Thinking about self-insuring? Be aware of the biggest hazards

If you decide to implement a self-insured health plan, be aware that any employee major illness can result in a major hit — some worse than others.

According to a report in the American Journal of Medicine, these four conditions are the most likely to cause catastrophic claims for self-insured companies:

  • Extreme premature births (24 to 25 weeks’ gestation) can cost $700,000 to $900,000 in hospital inpatient charges and followup outpatient treatments for mother and child.
  • Liver or kidney transplants average about $760,000 in total claims.
  • Non-transplant kidney disease treatments average $200,000 to $400,000 in claims.
  • Hemophilia-related claims average about $300,000.

Of course, privacy laws prevent you from asking your employees if they suffer from any of the high-cost problems, and you can’t just say to workers, “Don’t get sick.” What you could do is invest in awareness programs, such as health-risk assessments,  designed to aid prevention efforts or early detection.  That investment now could save you lots of money later.

0 thoughts on “Thinking about self-insuring? Be aware of the biggest hazards”

  1. Organ and tissue transplants can be taken out of your self insured health plan and covered completely by insurance. As your company’s privacy officer, you can ask about medical conditions within your health plan population. Health risk assessments completed by the member only tell part of the story, claims history will fill in the details and provide more truth.

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