Currently administering 75,000 self-insured covered lives across medical, pharmacy, dental and vision benefits. The Cook Group team has the third party administrative capabilities and medical stop loss experience to tailor a self-insured benefits plan for any group of 50 lives or more nationwide.
Our expertise comes backed by thoroughly vetted self-insurance partners, including, but not limited to industry-leading health networks, claims management and adjudication, ERISA plan document creation, and medical stop-loss underwriters and carriers. Medical stop-loss insurance is an important component of a comprehensive health plan. We work closely with plan sponsors to keep costs under control and all interests aligned.
When we built Cook Group Solutions, one of our primary goals was to address the informational needs of the self-insurance ecosystem. Today, our Self-Insurance Knowledge Center gives brokers, agents, TPAs, benefits consultants and plan sponsors unprecedented access. This thoughtfully curated library of recent news, reports and white papers are just another tool in our arsenal dedicated to helping you navigate and thrive in the ever-changing self-insurance marketplace.
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The passage of the 2010 Patient Protection and Affordable Care Act (‘ACA’ or ‘Obamacare’) has created a paradigm where companies with fewer than 500 full-time equivalent (‘FTE’) employees have an opportunity to realize substantial benefits by replacing their fully insured medical benefits with self-insured plans. The ACA changes the fully insured market substantially beginning in 2014, but most of the changes do not apply to self-insured plans. As of 2013, 83.9% of private-sector employers with 500+ FTE employees were already self-insured, so the impact of the increased risk sharing is particularly acute in the 100-499 and the 50-99 FTE employee segments, as only 25.3% and 13.3% of these companies are self-insured, respectively1.
1. Source: Agency for Healthcare Research and Quality, Center for Financing, Access and Cost Trends. 2013 Medical Expenditure Panel Survey-Insurance Component.