[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-573214-105":53,"doc-detail-573214-en":120},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":113,"head_meta":115,"extra_data":117,"updated_unix":119},105,"en","selling-to-self-insured-employers-insider-cheat-sheet","Selling to Self-Insured Employers - Insider Cheat Sheet","","A sales-focused insider cheat sheet explaining how to position offerings to self-insured employers. It contrasts self-funded plans with fully funded insurance models, outlines how administrators and stop-loss coverage shape plan administration and risk, and connects broader “Total Rewards” benefits to employee value. It also provides a structured set of insider questions to evaluate differentiation, adoption barriers, budget sources, ROI, clinical outcomes, experience improvement, talent retention, and alignment with health equity and DE&I.",{"@graph":63,"@context":112},[64,80,95],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":16,"@type":70,"position":76},"https://docshare.wps.com/template/resumes/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/selling-to-self-insured-employers-insider-cheat-sheet/573214/",4,{"url":78,"name":59,"@type":81,"author":82,"headline":59,"publisher":85,"fileFormat":88,"inLanguage":57,"description":61,"dateModified":89,"datePublished":89,"encodingFormat":88,"isAccessibleForFree":90,"interactionStatistic":91},"DigitalDocument",{"name":83,"@type":84},"Aria","Person",{"url":68,"name":86,"@type":87},"DocShare","Organization","application/pdf","2026-10-13",true,{"@type":92,"interactionType":93,"userInteractionCount":4},"InteractionCounter",{"@type":94},"ViewAction",{"@type":96,"mainEntity":97},"FAQPage",[98,104,108],{"name":99,"@type":100,"acceptedAnswer":101},"What distinguishes self-insured employers from fully funded plans?","Question",{"text":102,"@type":103},"Self-insured employers assume financial liability for workforce benefit and medical spending, while fully funded employers buy coverage from an insurance carrier under fixed monthly premiums by tier.","Answer",{"name":105,"@type":100,"acceptedAnswer":106},"How do stop-loss coverage and plan administration affect self-funded employers?",{"text":107,"@type":103},"Self-funded plans commonly use third-party administrators (TPA) or insurers via ASO units for administration, and employers may purchase stop-loss coverage to manage risk from high-cost claims.",{"name":109,"@type":100,"acceptedAnswer":110},"What insider questions help assess ROI and measurable outcomes?",{"text":111,"@type":103},"The cheat sheet asks about percentage coverage, target engagement drivers, PMPM/PUPM economic impact, time to ROI and attribution, and which measurable clinical outcomes the product enables, along with experience and talent retention effects.","https://schema.org",{"og:url":78,"og:type":114,"og:title":59,"og:site_name":86,"og:description":61},"article",{"robots":116,"canonical":78},"index,follow",{"doc_id":118,"site_id":56},573214,1791934651,{"code":4,"msg":5,"data":121},{"doc_id":118,"user_id":122,"nickname":83,"user_avatar":123,"doc_module":9,"category_id":15,"category_name":16,"doc_title":59,"doc_description":61,"doc_content":124,"file_id":125,"file_url":126,"file_type":127,"file_size":128,"view_count":4,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":129,"language":130,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":131,"faqs":132,"seo_title":133,"seo_description":61,"update_tm":119,"read_time":134},2336464648322,"https://ap-avatar.wpscdn.com/avatar/2200025388227c56fec?_k=1778556882303663488","[lionbird.com](lionbird.com)  \nSELLING TO SELF-INSURED EMPLOYERS:  \nINSIDER CHEAT SHEET  \nMore than 155 million Americans, including employees, spouses and dependents, receive health insurance coverage through employer-backed insurance plans. Among this group, approximately 65% participate in selffunded health programs, a figure that climbs to over 90% for companies employing over 1,000 individuals.  \nEmployers that are self-funded assume the financial liability for their workforce benefit and medical spending and entities operating in this sphere are commonly known as “self-insured employers”.  \nOn the other hand, in a ‘fully funded” plan, employers purchase health insurance through a health insurance carrier which minimizes volatility related to workforce benefits spending to a fixed monthly premium rate that will vary by tier (e.g. employee only, employee + spouse or family).  \nTypically, companies that sponsor self-funded plans engage third-party administrators (TPA) or insurers (via their Administrative Services Only (ASO) business units) to handle plan administration. It’s also common for employers to acquire Stop Loss coverage from either their administrator or a separate Stop Loss Insurer to address financial risk in the event one or more covered members have significantly highcost claims. However, larger corporations do leverage their ability to absorb financial risk associated with significant claims across a broad spectrum of employees and dependents.  \nIn addition to health insurance offerings, more employers and importantly their employees are paying close attention to the broader suite of benefits offerings that improve the employment value proposition. Often communicated to employees as “Total Rewards,” these offerings aim to attract and retain employees while also contributing to their overall well-being. Such benefits include retirement plans, paid time off (PTO), parental leave, life insurance, disability insurance, dental and vision coverage, wellness programs, and more.  \nFor a digital health vendor, selling to self-insured employers directly has the potential advantage of a generally shorter sales cycle as compared to approaching health insurance carriers directly as well as more established distribution channels through benefit brokersand other aggregators. Moreover, employers may be more open to experimenting with products that help to contain costs and enhance employee satisfaction.  \nNonetheless, in recent years, the sustainability of this go to market model has been challenged as employers have become overwhelmed by the number of vendors with whom they are contracting and as they confront a 20% surge in average premiums since 2016. This has caused employers to reassess their plan designs and benefit offerings and to embrace bundled solutions with proven return on investment (ROI) and heightened levels of employee engagement or utilization.  \nAssessing the viability of your startup’s offering in this fast-changing market demands a deep understanding of these dynamics. To help you through this process, we’ve collaborated with experts from the selfinsured employer market and documented the right insider questions.  \nThe paper is based on the conversations we had with experts from the field.  \nClick below to watch the full talks.  \nIn this paper, you’ll find questions to better understand the following:  \nRise above the noise:  \nevaluate your solution’s ability to differentiate itself among vendors in the context of self-insured employers’ relative priorities.  \nPlan for barriers to adoption:  \nunderstand how your offering would integrate into self-insured employers’ existing benefit plan designs and their vendor ecosystem with minimal disruptions. Be prepared to navigate potential utilization challenges and align with purchasing timelines.  \nIdentify budget sources for vendor relationships:  \ngain insights into the sources from which self-insured employers earmark budgets for new vendor relationships.  \n","cbCaihpgYCqdXVWW","https://ap.wps.com/l/cbCaihpgYCqdXVWW","pdf",1846691,22,"English","# Rise above the noise\n## Plan for barriers to adoption\n## Identify budget sources for vendor relationships\n# Q1: Health plan strategy and priorities\n## Eligibility coverage and target engagement\n## Dependents and caregiver relevance\n## Cost impact and economic value\n## ROI timing and clinical outcomes\n## Member experience and talent retention\n# Q1: DE&I, productivity, and utilization\n## Health inequities and SDOH\n## Worker productivity and disability metrics\n## Utilization across the benefits ecosystem\n## HR/leadership relevance","[{\"question\":\"What distinguishes self-insured employers from fully funded plans?\",\"answer\":\"Self-insured employers assume financial liability for workforce benefit and medical spending, while fully funded employers buy coverage from an insurance carrier under fixed monthly premiums by tier.\"},{\"question\":\"How do stop-loss coverage and plan administration affect self-funded employers?\",\"answer\":\"Self-funded plans commonly use third-party administrators (TPA) or insurers via ASO units for administration, and employers may purchase stop-loss coverage to manage risk from high-cost claims.\"},{\"question\":\"What insider questions help assess ROI and measurable outcomes?\",\"answer\":\"The cheat sheet asks about percentage coverage, target engagement drivers, PMPM/PUPM economic impact, time to ROI and attribution, and which measurable clinical outcomes the product enables, along with experience and talent retention effects.\"}]","Selling to Self-Insured Employers - Insider Cheat Sheet | PDF",8]