Self-Funded Employer Healthcare Analytics
Most self-funded employers have no visibility into what they're actually buying. Med-Vision changes that.
What Is a Self-Funded Health Plan?
A self-funded (or self-insured) employer plan means the employer -- not an insurance carrier -- directly pays employee medical claims. The employer takes on the financial risk in exchange for lower administrative costs and more control over plan design.
Approximately 65% of covered workers in the U.S. are on self-funded plans, yet most plan sponsors lack the analytics to know if their dollars are being spent effectively.
The Fiduciary Risk You May Not Know You Have
ERISA requires self-funded plan sponsors to act as fiduciaries -- meaning you must manage the plan prudently and solely in the interest of plan participants. Class-action attorneys are actively targeting employer leadership who cannot demonstrate:
- Cost benchmarking of procedures and pharmacy claims
- Vendor contract oversight
- Network discount validation
- PBM transparency and spread pricing review
Failure to monitor these is considered an automatic fiduciary violation.
Get Your Free Fiduciary Compliance Checklist
Discover the 10 contract clauses costing employers millions.
How Med-Vision Helps
- Big-data claims analytics -- powered by Cedargate Technologies
- Machine-readable file analysis -- full hospital and network rate transparency via Deerhold
- Milliman MARA risk stratification -- predict high-cost members before claims spike
- Vendor contract audits -- identify financial abuse provisions
- PBM audit -- employers routinely overpay 30%+ for pharmacy administration
Expected Outcomes
- 20-30% reduction in pharmacy administration costs
- Up to 300% reduction in high-cost procedure spend via value-based surgery alternatives
- Fiduciary documentation and defensibility
- Population health improvement through targeted interventions
Who We Work With
Corporations, municipalities, school districts, and associations across the United States with 50-10,000+ covered lives on self-funded or level-funded health plans.
Let's Look at Your Plan Data Together
No obligations. No conflicts of interest. Just an honest look at your data.
Schedule a Free ConsultationOr call (813) 962-7436