Self-Funded plans: are they the right plan for your clients?

self-funded plans
March 29, 2022
James Ashford

Self-funded plans have several benefits, from letting plan recipients choose an eye care provider in Tulsa or elsewhere to lowering the total cost of offering a benefits package. As a broker, you can stand out by educating employers about this alternative and recommending the best option for their needs.

Why choose a self-funded plan?

With a self-funded plan, the employer will set up an account and pay claims out of this account. Then, depending on the benefits package offered, the employer can either fund this account themselves or deduct premiums from employees to fund this account. Some employers also use a combination of these methods, which gives them more control over what they spend on benefits.

Typically, this costs less than paying a premium to an insurer for a fully insured plan. This is because, with a fully insured product, the employer pays the same premium regardless of the rate of use of the plan. However, if an employer opts for a self-funded plan instead, costs depend on how often employees file claims and for how much.

Because the employer carries the risk instead of the insurer, they have more control over the benefits offered. Plus, self-funded plans result in a regulatory environment that is easier to navigate since employers have to follow ERISA rules but don’t need to comply with state regulations.

Compared to fully insured products, self-funded plans allow more flexibility. They offer businesses the opportunity to customize their health care plan to meet their unique business needs. This results in higher satisfaction rates for plan recipients and better patient outcomes.

There are some similarities with fully insured products. Like with a traditional vision plan, plan recipients get pre-negotiated prices from participating vision care providers. Negotiating prices with eye care Tulsa doctors and ODs located in other areas allows employers to manage costs. Plus, employees know exactly what their out-of-pocket expenses will be if applicable.

Considerations for self-funded plans

Is a self-funded plan an option that makes sense for everyone? This benefit is prevalent among larger organizations since 82% of large firms offer self-funded plans. In addition, because the employer bears the risk of the plan, a large pool of employees can help mitigate this risk.

Besides assessing risks carefully, employers should look at administrative costs. The insurer typically rolls these costs into the plan premiums with a fully insured product.

Employers who opt for a self-funded product can outsource tasks like claims processing and enrollment to a TPA or third-party administrator. However, handling these tasks in-house often lowers costs.

Getting started with self-funded plans

A self-funded product makes sense for employers looking to cut costs and offer more value. Vision plans are a great place for these employers since this type of coverage is easy to customize and has very little if any risk.

As a broker, you can stand out by recommending self-funded options. With benefits costing $10.88 per hour per employee on average for the private sector, presenting employers with a way of cutting costs can be a powerful argument in favor of self-funded products.

Not sure where to get started with recommending self-funded plans? Vision Care Direct of Oklahoma is a pre-paid plan provider with an extensive network of specialists who deliver eye care in Tulsa and nationwide with excellent value for employers and plan recipients. Find out more about our self-funded plans and other flexible options.

Not sure where to get started with recommending self-funded plans? Vision Care Direct of Oklahoma is pre-paid plan provider with and extensive of specialists who deliver eye care in Tulsa and nationwide with excellent value for employers and plan recipients.

Find out more about our self-funded plans and other flexible options.

GET AN INSTANT PROPOSAL

Have a group in mind that you’d like us to quote? It’s simple! Fill out the online questionnaire and we’ll prepare a personalized quote.

Let's Talk About You

Let us know if you have any questions or if you’d like to chat.

Popular blog posts

Contact Lenses to Diagnose Glaucoma in the Works

Contact Lenses to Diagnose Glaucoma in the Works

Early detection and diagnosis of glaucoma protects your patients against serious vision loss. As you know, many people with early-stage glaucoma have no symptoms. By the time they’re diagnosed, they have already experienced changes in their vision. However,...

Remote Worker Eye Strain on the Rise

Remote Worker Eye Strain on the Rise

While the pandemic is over, working from home remains the new norm for many of us. Whether full-time or part-time, working from home has many advantages, but it also presents some challenges, including potential effects on our vision. The frequent use of phones and...

What Are Green Tinted Sunglasses Best For?

What Are Green Tinted Sunglasses Best For?

There are more options than ever when it comes to sunglasses, with tinted lenses emerging as a popular choice for fashion and comfort. These glasses use dyed lenses to dim some portions of the light spectrum and enhance others, with benefits including better contrast...

