“To gain control over the ever-increasing cost of employee health insurance, more and more employers are discontinuing their fully insured coverage and switching to self-funded models.”
Basically, this is an unbundled approach that separately hires all of the required functions — medical provider networks, carrier or third-party administrator (TPA), pharmacy benefit manager (PBM), stop-loss insurer, and consultants — subject to competitive bidding. Significant cost reductions in the neighborhood of 5% to 10% are typical.”
Milliman
