| SELF-FUNDED | VS. | FULLY INSURED |
|---|---|---|
| The employer does not pay premiums; instead, it pays fixed cost (administrative fees and stop loss premiums) and variable costs (employee health care claims) | PAYMENTS | The employer pays monthly premiums to an insurance carrier. |
| The employer assumes the risk. | ASSUMPTION OF RISK | The insurance company assumes the risk. |
| Employers have more control and freedom in their plan designs. | PLAN DESIGN | Employers are more limited by insurers’ plan design options. |
| The Employee Retirement Income Security Acts of 1974 (ERISA) pre-empts state regulations. | COMPLIANCE PAYMENTS | The plan most comply with state regulations. |
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