SELF FUND ADMINISTRATION

What is a self-funded health program? A self-funded (or self-insured) health program is one in which the employer assumes some or all of the risk for providing health care benefits to his employees. He takes control of the assets of his plan, invests them to his advantage, and eliminates the insurance company charges. He can completely redesign the plan if he wants.

When he decides to self-fund his health plan(s), the employer usually checks to see how well the insurance company has administered his plan. If he is not satisfied, this is the time to change administrators to register for Africa Medilink’s secure site for providers, simply click on the “Register Now” link which will bring you to a short online form you will need to complete prior to accessing the secure site. Have your practice license number, PIN number and/or TIN number handy when you register.

No. The major difference between an insured plan and a self-funded one is that in self-funding the employer assumes the risk for the claims and these claims should be somewhat predictable. Therefore, if the employer is very small, self-funding is not recommended. Although there are companies as small as 25 employees that so successfully self-fund their health plans, an employer this size should consult us as to the viability of self-funding. Also, if the work force is volatile making future claims difficult to predict, self-funding may not be an option. Volatility of future claims can be smoothed out to a great extent by the purchase of excess-risk coverage, but here again please consult with us for more information

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