Media Feature
Why Mid-Market Employers Are Rethinking Fully Insured
Nauman Shaikh in Benefits Brief News on Why Self-Funding Is the Cost Containment Strategy Mid-Market Employers Can't Afford to Ignore
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Article Summary
OneDigital's Nauman Shaikh on why self-funding, claims data, and cost containment strategies are replacing the fully insured default for mid-market employers.
For years, mid-market employers have absorbed annual premium increases as the predictable cost of staying fully insured. That calculus is changing. In a recent Benefits Brief News feature, Nauman Shaikh, National Vice President of Actuarial and Analytics at OneDigital, explains why the fully insured default is no longer the safe harbor it once was — and what mid-market employers stand to gain by moving toward self-funded health plans.
At the core of Shaikh's argument is a data problem. Mid-market fully insured employers often receive little to no meaningful claims data from their carriers — particularly around pharmacy spend — leaving them to negotiate renewals without visibility into where their healthcare dollars are actually going. Meanwhile, cost pressures are accelerating — and Shaikh is direct: specialty drug pipelines, rising chronic disease prevalence, and provider consolidation are structural, permanent forces. This is not a post-pandemic rebound.
"When you fully insure, you're just negotiating renewals every year. When you have self-funding and you have your data, you can actually apply control measures."
Self-funding changes that equation — giving employers direct access to claims data, visibility into cost drivers, and real leverage on unit cost and site-of-care variation. For employers concerned about volatility, level funding and captive arrangements offer a practical on-ramp, allowing organizations to stage the transition and build the claims history that makes a full move to self-funding both safer and more informed.
When CFOs and CHROs can look at actual claims data together, the conversation shifts from competing priorities to a shared opportunity.
"If they can move to self-funding and actually save the company 5%, 10%, or 20% in annual premiums, that money can be redistributed to enrich their benefits, and both sides win."
For mid-market benefits leaders navigating pre-renewal season, now is the moment to pressure-test the assumptions behind staying fully insured. The employers who move first will have the most to work with when it matters most.
Read the full Benefits Brief News article here: Mid-Market Employers Gain Real Control When Self-Funded Data Replaces the Annual Renewal Crunch
Ready to explore cost containment strategies for your organization? Visit OneDigital's Cost Containment Hub.