including self-insured plans and captive insurance companies. Jarid has a diverse insurance background which allows him to deliver technical insurance solutions to clients in a wide variety of industries including construction, real estate, staffing, manufacturing, trucking, and finance.

Jarid was awarded the Associate of Captive Insurance (ACI) designation from the International Center for Captive Insurance Education (ICCIE) along with the Construction Risk Insurance Specialist (CRIS) designation from the International Risk Management Institute (IRMI). He is a noted authority on the use of self-insurance and captives as a tool for companies to reduce the cost of providing group medical benefits.

Jarid graduated from the University of California, Riverside with a degree in Business Administration.

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