Self Funded Health Insurance

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What is a self funded health insurance plan?

A self-funded health insurance plan is a type of health insurance plan in which the employer assumes the financial risk for medical claims. The employer sets aside money in a trust fund to pay for claims, and they are responsible for any unpaid claims.

What is a self funded health plan
How easy are self-funded health plans to use

How easy are self-funded health plans to use?

The ease of use of a self-funded health plan depends on a number of factors, including the specific plan design, the employer’s administrative capabilities, and the patient’s individual needs. However, in general, self-funded health plans are considered to be more complex and challenging to use than fully insured health plans.

Here are some of the reasons why self-funded health plans are often considered to be more difficult to use:

  • The employer is responsible for all claims processing. This means that the employer must have a system in place to collect claims, process them, and pay the providers.
  • The plan designs can be more complex. Self-funded plans can be customized to meet the specific needs of the employer, but this can make them more difficult to understand and administer.
  • There is less flexibility in choosing doctors and hospitals. The employer may have to negotiate contracts with providers, which can limit the choice of providers for employees.

How fast can you implement self-funded health plans?

The speed of implementation of a self-insured health plan depends on a number of factors, including the size of the employer, the complexity of the plan, and the availability of third-party administrators (TPAs). However, in general, self-insured health plans can be implemented relatively quickly.

How fast can you implement self-funded health plans

Health Insurance Coverage Options for Small Businesses

Fully Insured

Fully insured small business health insurance is a type of health insurance plan where the insurance company assumes all of the financial risk. This means that the insurance company is responsible for paying for all of the medical expenses incurred by the plan members, regardless of how much they cost. Fully insured plans are not underwritten and accept all pre-existing conditions, because of this they are generally more expensive than the other health insurance options.


Level Funded

Level funded small business health insurance is a type of self-funded health insurance plan where the employer pays a fixed monthly premium to the insurance company. This premium is used to cover the cost of administrative services, claims payments, and stop-loss insurance. If the claims for the year are lower than the premium, the employer may receive a refund. If the claims are higher than the premium, the employer does not have to pay the difference on a completed plan year.

Self Funded

Self-funded small business health insurance is a type of health insurance plan where the employer is responsible for paying for all of the medical expenses incurred by their employees. This means that the employer sets aside money to cover claims, and they are responsible for any costs that exceed the amount that they have set aside. The main advantage with self funded plans is the customization to change and alter benefits as the employer sees fit.

Benefits of a Self Funded Plan for Small Businesses

Cost Savings

Self-funded plans can be more cost-effective for employers with healthy employees. This is because the employer is only responsible for the claims that are actually incurred, rather than paying a fixed premium regardless of the number of claims.

More Control

Employers have more control over the plan design and benefits with a self-funded plan. This can be beneficial if the employer wants to offer a more comprehensive or customized plan to their employees.


Self-funded plans can be more flexible than fully insured plans. For example, employers can set their own deductibles and copays, and they can also offer different levels of coverage to different employees.

Tax Advantages

Self-funded plans can offer tax advantages to employers. For example, employers can deduct the cost of claims from their taxable income.

Improved Cash Flow

Self-funded plans can improve cash flow for employers. This is because the employer only pays for claims as they are incurred, rather than paying a fixed premium in advance.

Frequently Asked Questions for Small Business Health Insurance

When is it required to offer health insurance to employees?

It is required to offer health insurance when you have 50 FTE (full-time equivalent) employees. Full time equivalent can be the combined full-time with part-time. For instance, 50 Part timers generally is considered 25 Full time equivalent.

How much does group health insurance cost for a small business?

The first step is to figure out what’s important to you. Do you need a plan with a low monthly premium? Does your budget allow for a plan with a lower deductible? Are you looking for a PPO or EPO plan? Do you have any preexisting conditions that must be covered? Once you know what’s important to you, it’ll be easier to find the right health insurance plan.

What are ways a small business owner can save money on health insurance?

There are a few different ways that people can save money on their insurance premiums. One way is to purchase a plan that is not based on the individual’s income. These plans can be found on the private market, and they typically have lower premiums than the traditional group or ACA plans.

Another way to save money on insurance is to shop around for the best deals. Different insurers offer different rates, so it’s important to compare and contrast the different options available.

Finally, it’s also important to be aware of the subsidies that are available through the Affordable Care Act. Many people are eligible for subsidies, which can help reduce the cost of premiums.

Apollo Insurance Group
Apollo Fights For You

Apollo Insurance Group is a health insurance brokerage located in Lee’s Summit, Missouri and Chicago, Illinois. We have been around since 2010, and our mission is to positively impact people’s lives. We do this by fighting to find the best option for our clients, create relationships with our employees, and give back to our communities. Apollo also specializes in Medicare, life insurance, dental, and vision plans. We have agents that are experts on group health insurance and are ready to help you find the right plan. Fill out our contact form to get in touch with an agent today.

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Insurance can be complicated. Between the dozens of providers, changing laws, different kinds of insurance, and so many options, it's a challenge to navigate and find the right plan for your budget and needs.

That's where an insurance broker can help. Apollo are the experts in health insurance and will fight for you. There's no extra cost to you and you'll have an insurance person to always turn to.

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Do you want to provide an affordable insurance option for your employees?

Or maybe your employees are already insured but the cost has increases. It may be time to shop for a better group plan. Having health insurance through an employer is an additional way to acquire and keep talent. Connect with Apollo to find the best group insurance plan for you and your employees.

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Let's be honest, we often don't think about the extremes of what could happen in life. Life insurance is the least purchased kind of insurance even though plans start at only a few dollars a month. If you want to make sure your family is taken care of, this simple insurance can have a huge effect in case of death.

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A good smile can be worth a million dollars.

Everyone can benefit to good oral care and the cost of emergencies can be quite large. Luckily there are flexible dental insurance plans for everyone. Contact us to get a dental plan that works for your budget.

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Our eyes are one of our most precious organs, and we only have two, so proactive protection and care is key to maintaining these vital organs! Particularly for children, they don’t yet know how beautiful the world is through perfect vision, it is our responsibility as parents and caretakers to be in-tune with the world through their eyes. On the flip side, as we age our eyes do as well, and thus the frequency for vision checks increases exponentially.

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