2016 Trend - Growth in Self-Insured Plans

Given the cost burden of the ACA, state taxes, and state mandates on fully insured plans, the industry is seeing a shift to self-funding at small to mid-sized organizations. According to a study by PwC (Health and Well-being Touchstone Survey Results), 66% of employers with 500-1,000 employees are self-insured, up from 59% in 2014.

While the move to a self-insured plan makes sense on many levels, it does encumber the employer with significantly more risk. It is imperative that these organizations employ comprehensive eligibility verification on all enrolled dependent and employ an ongoing verification mechanism, especially for the more costly dependent spouses.