Self‐insured employers increasing their role in healthcare In self‐insured (or 'self‐funded') group health plans, the employer assumes the financial risk for providing health care benefits to employees. These plans often use an insurance plan as a third party administrator (TPA) to administer their claims and "look like" traditional insurance, but with notable differences. Namely, group health plans are exempt from many of the taxes and mandates that the Affordable Care Act imposes on businesses and individuals. Due to these exemptions, the number of self‐insured group plans is growing. These plans are customizing traditional insurance plans to meet employees' specific needs, providing coverage for areas of interest and excluding components that are irrelevant to their employee base. We've seen a consolidation of traditional health plans as the number of self‐insured groups continues to increase!
Benefits differ greatly from plan to plan making them difficult to characterize in many databases. One of the key differentiators of our service is that we capture all benefit utilization through our exclusive employer research database. Using this database, the JeSTARx team will work with you to compare and contrast benefits even in self‐insured plans.
While we keep an eye on these changes, we are preparing for upcoming meetings and looking forward to connecting with you! Let us set up time to discuss your challenges. Our team will be attending the upcoming NASPRx meeting (Orlando), AMCP Meeting Boston), or ISPOR (Amsterdam). Let's find a time to get together!
We know that sometimes your data and research needs can't
wait. We are here to help! Please give me a call (office 973‐208‐
8621) or email me at RBrook@betterhealthworldwide.com to discuss.