{"id":54,"date":"2026-05-20T14:54:28","date_gmt":"2026-05-20T18:54:28","guid":{"rendered":"http:\/\/offplan.network\/?page_id=54"},"modified":"2026-08-31T15:31:51","modified_gmt":"2026-08-31T19:31:51","slug":"self-funded","status":"publish","type":"page","link":"http:\/\/offplancare.com\/es\/business\/employers\/self-funded\/","title":{"rendered":"Autofinanciado"},"content":{"rendered":"<section class=\"hero-slim bg-op-navy-gradient text-white py-5\">\n\t<div class=\"container py-5\">\n\t\t<div class=\"row\">\n\t\t\t<div class=\"col-12 col-lg-8 offset-lg-2 text-center\">\n\n\t\t\t\t\t\t\t\t\t<p class=\"section-eyebrow text-white\">Self-Funded Employers<\/p>\n\t\t\t\t\n\t\t\t\t\t\t\t\t\t<h1 class=\"display-5 fw-medium text-balance mb-4\">Self-funded, without the claims engine.<\/h1>\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/section>\n\n\n<section class=\"py-lg-6\"><div class=\"container\">\n\n\t<div class=\"row g-4 g-lg-5 align-items-center\">\n\t\t<div class=\"col-12 col-lg-5 reveal reveal-left text-center text-md-end\">\n\t\t\t\n\t\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<h2 class=\"fs-1 fw-bold text-op-navy mb-0 text-balance pe-lg-4\">You chose self-funding for control. OffPlan delivers it.<\/h2>\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t<div class=\"col-12 col-lg-7 reveal reveal-right orange-separator\">\n\t\t\t\t\t\t\t<div class=\"ps-lg-4\">\t\t\t\t\t<div class=\"two-col-header-body lead\"><p>You are already paying for care directly. But your TPA, your PPO network, and your PBM are still processing that care through an insurance infrastructure built for someone else&#8217;s margins. Every routine doctor visit generates a claim. Every claim feeds admin overhead. Every layer takes a cut. OffPlan replaces that infrastructure for the 80% of care that never needed it.<\/p>\n<\/div>\n\t\t\t\t<\/div>\t\t\t\t\t<\/div>\n\t<\/div>\n\n\t\n<\/div>\n<\/section>\n\n<div id=\"the-real-problem\" class=\"anchor\"><\/div><section class=\"py-lg-6 bg-op-light-gray\"><div class=\"container\">\n\n\t\t\t<div class=\"text-center mb-5 reveal reveal-up\">\n\t\t\t\t\t\t\t<p class=\"section-eyebrow mb-2\">The Real Problem<\/p>\n\t\t\t\n\t\t\t\t\t\t\t<h2 class=\"fs-1 fw-bold text-op-navy text-balance mb-3\">The problem is not self-funding. It is what sits inside the plan.<\/h2>\n\t\t\t\n\t\t\t\t\t\t\t<p class=\"lead col-lg-10 mx-auto mb-0 text-balance\">Self-funded employers assume they have control. But most are still running care through vendors who profit from volume and complexity, not outcomes.<\/p>\n\t\t\t\t\t<\/div>\n\t\n\t\n\t\t\t<div class=\"row g-4 offplan-card-grid justify-content-center reveal-stagger\" data-reveal-stagger=\"90\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"col-12 col-lg-6\">\n\t\t\t\t\t<div class=\"offplan-card offplan-card-navy-gradient p-4 p-lg-5\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<h3 class=\"offplan-card-heading h4 fw-bold\"><span class=\"offplan-card-kicker\">Your TPA<\/span><span class=\"text-op-orange\">Processes every claim, routine or major, at the same per-claim fee.<\/span><\/h3>\n\t\t\t\t\t\t<p>More claims, more revenue. No incentive to reduce volume.<\/p>\n\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"col-12 col-lg-6\">\n\t\t\t\t\t<div class=\"offplan-card offplan-card-navy-gradient p-4 p-lg-5\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<h3 class=\"offplan-card-heading h4 fw-bold\"><span class=\"offplan-card-kicker\">Your PPO Network<\/span><span class=\"text-op-orange\">Reprices at 200 to 350% of Medicare.<\/span><\/h3>\n\t\t\t\t\t\t<p>A knee MRI that Medicare reimburses at $442 costs your plan $1,200 to $3,000. That spread is someone else&#8217;s profit margin, not your employees&#8217; health.<\/p>\n\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"col-12 col-lg-6\">\n\t\t\t\t\t<div class=\"offplan-card offplan-card-navy-gradient p-4 p-lg-5\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<h3 class=\"offplan-card-heading h4 fw-bold\"><span class=\"offplan-card-kicker\">Your PBM<\/span><span class=\"text-op-orange\">Earns on the spread between what your plan pays and what the pharmacy receives.<\/span><\/h3>\n\t\t\t\t\t\t<p>Hidden rebates flow to them, not back to you. The formulary is designed around their margins, not your employees&#8217; health.