Contacts for Kids and Classroom Accommodations

Contacts for Kids and Classroom Accommodations

Children and teens can benefit from wearing contact lenses, especially if they practice sports or feel self-conscious about their appearance. However, contacts for kids can lead to hygiene-related challenges in the classroom. As a teacher, you can educate your...

Top Trends Shaping the U.S. Optometry Industry

Top Trends Shaping the U.S. Optometry Industry

Technology is transforming the U.S. optometry industry at a dizzying pace. For optometrists, staying abreast of the latest trends is more important than ever for offering quality care, optimizing revenues, and improving patient satisfaction. This blog post will review...

How Technology Can Help Students With Vision Impairments

How Technology Can Help Students With Vision Impairments

Students with blindness or vision impairments can encounter a number of challenges in a traditional classroom environment. Not being able to access printed material, videos, images, and other visual content is a common barrier to their learning experience. Technology...

Digital Marketing Strategies Tailored for Vision Care Plan Brokers

Digital Marketing Strategies Tailored for Vision Care Plan Brokers

Vision care brokers need to be creative to reach their target audience in today's crowded market. Finding the right prospects and getting their attention in a way that resonates with their needs is an ever-present quest. This requires balancing the usual methods of...

Blue Light Glasses for Digital Eye Strain: Tips for Office Workers

Blue Light Glasses for Digital Eye Strain: Tips for Office Workers

As an employer, it’s important to create a safe and comfortable work environment. With employees spending a significant portion of their workday staring at screens, it's important to consider blue light exposure and how it can affect eye health. Below, we’ll examine...

Understanding the Pros and Cons of Hard and Soft Contact Lenses

Understanding the Pros and Cons of Hard and Soft Contact Lenses

More patients than ever opt for contact lenses as a discreet and more natural alternative to eyeglasses. However, navigating the different types of contact lenses can feel confusing. We created the following guide to help you compare soft and hard contact lenses....

Evolving Vision Coverage: Exploring New Trends in Eye Care Benefits

Evolving Vision Coverage: Exploring New Trends in Eye Care Benefits

Keeping up with the latest vision coverage trends will help brokers adapt to the changing needs of their target audience. Let's take a closer look at what consumers expect from vision insurance plans in Oklahoma and how plan providers are expanding their offerings....

Choosing the Right Blue Light Glasses: A Buyer’s Guide

Choosing the Right Blue Light Glasses: A Buyer’s Guide

Digital screens are an integral part of the day for most American workers and students, translating into high exposure to blue light. If you've been dealing with headaches, eyestrain, and other symptoms, it's time to look into getting blue-light glasses. Read on to...

Understanding Contact Lenses: How Do They Correct Vision?

Understanding Contact Lenses: How Do They Correct Vision?

Contact lenses are a popular alternative to eyeglasses for those with refractive vision errors. In the following blog post, we'll explore the benefits of wearing contacts, how contact lenses work, and the different types of lenses available. Understanding Contact...

VCD Teacher Scholarship Success Story

VCD Teacher Scholarship Success Story

Students spend as many as seven hours a day in a classroom. This environment is crucial to learning and student well-being. Teachers are using creative solutions to transform their classrooms into welcoming environments that are conducive to academic success, but...

Senior Vision Care: The Importance of Specialized Vision Plans

Senior Vision Care: The Importance of Specialized Vision Plans

Your health needs change with age, including your eye health. For seniors, keeping up with annual eye exams and addressing eye health issues early is crucial. Here is how vision plans can make eye health plans more accessible for seniors and others. Why Seniors Need...

Patient Relationship Management in Optometry

Patient Relationship Management in Optometry

Building strong patient relationships results in better experiences and outcomes for eye health patients. As an optometrist, you can grow your optometry practice by taking a proactive approach to patient relationship management and implementing proven strategies to...

Teacher Resource Guide to Vision Health for Students

Teacher Resource Guide to Vision Health for Students

6 MIN. READ We often associate decreasing vision with aging, but eye health issues are common in school-age children. As an educator, you can make a difference by familiarizing yourself with common symptoms caused by vision problems. You can also connect families to...

