Self-Funded Benefits

Administrative Services.

A self-funded model that works.

The healthcare system is complex. Navigating through it is practically a full-time job. Luckily, it’s our full-time job.

As your health plan administrator we’re here to make your self-funded journey easier, so you can take control of your healthcare spend. Let’s partner to build a self-funded solution that actually works.

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Analytics & Reporting

With access to our robust data analytics and reporting, you have the insights you need to make informed decisions around health plan design.

Member Education & Support

We’re your health industry insider. We’ll help you and your health plan members navigate the complex healthcare system with access to resources and experienced client service teams. Learn more.

Web Portal & Mobile App

Easily access everything you need to manage your healthcare benefits, like an interactive dashboard, expense summaries, claims data and more.

Plan, Claims & Eligibility Management

From claims and eligibility management to on-site customer service, we’re here for you and your members every step of the way.

We’re here to help build your self-funded health plan.

We won’t shoe-horn you into a plan that’s not designed to work for you.

We’ve built our self-funded solution around the core components of a good health plan: administrative services, clinical care management and cost management, with options to help you personalize your offerings.

Here are some of the ways we help administer your self-funded health plan:

  • Member education & support
  • Web portal & mobile app
  • Reporting package
  • Coordination of benefits
  • Large claims management and adjudication
  • Electronic Data Interchange (EDI)
  • SBC & SPD template creation
  • Stop-loss administration
  • COBRA administration
  • Dental and vision administration
  • Flexible spending accounts
  • Healthcare savings accounts

Download our self-funded overview for more info.

Easy is a good thing. 

Simple is even better. Add a powerful solution to the mix and you get transparency into claims, access to data insights and a health plan administrator who is a true partner (not just another vendor). That’s when amazing things start to happen.

61% of U.S. Workers

The self-funded model is more popular than ever before. In 1999, only 44% of U.S. workers were covered by self-funded plans. Today, that number is 61%.

15-20% Reduction in Costs

Self-funded models cost between 15-20% less than traditional benefits plans, according to the International Foundation of Employee Benefit Plans (IFEBP).

70% Reduction in Medical Claims

By taking advantage of self-funded health plans, employers can reduce unnecessary claims and costs. In doing so, they get a better handle on healthcare spend and control overall costs.

11% Better Outcomes

Health outcomes can be tricky to quantify, but self-funded models have been shown to be 11% more efficient in performance per cost than traditional models.

Take your member engagement to the next level.

Healthcare is confusing. We work with our clients and their health plan members to navigate through the system by arming them with better education, support and insights.

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Self-Funded Benefits

Next up for your self-funded benefits solution.

Self-funded health plan administrative services are just one part of the equation when building your ideal health & benefits solution. Level up your solution with our Clinical Care Management and Cost Management components.

Clinical Care Management

Costs decrease when members are healthier. That’s why we focus on helping people be healthier before something goes wrong.

  • Overall wellbeing
  • Utilization review & ​pre-certification 
  • Chronic & complex condition management
  • Acute case management

Cost Management

Our team works with advisors and employers to lower costs by finding optimized solutions that do not compromise quality of care.

  • Provider network access options
  • Out-of-network repricing management
  • PBM maintenance
  • Alternative reimbursement & access strategies

Resource Hub

Resources to help you wrangle healthcare.

We’ve got your back. Our resources help you and your people better understand the convoluted healthcare industry.

Visit the Resource Hub.

Level up with Maestro Health.

Make health benefits simple. Use our services to flip the script and create a better benefits solution.

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