<\/p>\n\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"col-12 col-lg-6\">\n\t\t\t\t\t<div class=\"offplan-card offplan-card-navy-gradient p-4 p-lg-5\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<h3 class=\"offplan-card-heading h4 fw-bold\"><span class=\"offplan-card-kicker\">The Pattern<\/span><span class=\"text-op-orange\">Nobody in that stack has a financial incentive to lower your costs.<\/span><\/h3>\n\t\t\t\t\t\t<p>That is not a conspiracy. It is their business model. OffPlan replaces it with a stack where every partner is aligned with the same objective: lower cost, better care, full transparency.<\/p>\n\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\n\t\n<\/div>\n<\/section>\n\n<div id=\"the-structure-change\" class=\"anchor\"><\/div><section class=\"py-lg-6\"><div class=\"container\">\n\n\t\t<div class=\"text-center\">\n\t\t\t\t\t<p class=\"section-eyebrow mb-2 reveal reveal-up\">The Structure Change<\/p>\n\t\t\n\t\t\t\t\t<h2 class=\"fs-1 fw-bold text-op-navy text-balance reveal reveal-up mb-3\">How OffPlan rebuilds the stack.<\/h2>\n\t\t\n\t\t\t\t\t<p class=\"lead mb-5 reveal reveal-up\">We do not bolt new vendors onto a broken structure. We replace the structure for the care that does not belong in it.<\/p>\n\t\t\t<\/div>\n\t\n\t\t\t<div class=\"row g-4 reveal-stagger offplan-icon-grid-left pt-5\" data-reveal-stagger=\"90\">\n\t\t\t\t\t\t\t<div class=\"col-12 col-md-6 col-lg-4\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"offplan-icon-chip d-flex align-items-center justify-content-center bg-op-navy text-white fw-bold fs-4 rounded-2\" aria-hidden=\"true\">T1<\/div>\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"h4 fw-bold text-op-navy text-balance offplan-icon-title\">Primary Care + Specialist Care (80% of spend)<\/h3>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<p class=\"mb-0\">Primary care through physician-owned practices. 500 to 600 patient panels. Same-day access. Chronic disease management. Specialist referrals coordinated through a curated cash-pay network at pre-negotiated transparent rates. Transparent pharmacy through an aligned PBM. No claims generated. No prior authorizations. No PPO repricing. No billing friction. Fixed monthly cost.<\/p>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"col-12 col-md-6 col-lg-4\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"offplan-icon-chip d-flex align-items-center justify-content-center bg-op-navy text-white fw-bold fs-4 rounded-2\" aria-hidden=\"true\">T2<\/div>\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"h4 fw-bold text-op-navy text-balance offplan-icon-title\">Intermediate Event Protection<\/h3>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<p class=\"mb-0\">Protection for unexpected events below the major-event threshold. ER visits, urgent care, injuries, minor procedures. Hospital indemnity and accident insurance. HSA-compatible.<\/p>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"col-12 col-md-6 col-lg-4\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"offplan-icon-chip d-flex align-items-center justify-content-center bg-op-navy text-white fw-bold fs-4 rounded-2\" aria-hidden=\"true\">T3<\/div>\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"h4 fw-bold text-op-navy text-balance offplan-icon-title\">Protecci\u00f3n para eventos mayores<\/h3>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<p class=\"mb-0\">Stop-loss through a carrier selected for this model, not bundled from a legacy ASO product. Specific and aggregate protection. TPA administers claims only for true high-cost events: hospitalizations, major surgery, serious medical events. This is the only layer that generates claims. This is what insurance was designed for.<\/p>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\n\t\n\t\n<\/div>\n<\/section>\n\n<div id=\"misunderstanding\" class=\"anchor\"><\/div><section class=\"py-lg-6 bg-op-light-gray\"><div class=\"container\">\n\n\t\t\t<div class=\"row\">\n\t\t\t<div class=\"col-12 col-lg-9 mb-5\">\n\t\t\t\t<p class=\"section-eyebrow mb-2 reveal reveal-up\">A Common Misunderstanding<\/p><h2 class=\"fs-1 fw-bold text-op-navy text-balance mb-4 reveal reveal-up\">This is not a DPC practice bolted onto your plan.<\/h2><p class=\"lead mb-0 reveal reveal-up\">Any DPC doctor can give your employees unlimited visits and same-day access. <strong>That is worth $75 to $125 a month.