Skip to main content

Self-Funded Plan Administration

Meaning

Self-Funded Plan Administration refers to the process by which an employer, rather than purchasing a fully-insured policy, assumes the direct financial risk for its employees’ healthcare claims and manages the operational aspects of the benefit plan. This administration typically involves contracting with a Third-Party Administrator (TPA) to handle claims processing, network access, and utilization review, providing the employer with greater control over plan design and cost management. This structure offers unique flexibility for incorporating specialized hormonal health benefits.