Self-Funded Clients

Using Existing Group Health Medical Plan Funds More Efficiently

A case study of a 670 employee community bank that wanted help assessing the value of its self-funded medical plan. Community bank sponsored a self-funded medical plan administered by a local third party administrator (TPA). This was in response to high medical claims, benefits that were not competitive with other local employers, and unfunded medical cost reserves. Paradigm Group analyzed claims data and compared multiple carrier and TPA pricing proposals to determine whether the bank had the best available provider network and the most favorable network discounts. The process identified a carrier whose provider network was not only much larger but also had better discounts than the incumbent’s. Paradigm Group moved the bank’s self-funded medical plan to the new carrier/administrator.