<\/strong> OffPlan delivers that physician inside a direct care platform that a standalone practice cannot build:<\/p>\t\t\t<\/div>\n\t\t<\/div>\n\t\n\t\t\t<div class=\"reveal-stagger\" data-reveal-stagger=\"90\">\n\t\t\t\t\t\t\t<div class=\"border-top py-5 reveal reveal-up\">\n\t\t\t\t\t<div class=\"row g-4\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"col-12 col-md-4\">\n\t\t\t\t\t\t\t\t<p class=\"fw-bold text-op-navy mb-0\">Population health analytics<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"col-12 col-md-8 offplan-labelled-rows-body\">\n\t\t\t\t\t\t\t\t<p class=\"mb-0\">Visibility into what your HR and finance teams what is happening across your employee population. Utilization patterns. Chronic disease prevalence. Claims avoidance tracking. ER diversion rates.<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"border-top py-5 reveal reveal-up\">\n\t\t\t\t\t<div class=\"row g-4\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"col-12 col-md-4\">\n\t\t\t\t\t\t\t\t<p class=\"fw-bold text-op-navy mb-0\">Predictive risk stratification<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"col-12 col-md-8 offplan-labelled-rows-body\">\n\t\t\t\t\t\t\t\t<p class=\"mb-0\">Identifies which employees are trending toward high-cost events before they get there. The diabetic whose A1c is climbing. The pre-hypertensive employee who missed follow-ups.<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"border-top py-5 reveal reveal-up\">\n\t\t\t\t\t<div class=\"row g-4\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"col-12 col-md-4\">\n\t\t\t\t\t\t\t\t<p class=\"fw-bold text-op-navy mb-0\">Specialty care coordination<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"col-12 col-md-8 offplan-labelled-rows-body\">\n\t\t\t\t\t\t\t\t<p class=\"mb-0\">Curated cash-pay network. Rate negotiation, scheduling, and payment via benefit card. eConsults to deflect unnecessary in-person referrals entirely.<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"border-top py-5 reveal reveal-up\">\n\t\t\t\t\t<div class=\"row g-4\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"col-12 col-md-4\">\n\t\t\t\t\t\t\t\t<p class=\"fw-bold text-op-navy mb-0\">A dedicated account manager<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"col-12 col-md-8 offplan-labelled-rows-body\">\n\t\t\t\t\t\t\t\t<p class=\"mb-0\">For your HR team. Quarterly business reviews. Enrollment management. Advisor coordination. Not a call center.<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"border-top py-5 reveal reveal-up\">\n\t\t\t\t\t<div class=\"row g-4\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"col-12 col-md-4\">\n\t\t\t\t\t\t\t\t<p class=\"fw-bold text-op-navy mb-0\">Data that earns better renewal pricing<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"col-12 col-md-8 offplan-labelled-rows-body\">\n\t\t\t\t\t\t\t\t<p class=\"mb-0\">Clinical and utilization data compiled into evidence your advisor uses at renewal. The bridge between &#8220;our employees are healthier&#8221; and &#8220;our carrier prices accordingly.&#8221;<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\n\t\t\t<div class=\"offplan-section-note text-op-navy text-center pt-5 reveal reveal-up\">\n\t\t\t<p>The physician delivers the care. The platform delivers the results.<\/p>\n\t\t<\/div>\n\t\n<\/div>\n<\/section>\n\n<div id=\"the-cfo-question\" class=\"anchor\"><\/div><section class=\"py-lg-6\"><div class=\"container\">\n\n\t\t\t<div class=\"row g-5 align-items-start\">\n\t\t\t<div class=\"col-12 col-lg-4 reveal reveal-left\">\n\t\t\t\t<p class=\"section-eyebrow mb-2 reveal reveal-up\">The CFO Question<\/p><h2 class=\"display-5 fw-bold text-op-navy text-balance mb-4 reveal reveal-up\">Where the risk actually sits.<\/h2><p class=\"lead mb-4 reveal reveal-up\">Self-funded employers do not eliminate risk. They manage it. OffPlan changes where that risk lives and who profits from it.<\/p><p class=\"fw-bold text-balance mb-0 reveal reveal-up\">You are not waiting for claims savings. <strong>You are preventing claims from happening in the first place.<\/strong><\/p>\t\t\t<\/div>\n\t\t\t<div class=\"col-12 col-lg-8 reveal reveal-right\">\n\t\n\t\n\t\t<!