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FirstHealth of the Carolinas
 

 

SELF-FUNDED PLAN ADMINISTRATION

Because we knows that one size doesn’t always fit all, FCC provides a full array of administrative services for large employers that choose to self-fund health benefits.

Why Self-Funding?

With a self-funded health plan, the employer pays the direct cost of each claim as it is incurred, rather than paying insurance premiums to an insurer. Self-funding provides an employer with flexibility to create a benefit plan that meets the particular financial and design needs of employees and the employer. Self-funded plans are not regulated by state insurance laws, and are exempt from state law mandates. Mandated benefits can have a big impact on the overall cost of your health plan. Generally, self-funding makes sense only for employers with 250 or more employees.

What is self-funded plan administration?

Most self-funded health plans contract with a third party administrator to handle the day-to-day operations of the plan. With a strong history of quality services for its insured clients, FCC now offers self-funded plan administrative services including:

  • Enrollment
  • Claims adjudication and payment
  • Provider network access
  • Customer services
  • Underwriting and risk analysis
  • Financial and utilization analysis and reporting
  • Summary plan descriptions and ID cards
  • Utilization review, chronic condition management and wellness incentive programs
  • Appeal administration
  • HIPAA Certificate of Coverage production
  • COBRA administration
  • Stop loss insurance assistance

Most of our self-funded customers contract with FCC to handle all of the above services, but our services are available on an a la carte basis, as well. That’s because when it comes to self-funded benefits, the value comes from flexibility and customization.

For more information about self-funding and the administrative services available for self-funded plans, please contact sales manager John Crichton at 910-715-8126.

 

 

 

 

 



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