Level funded vs fully insured vs captive, compared across 6 dimensions, plus the 4 readiness tests and the exit question to ask before you sign anything.
What You'll Learn Why "we're already self-funded" is a starting line, not a finish line How a carrier ASO arrangement keeps the carrier's admin, network, and owned PBM while moving 100% of the claims risk onto your balance sheet The 4 levers a carrier ASO holds and an...
A self-funded plan feasibility study covers claims data, stop-loss modeling, and breakeven math. Here’s how to run it and what the results actually mean.
Pharmacy is the easiest line item to fix in a self-funded plan. How spread pricing, rebate traps, and independent PBMs really work in 2026 — and the test to run.
The best alternative funding models for group health benefits compared: self-funded, level-funded, captives, and RBP. See which fits your size and risk. Get clarity.
Most ESOPs treat health insurance the same way every other employer does. They renew it. They negotiate it down a point or two. They tell HR to “shop the market” if last year’s increase stung. Then they move on. That’s a $500K-to-$5M-a-year line item being managed...
Networks who brag about their network discount are bragging about how much they over charge clients. That sounds harsh. It's also true. And once you understand how the pricing actually works, you stop defending the number on your renewal and start asking better...
Too often companies that obsess over supply chains ignore the most expensive one they have You already know how to run a supply chain If you’re in manufacturing, construction, or logistics, this isn’t new territory. You manage: Raw material sourcing Vendor contracts...
When Catastrophe Strikes: What Happens When a Catastrophic Claim Hits Your Health Plan? A plain-language guide for employers navigating fully insured, level funded, captive, and self-funded health plans. It starts with a phone call you never expected. An employee has...
In early 2025, the leadership team at a 135-life manufacturing company in St. Louis sat down to review their group health insurance performance. What they saw wasn’t routine volatility. It was concentration risk. Out of 206 total members on the plan, three specialty...