There's more than one way to fund employee benefits. From traditional fully-insured plans to level-funded, self-funded, captives, and more—each approach has different trade-offs in cost, risk, and flexibility. This guide breaks down the options so you can make an informed decision. When you're ready, we'll help you figure out which strategy fits your Long Island business.
Annual premiums for employer-sponsored family health coverage have reached over $25,000—with increases of 7-12% year over year. For small and midsize employers, this creates an impossible choice between cutting benefits and cutting into profits.
Traditional fully-insured plans treat employee benefits as a commodity. You pay premiums regardless of whether your employees use the coverage, and you have little visibility into where your money goes.
Find a Better WayFor qualifying Long Island employers. Results depend on group size and claims experience.
Each approach offers different levels of risk, control, and potential savings. We'll help you find the right fit.
The traditional approach where you pay fixed premiums to an insurance carrier who assumes all risk. Predictable costs but limited control and no refunds for low claims.
A hybrid approach with predictable monthly payments that include claims funding, stop-loss coverage, and administration. If claims are lower than expected, you may receive a refund.
You pay claims as they occur, giving you complete control over plan design and maximum transparency. Stop-loss insurance protects against catastrophic claims.
Pool resources with similar-sized companies to access self-funding benefits typically reserved for large corporations. Collective buying power for companies as small as 25 employees.
Pay providers based on a percentage of Medicare rates rather than negotiated network discounts. Eliminates carrier markups and provides true cost transparency.
Individual Coverage Health Reimbursement Arrangement lets you reimburse employees for individual health insurance premiums and qualified expenses.
| Feature | Fully Insured | Level-Funded | Self-Funded | Captive |
|---|---|---|---|---|
| Minimum Group Size | Any | 25+ employees | 100+ employees | 25+ employees |
| Cost Predictability | High | High | Variable | Moderate |
| Potential Savings | None | 10-25% | 20-40% | 15-30% |
| Claims Refund Possible | No | Yes | Yes | Yes |
| Plan Design Flexibility | Limited | Moderate | Full | Moderate |
| Cost Transparency | Low | Good | Complete | Good |
| Risk Level | None | Capped | Managed | Shared |
Carrier requirements and state regulations change frequently. Contact Benton Oakfield to discuss current options and eligibility for your business.
Alternative funding isn't for everyone—but for the right organizations, it can transform employee benefits from a cost center into a competitive advantage.
Assess Your OptionsGroup medical captives make self-funding accessible to smaller employers.
Low claims means more refunds and greater savings potential.
Organizations committed to wellness culture and employee well-being.
Comfortable with variable costs in exchange for potential savings.
We sit down with you—in person, at your Long Island office—to understand your goals and concerns.
Review your claims history, employee demographics, and current costs to identify opportunities.
Project potential savings under different funding scenarios with realistic, NY-specific assumptions.
Handle the implementation details so your team experiences zero disruption.
These aren't set-it-and-forget-it decisions. We sit down with you in person to review claims data, model different scenarios, and explain the trade-offs in plain English. When questions come up mid-year—and they will—you call us directly, not a 1-800 number.
Let's Talk Through Your Options