Self-funded benefit options

Self-funding allows you to choose only the options you want for your health insurance plan, and nothing that you don’t. From Social Work Services to COBRA administration, you choose what your plan offers. Options include:


Outsourcing your COBRA administration will eliminate your non-compliance worries. The Health Plan will keep you in compliance and save your company money. Our experienced account executives will coordinate with our COBRA administration, including company set-up, day-today service, and compliance monitoring.

Behavioral health services

We have an in-house team of behavioral health professionals and certified nurses working in an all-inclusive unit with customer service, pre-authorizations, utilization review, care/ case/disease management, and claims payments. Our team also has strong initiatives in place for anti-depressant therapy, autism, ADHD, suboxone, and discharge follow-up planning.

Disease management

The Health Plan employs full-time registered nurses certified in diabetes education, obstetrics, and advance cardiac life support. We have specialized programs for diabetes, chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), and prenatal care (high-risk pregnancy).

Health care analytics

The Health Plan incorporates health care analytics into the business intelligence of the managed care process thus improving the quality and delivery of care while driving efficiency, productivity, and financial performance.

Flexible spending account (FSA)

The Health Plan FSA allows your employees to contribute pre-tax funds on qualified medical expenses for out-of-pocket medical, dental, vision, and dependent care expenses for a benefit year. We offer both a health care FSA and a dependent care FSA.

FMLA administrative services

The Health Plan can offer employers Family Medical Leave Act (FMLA) services. These services support employers in eligibility determinations, leave certifications, leave tracking, and benefit payment processing.

Health reimbursement arrangement (HRA)

The HRA is funded by you, the employer. You contribute benefit dollars into an HRA for your employees. Employees are not taxed on these dollars, and account balances can be rolled over into the following year. The HRA reimburses your employees for qualified medical expenses.

Health savings account (HSA)

Another plan offered by The Health Plan is a tax advantage medical savings account. Funds are contributed by either you, the employer, or your employees on a pre-tax basis. Funds are owned by the employee and can be rolled over at the end of the plan year. To qualify, you must be enrolled in a qualified high-deductible health plan (QHDHP).

Network services

The Health Plan network services team is NCQA accredited. With access to over 650,000 national and regional providers, our capabilities include a national transplant network, high dollar claims negotiations, and custom network development.

Social work services

Our full-time, licensed, masters-level social workers have extensive experience working with hospital long-term, term care/rehab, and community services in helping members with financial assistance for medications, accessing community resources, and providing support and counseling.

Short-term disability services

This Health Plan program provides support to Ohio and West Virginia employers in administering self-insured short-term disability benefits to employees with non-work related periods of disability. Certified case managers utilize the managed care principles of early intervention and care coordination to assist in the control of both direct and indirect costs associated with short-term disability.

Pharmacy services

Our highly trained team of pharmacists and pharmacy technicians are dedicated to providing a comprehensive pharmacy benefit design with compassion and respect. This includes clinical and cost-effective services to meet the needs of our clients, members, and providers.

Utilization management

Our full-time registered nurses are certified in managed care and care management. We provide oversight of the many health care services we provide to members. The Health Plan promotes access to care in a timely, effective, and efficient manner.

A healthier workplace

Preventive services are the key to wellness. Our broad spectrum of wellness services focus on promoting healthy lifestyles.

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The Health Plan’s telehealth program, powered by HealthiestYou, gives members exclusive access to a physician over the phone, 24 hours a day. This benefit has the potential to save employees and employers money.

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Could you benefit?

Self-funded plans are operated by the employer, not a health insurance company. This could mean more flexibility and cost-containment and usable data.

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