Today's benefits advisors are well aware that one-size-fits-all benefits packages are no longer attractive to employers. Increasingly, customization and flexibility in benefits plans are a necessity. Not only that, but employers want to see a return on investment in their benefits offerings, especially as the cost of traditional benefits plans continues to increase significantly year over year. At the same time, employees demand personalization and are increasingly seeking non-traditional health benefits like family planning and behavioral health services. Research has shown that health benefits packages are a key factor influencing employee retention, so employers are incentivized to meet the demands of their workforce while keeping the costs of their benefits programs as efficient as possible. Yet doing so has been a tremendous challenge.

In recent years, brokers have turned to self-funded plans (typically administered by a third party, or TPA) as a popular alternative to fully-insured plans that can offer more value by being fully customized to an employer's workforce. 

Myths about self-funded plans

Self-funded plans have begun to gain momentum in recent years, with TPAs serving as the catalyst for their increased adoption. Yet many brokers and HR professionals maintain a high level of skepticism when it comes to considering whether a self-funded plan is the best solution for their employers. Here are three myths brokers and HR professionals must reconsider about self-funded plans. 

"I'm concerned the focus of a self-funded plan won't be on member advocacy." 

One reason benefits leaders may be resistant to self-funded plans is because of the perception that the member experience is lacking. Without the full support of an insurance company, members with self-funded plans can struggle to navigate the complex health care system, understand their benefits, or find the best care options for their needs. 

Benefits professionals know that health care benefits plans lacking in member support are a bad investment because without it, benefits utilization is lower, and expenses for things like out-of-network, specialty care, and ER visits are higher. As a result, benefits leaders typically choose to work with health care companies they are familiar with and that they know have an established member support program.