Self-funding isn't just for Fortune 500 companies. And fully insured isn't always the safest choice.
The funding model you choose for your health plan is one of the most consequential financial decisions your organization makes. Yet most employers make it without complete information, without claims data analysis, and without objective guidance.
Core Benefits conducts disciplined, unbiased funding strategy analysis — evaluating every available option against your organization's specific financial profile, risk tolerance, and long-term objectives.
FUNDING STRUCTURES WE ANALYZE
All Funding Models. No Bias.
We evaluate every available structure against your organization's specific data and objectives — not carrier incentives or product quotas.
Option 01
Fully Insured
Traditional carrier-backed coverage. Maximum predictability, minimum claims visibility. Often the right starting point — but not always the most efficient structure as organizations grow.
Option 02
Level-Funded
A hybrid approach combining fixed monthly costs with access to claims data and potential year-end refunds when claims perform well. Increasingly popular for employers with 25–200 employees.
Option 03
Self-Funded
The employer assumes direct financial responsibility for claims, typically paired with stop-loss insurance to cap catastrophic risk. Offers maximum transparency, plan design flexibility, and long-term cost control potential for the right organizations.
Option 04
Captive Programs
Group purchasing structures that pool risk across multiple employers — offering self-funding economics with reduced individual volatility. Appropriate for employers seeking cost control without full self-funding exposure.
Our Process
How We Evaluate Your Funding Strategy
Every funding evaluation begins with your data — not a product recommendation. We build a complete picture of your organization's financial profile before presenting any options.
1
Claims history analysis and trend review
3–5 years of claims data reviewed to identify cost drivers, high-cost claimants, and utilization patterns.
2
Workforce demographics and utilization modeling
Age banding, dependent coverage, and utilization trends modeled to project future cost exposure.
3
Financial risk tolerance assessment
Understanding your organization's capacity and appetite for claims volatility before recommending any structure.
4
Stop-loss strategy and carrier evaluation
Specific and aggregate stop-loss options evaluated to cap catastrophic risk exposure for self-funded structures.
5
3–5 year cost projection modeling across funding scenarios
Side-by-side financial projections across all viable structures so leadership can compare options clearly.
6
Administrative structure and vendor alignment review
TPA, carrier, and technology vendor requirements evaluated for each funding model.
7
Implementation roadmap and transition planning
A clear, sequenced plan for moving from your current structure to the recommended model.
IMPORTANT
Funding-Agnostic by Design — Always.
Our recommendations are driven entirely by your data and long-term objectives — never by carrier relationships or product incentives. If fully insured is the right answer for your organization, we will tell you. If self-funding or a hybrid model will create a more sustainable cost structure, we will show you why.
That independence is one of the primary reasons employers trust Core Benefits as their long-term strategic advisor.