Comprehensive Self-Funded Insurance Coverage for Your Staff

Discover personalized insurance solutions with Cosmo and pave your path to security.

As an employer, deciding how you fund your staff’s medical expenses is of the utmost importance. At Cosmo Insurance Agency, we offer self-funded insurance policies that provide extensive coverage for your team while optimizing your financial planning. Our agents are well versed in all self-funded options including Carrier networks, Reference Based Pricing, and Captive Insurance.

Our experienced insurance agents support you from budget planning to claim handling, offering an economical alternative to traditional fully insured plans. With Cosmo, our plans are built with stop loss, claims administration, and funding strategies are taken care of seamlessly. You pay only for the actual claims your employees make, allowing you to enjoy significant end-of-year savings.

Don’t wait to secure a flexible, affordable, self-funded insurance policy for your business. Contact Cosmo Insurance Agency for a personalized quote and start saving on healthcare coverage today.

Comprehensive Self-Funded Insurance Coverage for Your Staff

Don’t wait to secure a flexible, affordable, self-funded insurance policy for your business. Contact Cosmo Insurance Agency for a personalized quote and start saving on healthcare coverage today.

Who Uses Self-Funding?

Self-funding is commonly used by larger organizations (200 or more employees) that have the financial resources to assume the risk of paying for employee healthcare claims. These typically include large corporations, government entities, and unions.

However, with the availability of stop-loss insurance, even smaller companies (with as few as 10 employees) are increasingly adopting self-funded plans to control costs and customize benefits for their workforce. Companies prioritizing flexibility, cost control, and transparency in their healthcare offerings often find self-funding a suitable choice.

Benefits of Selecting A Self-Funded Insurance Policy

Opting for a self-funded insurance policy offers numerous advantages for employers looking to optimize their healthcare benefits. These plans provide unparalleled flexibility, allowing organizations to tailor their benefits to meet specific employee needs while controlling costs more effectively.

Additionally, self-funded insurance policies offer significant financial benefits, such as improved cash flow management and the potential for substantial cost savings.

Flexibility & Customization

Self-funded insurance policies enable employers to design customized health benefit plans that cater to the employee population. This flexibility allows for the inclusion of unique benefits and services that may not be available in traditional insurance plans, like coverage options and wellness programs.

Cost Control & Savings

One of the primary benefits of self-funding is the ability to control healthcare costs directly and implement cost-containment strategies. Employers pay only for the claims that are incurred rather than a fixed premium, eliminating the profit margin and risk charges typically associated with traditional insurance carriers.

Additionally, employers can negotiate directly with providers, access discounted rates, and implement cost-containment strategies to reduce overall healthcare costs.

Separate Network Selection from ISL & ASL

Self-funded plans offer the advantage of separating network selection from Individual Stop-Loss (ISL) and Aggregate Stop-Loss (ASL) insurance. This separation allows employers to choose the most appropriate provider networks without being constrained by the limitations of bundled insurance plans.

As a result, organizations can negotiate better rates and access higher-quality care for their employees.

Cash Flow Management

Improved cash flow management is a significant benefit of self-funded insurance policies. Employers retain the funds that would otherwise be paid as premiums, using them to pay claims as they occur.

This allows for more efficient use of capital and the opportunity to invest in other areas of the business, enhancing overall financial stability.

Data Access & Analysis

Self-funded plans provide employers with greater transparency and access to detailed claims data. This access allows for in-depth analysis of healthcare expenditures, helping organizations to identify cost drivers and implement strategies to manage expenses more effectively.

Enhanced data access supports informed decision-making and continuous improvement of the health benefits program.

Regulatory Flexibility

Self-funded insurance policies offer regulatory flexibility by being generally exempt from many state insurance regulations and instead governed by federal regulations. This exemption allows employers to design benefit plans without being bound by state-mandated benefits, giving them more control over plan structure and offerings.

Regulatory flexibility ensures that employers can more consistently and flexibly create a health plan that fits their organizational needs and objectives.

