Are self-funded plans the right option? Find out all you need to know to make the right decision for your organization.
The Patient Protection and Affordable Care Act creates incentives for certain employers to self-insure health care coverage. For example, self-insured plans are not subject to the small-group rating regulations, risk adjustment policies, and essential health benefits provisions newly imposed by PPACA. Self-insured businesses are also exempt from many state insurance regulations. This topic examines the factors that may motivate employers to self-insure, and the ways incentives to self-insure might change after PPACA becomes effective. The topic also will discuss how self-insurance influences benefit design, benefit claims decisions, and financial exposure. Finally, the program will offer practical tips to employers facing this certain uncertainty in the group health care context.
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Why Lorman?
Over 34 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.
Agenda
Self-Insurance Overview
- Dispelling Myths
- PPACA's Large Group Market Study
PPACA's Impact on Self-Funded Plans
- Specific Exceptions
- Reinsurance Requirements
- 2012 DOL Report
Factors Impacting Decisions to Self-Fund
- Regulatory Factors
- Financial Exposure
- Administrative Concerns
- Advantages and Disadvantages
- Stop Loss Issues and Case Studies
- Practical Considerations
Cost Containment Strategies for Self-Funded Plans
- Alternative Risk Arrangements for Small Groups
- Wellness Programs and Incentives
- Paying Instead of Playing
Practical Tips
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Why Lorman?
Over 34 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.
Credits
OnDemand Course
This course was last revised on December 14, 2015.
Call 1-866-352-9540 for further credit information.
This program does NOT qualify, nor meet the National Standard for NASBA accreditation.
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Why Lorman?
Over 34 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.
Faculty
Kristopher R. Alderman
Lewis Brisbois Bisgaard & Smith LLP
- Attorney with Lewis Brisbois Bisgaard & Smith LLP
- Represents group health plans, plan sponsors, participants and beneficiaries, insurers, plan fiduciaries, third-party administrators, and employee benefits consultants in a wide variety of matters related to plan administration
- Practice focuses on clients engaged in disputes related to health care reimbursement, including claim audits and reinsurance matters, and ERISA litigation
- J.D. degree, magna cum laude, Georgia State University College of Law; B.A. degree in English, cum laude, University of Georgia
- Can be contacted at 404-991-3783 or [email protected]
More Program Information
Why Lorman?
Over 34 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.

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