Fully insured vs. self-funded health plans

We're all about protecting the health of your employees and their families. And we want to protect the health of your business, too. That's why choosing a funding arrangement for your health plan is a big decision.

Fully insured: The risk-free option

The most traditional type of health insurance funding where you pay a fixed and easy-to-budget premium to Wellmark every month. Then, we process and pay all claims for covered services to your employees.

Ideal if you want to:

• Assume zero risk, since Wellmark assumes all risks and absorbs all the losses.
• Protect yourself from the effects of high individual claims.
• Not maintain claim reserves, as Wellmark assumes that responsibility.

Keep in mind:

• You'll have limited flexibility in controlling your financial liabilities.
• All employers with 1+ enrolled employees qualify.

Self-funded: Greater financial control

With self-funding, you directly fund the claims and only pay for the health care services actually used by your employees and their covered family members. A stop-loss option is also available, which lets you pay all claims up to a set limit until your stop-loss coverage kicks in and Wellmark pays the remaining claims.

Ideal if you want to:

• Improve your cash flow, because you maintain your own reserves.
• Assume risk and legal responsibilities.
• Save money if your claims utilization is lower than expected.

Keep in mind:

• Claims utilization may be higher-than-expected and more difficult to budget.
• Available for employers with 101+ enrolled employees.