Stop-Loss Protection

Employers often purchase stop-loss insurance to mitigate the financial risk associated with self-funding insurance. This protection caps the employer’s liability for high-cost claims, safeguarding against unexpected expenses.

Individual Stop-Loss (ISL) and Aggregate Stop-Loss (ASL) cover large single claims and overall claims exceeding a predetermined amount, ensuring financial stability while maintaining the advantages of a self-funded plan.

What Is Reference-Based Pricing?

Reference-Based Pricing (RBP) is a self-funding strategy in which employers set a cap on the amount they will cover for specific medical services based on a reference point like Medicare rates. Typically, this pricing cap is set between 120% and 175% of what Medicare pays, significantly lower than the average PPO plan, which can be as high as 300% of Medicare rates.

Employers can achieve substantial cost savings by using RBP while offering employees the flexibility to seek services outside of a traditional PPO network. Third-party administrators facilitate this model, minimizing employer involvement and administrative burden.

While RBP allows for broader provider access, it’s important to note that some providers may not accept Medicare rates, potentially leading to limited acceptance of the plan. However, instances of provider refusal are generally minimal, making RBP an attractive option for employers seeking to control healthcare costs effectively.

With Cosmo, we provide our member advocacy team supports employees that recieve a balance bill. Legal support is provided if necessary.

Don’t be limited by traditional health insurance plans. Explore self-insurance coverage options with Cosmo.

The Employee Retirement Income Security Act (ERISA)

The Employee Retirement Income Security Act (ERISA) of 1974 is a federal law that governs self-funded insurance plans. ERISA set forth minimum standards for pension and health plans in the private sector to ensure employees receive their promised benefits.

It requires employers to manage their self-funded plans responsibly and transparently, providing essential information about plan features, funding, and procedures for handling complaints or appeals. Under ERISA, employers are directly responsible for the administration of self-funded plans rather than deferring to insurance companies.

This responsibility includes acting in the best interests of plan participants and managing the plan’s assets with a high standard of care. By adhering to ERISA regulations, employers can offer customized health benefits while maintaining a high level of protection and reliability for their employees, ensuring that benefits are managed fairly and effectively.

Hear From Our Satisfied Customers

“I am thrilled to write this 5-star review for Cosmo Insurance Company! They went above and beyond to help us get our three-month-old baby added to our health insurance policy, even though the special enrollment period had already ended. We were facing a challenging situation, and Cosmo Insurance Company came to our rescue.

Mark, Rebecca, and Dassi, the amazing team members we had the pleasure of working with, were absolutely phenomenal. They displayed exceptional professionalism.

We highly recommend Cosmo Insurance Company to anyone seeking reliable, caring, and efficient assistance with their insurance needs. Mark, Rebecca, and Dassi have our heartfelt gratitude for going the extra mile to make sure our family is taken care of. They have earned our trust, and we look forward to continuing our relationship with them for years to come. Thank you once again for your exceptional service!”

by Bernard Link

“Cosmo is truly a pleasure to work with. Their knowledgeable staff always return emails and calls quickly, they answered all my questions when choosing insurance plans for my family, and provided me with honest feedback about which plan would give my family the most benefits without spending the most money. I highly recommend them to family and friends.”

by Ariel Beniflah

Why New Jersey Chooses Cosmo Insurance Agency for Self-Funded Insurance Policies

With a reputation for reliability, integrity, and exceptional customer service, Cosmo Insurance Agency provides reliable self-funded insurance policies for New Jersey residents. We’ll work closely with you to develop tailored, affordable health insurance plans and provide ongoing support to ensure your absolute satisfaction.

Comprehensive & Affordable Insurance Plans

At our insurance company, we believe that comprehensive insurance coverage should be accessible to everyone. We proudly offer a wide range of self-funded insurance plans that provide robust, low-cost coverage at affordable rates. Our experienced agents will assess your needs and budget constraints when selecting your plan and buying health insurance so you’ll get maximum health coverage without breaking the bank on out-of-pocket costs.

