Self-insured vs self-funded

Self-funded health plans, otherwise known as self-insured health plans, are health plans where the financial risk associated with medical claims is held by the organization sponsoring the health coverage. In the case of an association health plan, self-funding would mean that the association itself retains the risk.

What is meant by self-insured?

Being self-insured means that rather than paying an insurance company to pay medical, dental and vision claims, we pay the claims ourselves, using a third-party administrator to process the claims on our behalf.

What does being self-funded mean?

Self-insurance is also called a self-funded plan. This is a type of plan in which an employer takes on most or all of the cost of benefit claims. The insurance company manages the payments, but the employer is the one who pays the claims.

What is the difference between self-funded and fully funded?

Fully-insured plan—employer purchases insurance from an insurance company. Self-funded plan—employer provides health benefits directly to employees. insurance company assumes the risk of providing health coverage for insured events.

How do I know if I am self-insured?

If you're debt-free and have enough in savings, investments and assets to ensure your family can live off the income generated by them, then you're self-insured.