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Self-Insured Health Plans

Meaning

Self-Insured Health Plans describe an arrangement where an employer assumes the direct financial risk for employee healthcare claims, pooling the risk internally rather than transferring it entirely to an external carrier. The employer pays for medical services directly as they are incurred, often utilizing a third-party administrator for claims processing. This model provides greater control over plan design and access to aggregated utilization data, which is invaluable for targeted wellness initiatives.
A man’s vital appearance represents successful hormone optimization, embodying optimal metabolic health and enhanced cellular health. This signifies a positive patient journey achieved through clinical protocol to support endocrine balance and comprehensive wellness outcome.
Are There Any Differences in Wellness Program Rules for Self-Insured versus Fully-Insured Companies?

Are There Any Differences in Wellness Program Rules for Self-Insured versus Fully-Insured Companies?

The rules for wellness programs differ because self-insured plans are governed by uniform federal law, allowing for greater customization, while fully-insured plans must also adhere to varying state insurance laws.
∞ Genetic Information Nondiscrimination Act
∞ Wellness Programs
∞ Employee Benefits Law
HRTio
August 14, 2025