Self-Funded Dental/Vision/Hearing Reimbursement

A self-funded group health plan is an alternative to the traditional one-size-fits-all model, one in which the employer assumes the financial risk of providing health care benefits to its employees. Rather than paying a fixed premium to an insurance carrier, a self-insured employer pays for each claim out of pocket. Employers must have the financial resources to do so, and will typically set aside funds each month to cover the expected costs of administrative fees, stop-loss insurance, and their employees’ anticipated hospital and doctor bills.

The benefits of a self-funded group health plan are that they are subjected to fewer state regulations, allowing for more flexibility to meet the health care needs of employees. At the end of each year, the total amount of funds set aside is compared with the total claims paid out. The difference is often split between the employer and the insurance company.

Administrative Services for Self-Funded Insurance Reimbursements

Burnham & Flower enhances the effectiveness of our clients’ Human Resource Departments by providing administrative services for employers who offer self-funded group health plans for their employees. Our benefits specialists can help manage your employee health benefits program, process claims reimbursements, and handle all aspects of customer service.

Our in-house services include, but are not limited to, a premier enrollment/administration system, an employee portal and mobile app, streamlined EOB retrieval, and paperless claims submissions. Detailed claims information is also made available to employers and employees.

If you are based in the state of Michigan, contact Jack Schmitz at jschmitz@bfgroup.com or 800.748.0554 for more information, and if you are based in the state of Ohio, contact Tracy Ames at tames@bfgroup.com or 800.748.0554.