Tips for Including Eye Breaks and Visual Exercises in the Classroom

Tips for Including Eye Breaks and Visual Exercises in the Classroom

4 MIN. READ Healthy vision among students is a top priority for teachers and a lofty, commendable goal. This blog explores the ease and benefits of incorporating eye breaks and visual exercises into your classroom routine. Implementing these techniques helps Oklahoma...

Preventing, Treating, and Managing Childhood Myopia

Preventing, Treating, and Managing Childhood Myopia

Childhood myopia, or nearsightedness, is a common eye health condition that makes far-away objects appear blurry to children. Experts believe it affects as many as 20% of students. While symptoms can vary, myopia often causes issues for school-age children with...

5 Ways to Enhance Your Optometric Practice in 2023

5 Ways to Enhance Your Optometric Practice in 2023

Practice growth is a priority for many Oklahoma vision care providers. Although the average provider's income in Oklahoma is close to $57/hour, the regional income lags behind other parts of the country. Staying ahead of the curve and continuously improving your...

Vision Plans Are a Valuable Employee Benefit Solution

Vision Plans Are a Valuable Employee Benefit Solution

As an employer, you may wonder, “Are vision plans worth it?” Yes, vision plans are valuable employee-benefit solutions that can benefit both your business and your employees. We will explain the different types of vision plans, how they can impact your employees, and...

Smart Contact Lenses Are Coming Soon – Here’s How to Get Them

Smart Contact Lenses Are Coming Soon – Here’s How to Get Them

Smart contact lenses are still in the early stages of development, but they hold enormous potential for the future. They can monitor and manage chronic health conditions, provide real-time feedback during athletic training, or even enhance our daily lives with...

Your Employees Will Love You for Offering Vision Screening

Your Employees Will Love You for Offering Vision Screening

An eye exam is a crucial aspect of maintaining good eye health. It involves a series of tests that assess a person's visual acuity, depth perception, color vision, and eye alignment. The benefits of vision exams are numerous, including early detection of eye diseases,...

How Employers Can Help in the Fight Against Vision Loss

How Employers Can Help in the Fight Against Vision Loss

According to the Centers for Disease Control and Prevention, the economic cost of major vision problems is projected to increase to $373 billion by 2050. Vision-related issues are estimated to impact 20 million Americans. This means that the likelihood that your...

Customer Care and Personalized Vision Plan Access

Customer Care and Personalized Vision Plan Access

For individuals and families in Oklahoma and nationwide, eye care health is a significant concern. Brokers play an essential role by helping customers navigate their insurance options and advocating for their best care. Customer care and personalized vision plan...

Why You Should Care About the Optometrist/Eye Doctor Face-Off

Why You Should Care About the Optometrist/Eye Doctor Face-Off

In 2022, California Gov. Gavin Newsom vetoed a measure giving optometrists in the Golden State the legal authority to perform laser eye surgery and some other advanced procedures. It was a victory for ophthalmologists in the ongoing eye doctor or optometrist debate....

Are Blue Light Protection Glasses Worth it?

Are Blue Light Protection Glasses Worth it?

With the advancement of digital devices and the amount of time we now spend in front of them, many people are dealing with eyestrain and fatigue. As a result, blue light protection glasses have become increasingly popular as a way to diminish this stress, and they...

Effective Eye Care for Older Adults Includes These Five Things

Effective Eye Care for Older Adults Includes These Five Things

Since 1900, the percentage of Americans over 65 has almost quadrupled. Yet, only a handful of these individuals live in institutional settings. Therefore, access to quality healthcare, especially eye care, is an issue. That’s especially true since these providers must...

How important are vision care benefits to employees?

How important are vision care benefits to employees?

Eye health is essential to our overall wellness, and employee vision plans are an increasingly popular option for employers. However, do employees understand the unique benefits of these plans and why they’re so vital to our health? Employers should understand what...

What Is Genetic Ophthalmology and What Does It Mean for Eye Health?

What Is Genetic Ophthalmology and What Does It Mean for Eye Health?

Genetic ophthalmology (GO) is an emerging field that could provide more effective treatment for genetic eye diseases such as glaucoma. However, GO also raises some serious concerns that should be addressed as this technology progresses. What is Genetic Ophthalmology?...

