Self-Insurance

Self-insurance is a risk management strategy in which an organization or individual chooses to bear the financial responsibility for potential losses, rather than transferring that risk to an insurance company. In self-insurance, the individual or organization sets aside a sum of money to cover potential losses and assumes the responsibility for paying any claims that may arise.  

For example, a large corporation may choose to self-insure for certain types of risk, such as workers' compensation or liability claims. Rather than paying premiums to an insurance company, the corporation establishes a fund to cover potential claims and manages the claims process in-house.

Key features of self-insurance include:

  • Risk assumption: Self-insurance involves assuming the financial responsibility for potential losses, rather than transferring that risk to an insurance company.

  • Cost savings: Self-insurance can potentially result in cost savings, as the individual or organization does not have to pay premiums to an insurance company.

  • Increased control: Self-insurance gives the individual or organization greater control over the claims process and may allow for more customized coverage.

  • Higher risk: Self-insurance involves higher risk, as the individual or organization is responsible for paying claims out of pocket.

Regulatory requirements: Some states or jurisdictions may require certain levels of financial reserves for self-insured entities to ensure that they are able to pay claims when they arise.

Adequate resources: Self-insured entities must have adequate financial resources to cover potential losses, as well as the resources to manage the claims process effectively.

Next Up

Vision is the most commonly offered ancillary benefit in employer-sponsored plans — 89% of employers offer it nationally, higher than dental, higher than life insurance, and higher than any voluntary benefit. And yet vision is also one of the most underfunded benefits in the market.
Dental benefits are not your largest cost center. For most employers, dental represents a fraction of what medical costs per covered employee annually. But dental is one of the highest visibility benefits in your package: employees use it, notice it, and talk about it. When it’s good, it builds goodwill. When it’s inadequate (low maximums, no orthodontia, zero employer contribution) it registers as a signal that the employer isn’t invested in the total package.
How an employer funds its health plan sits quietly in the background of every benefits decision. Most CHROs and CFOs know their premium cost. Fewer understand the mechanics of how their plan is actually structured: who holds the risk, who administers the claims, how costs flow, and what flexibility, if any, they have to change any of it.