Lifetime Support

When you choose Cosmo Insurance Agency for your self-funded insurance needs, you’re not just getting a policy on the health insurance marketplace – you’re gaining a lifetime partner. Our team of insurance professionals provides ongoing support throughout the life of your policy. Whether you have questions about coverage options, need to make changes to your plan, or require assistance with a claim, we provide reliable guidance for every insurance need.

15+ Years of Quality Coverage

Leveraging over 15 years of specialization in the insurance sector, Cosmo stands out as a leader in providing customized self-funded insurance solutions. Our seasoned team addresses the intricacies of self-funded insurance, ensuring that your business benefits from optimized, effective health plan coverage to meet specific corporate needs. Trust in our proven track record to deliver a strategic partnership to enhance your financial and operational health.

Other Insurance Products We Offer

In addition to self-funded insurance policies, we proudly offer a variety of other plans to safeguard your health. From annual checkups to future planning with life insurance policies, Cosmo Insurance Agency provides comprehensive solutions for all of your New Jersey insurance needs.

Take control of your healthcare costs. Get a self-insurance quote today.

Employee Benefits

Our customizable employee benefits packages include health insurance, dental insurance, vision insurance, disability insurance, and more. They are designed to attract and retain top talent while promoting the well-being of your staff.

With our expertise in employee benefits administration and compliance, we’ll help you navigate the complexities of benefits management with ease, ensuring that your employees have access to quality coverage.

Health Insurance

At Cosmo Insurance Agency, we understand the importance of reliable medical coverage when preserving your well-being. We offer a variety of health insurance options, including individual health plans, family health plans, Medicare plans, and more. Our experienced agents will assess your healthcare needs and budget constraints and recommend health insurance plans that offer quality coverage at affordable rates.

Life Insurance

In the event of your passing, life insurance provides crucial financial protection and peace of mind for your loved ones. Whether you’re seeking term life insurance, whole life insurance, or universal life insurance, we offer a variety of coverage options to suit your needs and budget. With Cosmo Insurance Agency, you can ensure that your loved ones are financially protected no matter what the future holds.

Vision Insurance

Cosmo Insurance Agency offers a range of vision insurance options to help you and your family access quality eye care services and products. This service can offer coverage for routine eye exams, glasses, contacts, or even corrective surgery for a medical condition. We’ll help you find a vision insurance plan that meets your needs without breaking the bank.

Frequently Asked Questions About Self-Funded Insurance Policies

Fully funded insurance involves an employer paying a fixed premium to an insurance carrier, which assumes the financial risk of covering employees’ healthcare claims. The insurance company manages all aspects of the plan, including claims processing and administrative tasks.

In contrast, self-funded insurance means the employer assumes the financial risk for providing healthcare benefits, paying for actual claims incurred rather than fixed premiums. This approach offers greater flexibility and potential cost savings, as employers can customize their plans and directly manage their healthcare expenditures.

In a self-funded group health insurance plan, claims are typically administered by a third-party administrator (TPA). TPAs handle various administrative tasks, such as processing claims, managing benefits, and providing customer service, which reduces the administrative burden on the employer.

By partnering with a TPA, employers can ensure efficient and effective management of their self-funded plans. This allows them to focus on customizing benefits and controlling healthcare costs without being directly involved in the plan’s day-to-day administration.

Ultimately, the cost-effectiveness of self-funded insurance should be evaluated based on your organization’s specific needs and circumstances. While self-funded insurance offers potential cost savings on administrative expenses and more control over claims management, it also carries the risk of large financial losses. Additionally, self-insured employers may need to set aside funds to cover potential claims, which may require a significant upfront investment.

Get A Free Quote For Your Self-Funded Insurance Policy From Cosmo Insurance Agency Today

If you’re seeking comprehensive coverage at an affordable rate, don’t wait to save money on self-funded insurance policies with Cosmo Insurance Agency today.

Contact Cosmo Insurance Agency to get a personalized self-funded insurance quote from an experienced New Jersey agent.