Top 5 KPIs to Track When Assessing Plan Performance and Satisfaction

Top 5 KPIs to Track When Assessing Plan Performance and Satisfaction

As a broker, you need to maintain a diverse product portfolio so you can help companies build packages adapted to their needs and budgets. Tracking these 5 key performance indicators when comparing plans will help you better identify the ones that are more likely to...

How to Get Discounts on Frames and Discontinued Lines

How to Get Discounts on Frames and Discontinued Lines

Eyewear and contact lenses are vital to the optometry field. Keeping this in mind, doctors should be aware of the purchase costs of these goods to boost their revenue. Frame reps make commissions on sales, so they’re incentivized to sell as much as possible, but are...

Designing a Modern Optometry Practice

Designing a Modern Optometry Practice

One question that optometrists should consider is, “When patients walk into your optometry office, how do you want them to feel?” Naturally, patients desire comfortable, welcoming, and modern environments, as these characteristics put them at ease. Therefore,...

November 2022: Native American Heritage Month

November 2022: Native American Heritage Month

Native American Heritage Month celebrates a rich culture and educates people about issues unique to the Native American community. It’s an opportunity to draw attention to health issues that disproportionately affect Native Americans. It’s a group that is at higher...

Top 3 Reasons to Work with Smaller Plan Providers

Top 3 Reasons to Work with Smaller Plan Providers

In the healthcare benefits industry, brokers are essential in helping small businesses find plans. Smaller companies might not have the resources or experience to do thorough research into the options available. Fortunately, there are brokers who understand that...

3 Signs It’s Time to Review and Upgrade Your Benefits Package

3 Signs It’s Time to Review and Upgrade Your Benefits Package

A routine inventory of your benefits package can tell you where you may be able to reduce spending and, equally importantly, can also ensure that it continues to meet the needs of employees. That’s why Vision Care Direct of Oklahoma recommends reviewing your benefits...

October 2022: Breast Cancer Awareness Month

October 2022: Breast Cancer Awareness Month

It’s Breast Cancer Awareness Month. You might be wondering about the link with vision health. The truth is that a simple eye exam can sometimes detect early signs of cancer. Breast cancer can result in metastasis. When cancer cells break away from the main tumor, they...

Understanding the Ins and Outs of the Vision Plans You Accept

Understanding the Ins and Outs of the Vision Plans You Accept

For eye doctors in Tulsa OK, as well as other states, a regular review of the plans you’re currently accepting, and their ins and outs, is something you should be doing. By understanding the vision plans you accept, you can better identify how you are paid and the...

Top Strategies for Helping Plan Providers Meet Their Goals

Top Strategies for Helping Plan Providers Meet Their Goals

When trying to reduce healthcare spending, employers who offer employee benefits in the state of Oklahoma, as well as anywhere else, should be aware of one fact: there are options available that don’t increase the costs to employees via high deductibles. As a broker,...

Rethinking How You Offer Value Part 3: Build Digital Connections

Rethinking How You Offer Value Part 3: Build Digital Connections

The pandemic has sped up the digital transformation. Many professionals are embracing the virtual world because they realize connections matter. We've been sharing tips about how to rethink the way you offer value as a broker who offers plans accepted by an...

eGuide: Top 10 Ways Vision Care Direct Makes a Broker’s Job Easier

eGuide: Top 10 Ways Vision Care Direct Makes a Broker’s Job Easier

Top 10 Ways eGuide - Vision Care Direct Makes a Broker’s Job EasierOur eGuide is chocked full of ways Vision Care Direct can simplify working with a vision plan.  When you quote a vision plan certainly you are looking at the price and size of the network, and so is...

Educating Prospects About Myopia Prevention and Management

Educating Prospects About Myopia Prevention and Management

With myopia rates projected to reach 58.4% by 2050, understanding how to prevent myopia has never been more crucial. The condition is a refractive error in which distant objects appear blurred while close objects are seen clearly. It is becoming increasingly common,...

Limiting Screen Time for Kids and Other Back-to-School Eye Care Tips

Limiting Screen Time for Kids and Other Back-to-School Eye Care Tips

As you gear up for another school year, now is the perfect time to consider incorporating some best practices for supporting eye health in your classroom. Teachers can play a crucial role in detecting refractive errors early, preventing computer vision syndrome, and...

Search blog posts