When Michael Turpin was a top insurance executive, he understood that the more comprehensive coverage his company sold customers, the more profit his business would make.

Self-insurance is common among large companies and rare among small ones. Midsized businesses are the ones that should reconsider their options, he says.

"Insurance can cost close to $10,000 per employee per year," Turpin says, "so 100 employees cost as much as $1 million a year. Self-insurance can save 12 percent, or $120,000, which can be better used to hire more employees or grow the business."

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