Self-Funded Health Plans for Oklahoma Employers

Under a true self-funded plan, your business pays medical claims directly as they are incurred rather than paying a carrier to take that risk. You buy stop-loss insurance to cap the downside and hire a third-party administrator to process claims. It offers the most control and the most upside, and it carries real month-to-month variability.

How It Works

You fund a claims account, a TPA adjudicates and pays claims out of it, and you buy two layers of stop-loss: specific, which caps what any one member can cost you, and aggregate, which caps what the whole group can cost you in a year. You keep every dollar that is not spent on claims and fees.

Where It Wins

• Full retention of savings. Unlike level funding, there is no surplus-sharing formula. Unspent claim dollars stay with your business.
• Plan design freedom. You build the benefit structure around your workforce instead of choosing from a filed menu.
• Full claims data. Complete visibility into cost drivers, which makes multi-year cost management possible.
• Fewer state-level premium taxes. Self-funded plans are governed primarily by federal ERISA rules rather than state insurance mandates.

Where It Costs You

• Cash flow varies. A heavy claims month is a heavy cash month. This is the reason most small employers choose level funding instead.
• Real fiduciary responsibility. You become the plan sponsor with ERISA obligations, and that is not a paperwork formality.
• Scale matters. Self-funding generally makes sense above roughly 100 employees, where claims are predictable enough to model. Below that, level funding usually delivers most of the benefit with far less exposure.

For most Oklahoma small employers, level funding is the better first step. It captures the majority of the upside without asking your business to absorb claim timing risk. We will tell you honestly if your group is not a fit for self-funding.

Get Your Group Priced Both Ways