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Save up to 40% On Group Health Insurance

Self-funded health plans are a proven solution to controlling healthcare costs.

What’s different about a self-funded plan?

Instead of paying an insurance carrier, Memberly matches employers with a Third Party Administrator, known as a TPA. The TPA manages the health plan with the objective of conserving the employer’s claims funds and returning any unspent claims reserves. All parts of the self-funded plan are seamlessly managed by the TPA:

  • Stop-loss insurance protects against higher than expected claims eliminating risk
  • There’s a set monthly premium which pays the TPA and funds the claims account
  • Employees access an independent physician network for their healthcare
  • Claims are paid by the TPA from the employer's claims account
  • Unused claims funds are returned to the employer at the end of the plan term

Built With You In Mind

Flexible Participation Rates

With Memberly, there's no minimum participation level giving employers the flexibility to tailor the plan to their needs without covering more employees than necessary, or paying surcharges for low participation rates.

Starting at 10 Enrolled Employees

Small groups can start saving sooner with a self-funded health plan. With Memberly, employers with 10 or more enrolled employees can start a self-funded plan any time and see significant savings and unused claims funds back.

Save with Healthy Employees

Are your employees active and healthy? Healthy employees use less healthcare, and with Memberly employers see the savings upfront in their plan and get more money returned on the backend in the form of unused claims funds.

Comparing Cost

By comparison, many hospitals are billing 350 to 600% of Medicare rates. A self-funded plan using RBP can reduce the cost to 150% of Medicare protecting the plan from excessive billing.

Fast Payouts

Hospitals and facilities are accepting RBP reimbursement as they are paid quickly and directly from the plan's TPA. Memberly's partnered TPAs access RBP data to assess the effectiveness of RBP in each zip code when designing a self-funded plan to ensure the best outcome for the employer and employees.

Getting Control of Hospital
Costs

With a self-funded plan, hospital and facility bills are paid based on a percentage of Medicare using a re-pricing system known as Reference Based Pricing, or RBP. A Memberly TPA will pay hospital bills based on 150% of Medicare which has a 98% initial acceptance rate. 

All Provider Network

Employees are not restricted to in-network facilities and physicians when seeking care in a self-funded plan. Instead of limiting employees to networks, employees can use any facility or doctor and the TPA will arrange payment before or afterwards pursuant to RBP. This gives a Memberly designed self-funded plan an "All Provider Network".