Stop Paying the Insurance Company's Margin — Fund Your Plan With More Control
Stop paying fixed premiums into a black box. Self-funded plans put your money to work — and give you full visibility into where every dollar goes.
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What Is a Self-Funded Health Plan?
With a self-funded (self-insured) health plan, your company pays employee medical claims directly as they occur — rather than paying a fixed monthly premium to a carrier who assumes all the risk and keeps all the profit. You take on the financial responsibility for claims, and in exchange you get full cost transparency, the ability to keep surplus funds in healthy years, and access to plan designs that fully insured arrangements simply can't offer.
How It Works
Instead of a premium, you fund a claims account. A Third Party Administrator (TPA) processes claims on your behalf. You purchase stop-loss insurance to cap your financial exposure — both per individual and in aggregate.
Who It's For
Self-funding works best for employer groups with 50 or more enrolled lives, a reasonably stable claims history, and an appetite for transparency over the predictability of a fixed premium.
What You Control
Plan design, network strategy, pharmacy benefits, and stop-loss structure — all customizable to your workforce. You're not locked into a carrier's off-the-shelf product.
Built-In Risk Protection: How Stop-Loss Insurance Works
The most common concern about self-funding is catastrophic claims exposure. Stop-loss insurance is the answer. It caps your financial liability at two levels:
Specific Stop-Loss (Individual)
Caps your liability for any single covered member's claims in a plan year. Once a member's claims exceed your specific deductible (e.g. $50,000), the stop-loss carrier covers the remainder. Your exposure per catastrophic individual claim is defined and finite.
Aggregate Stop-Loss
Caps your total claims liability for the entire group in a plan year. If your total claims exceed a set percentage of expected claims (typically 125%), the aggregate stop-loss carrier covers the overage. Your worst-case scenario is known before the plan year begins.
We structure stop-loss at the right deductible levels for your group's size, risk profile, and budget — not a one-size-fits-all default.
Where the Savings Come From
Most employers we work with reduce total healthcare spend 15–30% when transitioning to a self-funded arrangement. Here's why.
No carrier profit margin built into your premium
Fully insured carriers build a profit margin and risk charge into every premium dollar. In a self-funded arrangement, those dollars stay in your claims fund.
Surplus stays with you
In a good claims year, unused funds in your claims account belong to your organization — not the carrier.
Full claims data visibility
You see exactly what's being spent, on what conditions, at what facilities. That data drives smarter plan design decisions every year.
Pharmacy carve-out opportunities
Self-funded employers can carve out their pharmacy benefit to a specialized PBM — often generating 20–40% Rx savings independent of the medical plan.
Is Your Group a Candidate for Self-Funding?
Self-funding isn't right for every employer. Here's how to know if your group is a strong candidate.
Strong indicators you're a fit
- 50 or more enrolled employees
- Stable or improving claims history over 2+ years
- Desire for full cost transparency
- CFO or owner who wants to understand the numbers
- Currently paying fully insured renewals above market trend
Signs it may not be the right time
- Fewer than 25 enrolled lives
- Recent large claims or volatile claims history
- No appetite for variable monthly cost
- Already in a level-funded plan with poor claims experience
- Transitioning industry or high employee turnover
Not sure where your group falls? Our free plan diagnostic evaluates your current plan, claims history, and group profile to tell you exactly what you qualify for.
Run Your Free DiagnosticWhy Independent Advice Changes Everything
What a Traditional Insurance Agent Does
- Represents one carrier or a limited set of preferred carriers
- Compensation is tied to premium volume (higher premiums = higher pay)
- Renews coverage with minimal market testing
- Presents a narrow set of options as the full market
- Lacks access to advanced structures (captives, association health plans, alternative funding models)
What Demand Benefits Does
- Analyzes every available carrier and funding strategy
- Compensation is structured to reward savings, not premium volume
- Runs a full market analysis at every renewal
- Presents 70+ options with transparent side-by-side comparison
- Accesses captive, AHP, and financial engineering strategies most traditional agents don't offer
A Transparent Approach to Employee Benefits in 5 Steps
We've built a proven process that gives employers full market visibility, a custom strategy, and a seamless transition — with no disruption to your employees.
Analyze
We break down your current plan to identify hidden costs, inefficiencies, and risk exposure you didn't know existed.
Compare
We evaluate 70+ plan designs, funding strategies, and network options across every available carrier in your market.
Redesign
We build a customized strategy aligned with your workforce demographics, claims history, and financial goals.
Implement
We manage the full transition — carrier setup, employee communications, and enrollment — with zero disruption to your team.
Optimize
We continuously monitor plan performance and identify new savings opportunities so your results improve over time.
Serving Employers Across Louisiana
We provide full-market benefits access to groups in every major Louisiana market. See all markets →
Trusted by Employers Across Louisiana
"We were blindsided by a 24% renewal increase. Demand Benefits ran a full market analysis and found a level-funded option that cut our costs by 18% — with better coverage than what we had."
HR Director — Restaurant Group
New Orleans, LA
"Our old broker showed us two options every year. Demand Benefits showed us over 70. For the first time, we actually understood what we were buying and why."
CFO — Construction Firm
Baton Rouge, LA
"They identified $140,000 in wasted premium we didn't even know about. The switch to a self-funded plan was seamless, and our employees kept all their doctors."
Practice Administrator — Healthcare Group
Metairie, LA
Common Questions About Self-Funded Health Plans
Ready to Find Out If Self-Funding Is Right for Your Group?
Most employers we work with find that self-funding delivers meaningful savings within the first plan year. Schedule a free 30-minute review — we'll evaluate your group profile, claims history, and current plan and tell you exactly what you qualify for.