#027 – Your employer is really your health insurance company.  Two out of every three (67%) Americans who get their health insurance through their employer are in a self-funded insurance plan – which means your employer is paying the claims, not an insurance company.

2020 Kaiser Family  Foundation Survey – 2 out of 3 Employers Are Self-Funded

Scott considers the unfortunate comments of someone who has met their insurance plan’s annual out of pocket maximum in June and wants to load up on perceived “Free” benefits that their plan provides for them over the course of the next 6 months.  Scott explains why that perception is backwards and how it harms their employer, coworkers and themself.

If you have health insurance through your employer, you are not alone.  About half of the United State’s population receives health insurance through their employer, which covers 157  million Americans.  If your employer has over 1,000 employees, it is nearly a certainty that your employer is your insurance company.  If you work for an employer with fewer than 200 employees, you have a 1 in 4 chance that your employer is self-funded.  More and more small employers are learning about self-funding……talk to your boss, office manager or firm administrator about getting a self-funded health insurance plan for your company.

Why You Get Your Health Insurance Through Your Employer

When the employer is self-funded, the employer pays claims on behalf of the employee.  The employer relies on an Administrative Services Only (ASO) contract with a Third Party Administrator (TPA), which can be an independent firm or sometimes is a division or department within an insurance company.  The employer may purchase Stop Loss insurance, with which the employee is not directly involved.

Learn More About Trends In Employer Self-Funded Health Plans here

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Next episode, we’ll take a deeper look at the High Deductible Health Plans that make you eligible for a Health Savings Account.

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