-- Desktop table -->\n\t\t<div class=\"table-responsive d-none d-lg-block reveal reveal-up\">\n\t\t\t<table class=\"table table-bordered align-middle mb-0 offplan-comparison-table\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<th class=\"p-4 bg-op-navy text-white\" scope=\"col\" style=\"width:50%\">\n\t\t\t\t\t\t\t\tTraditional Self-Funded\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/th>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<th class=\"p-4 bg-op-navy text-white\" scope=\"col\" style=\"width:50%\">\n\t\t\t\t\t\t\t\tOffPlan\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/th>\n\t\t\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t<\/thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t\t\t\t\t\t\t<tr class=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<td class=\"p-4   text-secondary\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tVariable claims. TPA adjudicates.\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<td class=\"p-4   text-secondary\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<strong>Fixed cost.<\/strong> No claims. No variability.\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t\t\t\t\t\t\t\t<tr class=\"offplan-comparison-row-alt\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<td class=\"p-4   text-secondary\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tPPO repricing at 200 to 350% of Medicare\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<td class=\"p-4   text-secondary\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tCash-pay at transparent, <strong>pre-negotiated rates<\/strong>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t\t\t\t\t\t\t\t<tr class=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<td class=\"p-4   text-secondary\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tRun through claims. Drives volatility. Hits stop-loss in bad years.\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<td class=\"p-4   text-secondary\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tHospital indemnity and accident insurance layer. HSA-compatible. <strong>Reduces stop-loss exposure.<\/strong>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t\t\t\t\t\t\t\t<tr class=\"offplan-comparison-row-alt\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<td class=\"p-4   text-secondary\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tPBM spread pricing. Hidden rebates retained.\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<td class=\"p-4   text-secondary\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tTransparent PBM. <strong>No spread.<\/strong> 100% rebate pass-through.\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t\t\t\t\t\t\t\t<tr class=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<td class=\"p-4   text-secondary\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tTPA paid per claim. More claims = more revenue.\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<td class=\"p-4   text-secondary\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tTPA handles coverage for large and unexpected medical expenses only. <strong>80% fewer claims to process.<\/strong>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t\t\t\t\t\t\t\t<tr class=\"offplan-comparison-row-alt\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<td class=\"p-4   text-secondary\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tStop-loss (often bundled with carrier ASO)\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<td class=\"p-4   text-secondary\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tStop-loss through aligned carrier. <strong>Better data, better pricing.<\/strong>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t\t\t\t\t\t<\/tbody>\n\t\t\t<\/table>\n\t\t<\/div>\n\n\t\t<!-- Mobile carousel -->\n\t\t\t\t\t<div class=\"d-lg-none reveal-stagger\" data-offplan-carousel data-reveal-stagger=\"70\" data-reveal-stagger-children=\".offplan-comparison-carousel-card\">\n\t\t\t\t<div class=\"offplan-comparison-carousel-viewport\" tabindex=\"0\" aria-label=\"The CFO Question comparison cards\">\n\t\t\t\t\t<div class=\"offplan-comparison-carousel-track\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"offplan-comparison-carousel-card border rounded-3 p-4\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"h5 fw-bold text-op-navy mb-4\">Primary care<\/h3>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"small fw-bold text-uppercase text-secondary mb-1\">Traditional Self-Funded<\/p>\n\t\t\t\t\t\t\t\t\t<p class=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tVariable claims. TPA adjudicates.