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Self-Funded Plans

Meaning

Self-Funded Plans are employee health benefit arrangements where the employer assumes the direct financial risk for providing healthcare benefits to its employees, rather than paying a fixed premium to an insurance carrier to cover claims. The employer pays for each claim as it is incurred, often using a third-party administrator for claims processing and network access. This structure grants employers greater flexibility in designing wellness programs and coverage for specific treatments, including those related to advanced hormonal health.