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What are the downsides to self-insurance (self-funded plans)?

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What are the downsides to self-insurance (self-funded plans)?

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The primary shortcoming of a self-funded plan is the volatility of monthly costs. Even with stop-loss insurance, the employer assumes greater risk than with an insured policy. The volatility can put greater demands on budgeting and monthly cash flow. However, having proper stop-loss coverage amounts generally limit the possibility of large annual cost fluctuations.

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