Quote and Bind Self-Funded Health Plans in Minutes with eDIYBS

Insurance brokers, third-party administrators, and insurance carriers who want to grow their business and offer cutting-edge health plan options for small to large businesses. Companies who’d like to quote and bind their own self-funded or level-funded plans can also use our solutions. In self-funded health plans, the employer is responsible for paying health claims directly from plan assets, rather than paying premiums to an insurer.

Health in Tech’s eDIYBS platform generates bindable quotes in just minutes, a significant reduction from traditional methods that take days or weeks.

The HI Card centralizes healthcare interactions, simplifying access for employees and enabling seamless communication between providers, claims payments processors, and carriers.

Employees gain access to Medicare-based provider pricing through the HI Performance Network, which is one of the lowest cost available on the market to help reduce out-of-pocket expenses and improving affordability.

eDIYBS is specifically designed for brokers, TPAs, and carriers, but also small to large businesses who wish to quote and built their own plan.

When choosing health coverage, employers must weigh the differences between fully insured health plans and self-funded health plans. With fully insured plans, employers pay a fixed premium to an insurance company, which then assumes responsibility for claims payments and manages the risk. This approach offers predictability, but can increase costs, and limit flexibility as well as access to claims data.

In contrast, self-funded plans, also known as self-insured health plans, allow employers to pay claims directly for covered health services as they are incurred, rather than paying fixed premiums to an insurance carrier. This gives them more control over health care costs and the ability to customize plan benefits. Self funded health plans are often paired with stop-loss insurance, which protects employers from high cost claims by capping their financial exposure. According to the Kaiser Family Foundation, a majority of covered workers—61%—are now enrolled in self-funded health plans, reflecting a growing trend toward alternative funding options. Employers considering self-funding should evaluate the potential for cost savings, the need for detailed reporting, and the administrative costs involved, as well as the level of risk they are willing to assume. By understanding the key differences between fully insured and self-funded plans, employers can make informed decisions that align with their company’s goals and employee needs.

While self-funded health plans offer significant advantages in terms of cost control and flexibility, they also come with unique risks that employers must manage carefully. One of the primary concerns with self-funded plan is exposure to high cost claims, which can have a major impact on a company’s finances. To mitigate this risk, most self-funded plans include stop-loss insurance, providing a crucial safety net that limits the employer’s liability for catastrophic claims.

Additionally, employers often partner with a third party administrator to handle claims payments, manage administrative costs, and ensure compliance with federal laws such as the Employee Retirement Income Security Act (ERISA). These regulations set standards for plan benefits, non-discrimination, and access to health coverage, making it essential for employers to stay informed and compliant. By proactively managing risks—through stop-loss coverage, effective administration, and adherence to federal laws—employers can maximize the benefits of self-funded health plans, including detailed reporting, greater transparency, and the ability to tailor coverage to their workforce. This strategic approach helps companies provide robust health benefits while maintaining control over health care costs and minimizing financial risk.

A level-funded plan is a type of self-funded coverage. It is a combination of fully insured health plans and self-insurance. They include predictable monthly payments and stop-loss insurance. Administrative fees are also part of the total cost of level-funded health plans, covering the expenses of plan administration and management. They can be enhanced with your voluntary ancillary benefits for comprehensive coverage.