Direct answer
The primary risk is unexpected high-cost claims, which can exceed the employer’s budgeted reserves if stop-loss insurance coverage is not appropriately structured. It depends on the size of your workforce and your historical claims data, which determine your risk tolerance.
Actuarial analysis reports regarding employer-sponsored health plan insolvency risks. For additional information about the prevalence and financial structures of self-funded plans, see the KFF employer health benefits survey.
What this means for you
The primary risk is unexpected high-cost claims, which can exceed the employer’s budgeted reserves if stop-loss insurance coverage is not appropriately structured. It depends on the size of your workforce and your historical claims data, which determine your risk tolerance.
ARMFOX HEALTHCARE
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This page is informational and not a coverage guarantee or quote.
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