Health Payer Intelligence April 8, 2021
There are three ways to fund employer-sponsored health plan claims—the self-insured, level-funded, and fully-insured models—and the insurer-employer dynamics and risk differ in each.
Employers have three primary options to choose from when they are deciding how to fund their employer-sponsored health plan claims: the self-insured, level-funded, or fully-insured health plan models.
Both employers and insurers can be payers, covering medical claims for the employees. But each model presents unique ways to distribute risk and to provide funding for medical claims.
Various factors will dictate which model an employer chooses. However, employers and insurers alike should be aware that there are slight differences in how employers and insurers engage with one another in each format.
Thus, it is worthwhile to review...
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