Here's what self-funded health plans pay indie carriers for administration
Employers may be doing better than other payers at holding costs down.
The help you’re giving employer clients to run their own self-insured health plans might be giving them an edge over other payers.
Analysts at Sherlock Company, a health plan tracking firm, studied payers that used independent carriers and provider-owned carriers as the insurers or administrators.
For the self-funded employer plans included in the study, the median amount spent on administrative costs in 2023 was $27.23 per member per month.
The median was 4.6% higher than the 2022 median.
The self-funded plans did a much better job of holding administrative costs down than the other payers.
The median for all payers, including insured employer plans, Medicare plans and Medicaid plans, increased 11%, to $45.70 per member per month.
The median fell 5.2%, to $60.01, at employers’ fully insured preferred provider organization plans and non-network plans, but it increased 19%, to $59.51, and fully insured health maintenance organization plans.
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Sherlock analysts see plans spending more on information systems, customer service and broker commissions and less on finance and accounting.
The carriers included in the analysis included many of the organizations that belong to the Alliance of Community Health Plans and the Health Plan Alliance.
Sherlock produces separate analyses of costs at Medicare plans, Medicaid plans, Blue Cross and Blue Shield carriers, third-party administrators and very large plans.