Here’s a truth that might surprise you: self-insurance alone won’t control your health plan costs.
It’s what you do with self-insurance that matters.

Let’s talk about a reality in healthcare spending: 20% of your employees typically drive 80% of your health plan costs. Yet most employers focus their cost-saving efforts on the wrong group – the 80% who rarely use the plan.
Think about that for a moment. You’re spending time and resources trying to influence people who aren’t significantly impacting your costs, while your highest-cost claims continue unchecked.

Here’s a real example that shows what’s possible: We recently worked with a company whose employees included two brothers both needing kidney transplants. Each brother required medication costing $500,000 annually. That’s a guaranteed $1 million in pharmacy claims hitting the health plan.
Most employers in this situation would simply absorb the cost and watch their premiums soar. Or they’d shop for new carriers, hoping for better rates.

But here’s what actually worked: Through careful research, we discovered these brothers qualified for federal assistance programs that could cover their medications. The result? The family got the care they needed without devastating out-of-pocket costs, and the employer avoided a massive hit to their health plan.

This isn’t just about saving money – it’s about smart healthcare management that benefits everyone. When you help your highest-cost claimants find better options, you’re not just controlling costs. You’re often connecting people with better care solutions they didn’t know existed.
Through Self Insure Wisconsin, we’ve built a system that actively identifies and assists members with high-cost claims.