Why 60% of mid-market companies are overpaying on health benefits
Most business owners with 50-500 employees are on fully-insured health plans. They get a renewal letter every year with a 10-20% increase and just accept it.
Here's what the insurance industry doesn't want you to know: you're subsidizing other companies' claims.
Fully-insured plans pool your premiums with thousands of other businesses. If your workforce is healthy, you're paying for someone else's bad risk. That's the model working as designed — for the carrier, not for you.
Self-funded plans flip this entirely. You pay your own claims directly, buy stop-loss insurance for catastrophic events, and keep the savings when your team is healthy. Most companies save 20-40% in the first year alone.
The three things holding most companies back:
"It's too risky" — Stop-loss insurance caps your exposure. Your downside is limited. Your upside is unlimited savings.
"We're too small" — Companies with as few as 50 employees can self-fund profitably. Level-funded plans make it even easier to start.
"It's too complicated" — That's why program managers exist. The right advisor handles plan design, TPA selection, compliance, and ongoing optimization.
If your renewal is coming up in the next 6 months, now is the time to run the numbers. You might be surprised.
