Although self-funding has historically been a popular choice among large group employers, interest in it has grown in recent years. The interest has spiked particularly in smaller and mid-size groups, which may not have considered the self-funding option in the past. 

Among fully insured employers with 50 to 999 employees, there are various levels of interest and opportunity. Sun Life's research among employers shows that 36 percent of fully-insured employers in the small group market (under 250 employees) and 46 percent of mid-size employers (250-999 employees) would consider self-funding. These groups are further divided among those who range from definitely switching to interested but have no plans to move, and other levels of interest in between. 

The advantage of increased control over medical benefits plan design and potential cost savings have led small and mid-size employers to explore the option; however, they are looking for guidance to better understand the potential risk and, ultimately, decide whether self-funding is right for them.