\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"small fw-bold text-uppercase text-secondary mb-1\">OffPlan<\/p>\n\t\t\t\t\t\t\t\t\t<p class=\"mb-0\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<strong>Fixed cost.<\/strong> No claims. No variability.\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"offplan-comparison-carousel-card border rounded-3 p-4\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"h5 fw-bold text-op-navy mb-4\">Specialists<\/h3>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"small fw-bold text-uppercase text-secondary mb-1\">Traditional Self-Funded<\/p>\n\t\t\t\t\t\t\t\t\t<p class=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tPPO repricing at 200 to 350% of Medicare\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"small fw-bold text-uppercase text-secondary mb-1\">OffPlan<\/p>\n\t\t\t\t\t\t\t\t\t<p class=\"mb-0\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tCash-pay at transparent, <strong>pre-negotiated rates<\/strong>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"offplan-comparison-carousel-card border rounded-3 p-4\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"h5 fw-bold text-op-navy mb-4\">Gap events (ER, urgent care, injuries)<\/h3>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"small fw-bold text-uppercase text-secondary mb-1\">Traditional Self-Funded<\/p>\n\t\t\t\t\t\t\t\t\t<p class=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tRun through claims. Drives volatility. Hits stop-loss in bad years.\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"small fw-bold text-uppercase text-secondary mb-1\">OffPlan<\/p>\n\t\t\t\t\t\t\t\t\t<p class=\"mb-0\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tHospital indemnity and accident insurance layer. HSA-compatible. <strong>Reduces stop-loss exposure.<\/strong>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"offplan-comparison-carousel-card border rounded-3 p-4\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"h5 fw-bold text-op-navy mb-4\">Pharmacy<\/h3>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"small fw-bold text-uppercase text-secondary mb-1\">Traditional Self-Funded<\/p>\n\t\t\t\t\t\t\t\t\t<p class=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tPBM spread pricing. Hidden rebates retained.\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"small fw-bold text-uppercase text-secondary mb-1\">OffPlan<\/p>\n\t\t\t\t\t\t\t\t\t<p class=\"mb-0\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tTransparent PBM. <strong>No spread.<\/strong> 100% rebate pass-through.\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"offplan-comparison-carousel-card border rounded-3 p-4\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"h5 fw-bold text-op-navy mb-4\">Admin<\/h3>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"small fw-bold text-uppercase text-secondary mb-1\">Traditional Self-Funded<\/p>\n\t\t\t\t\t\t\t\t\t<p class=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tTPA paid per claim. More claims = more revenue.\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"small fw-bold text-uppercase text-secondary mb-1\">OffPlan<\/p>\n\t\t\t\t\t\t\t\t\t<p class=\"mb-0\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tTPA handles coverage for large and unexpected medical expenses only. <strong>80% fewer claims to process.<\/strong>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"offplan-comparison-carousel-card border rounded-3 p-4\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"h5 fw-bold text-op-navy mb-4\">Catastrophic<\/h3>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"small fw-bold text-uppercase text-secondary mb-1\">Traditional Self-Funded<\/p>\n\t\t\t\t\t\t\t\t\t<p class=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tStop-loss (often bundled with carrier ASO)\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"small fw-bold text-uppercase text-secondary mb-1\">OffPlan<\/p>\n\t\t\t\t\t\t\t\t\t<p class=\"mb-0\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tStop-loss through aligned carrier. <strong>Better data, better pricing.<\/strong>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\n\t\t\t\t<div class=\"offplan-comparison-carousel-nav mt-4\">\n\t\t\t\t\t<div class=\"btn-group offplan-comparison-carousel-pill\" role=\"group\" aria-label=\"The CFO Question carousel controls\">\n\t\t\t\t\t\t<button class=\"btn btn-outline-primary\" type=\"button\" data-offplan-carousel-prev aria-label=\"Previous card\">&lt;&lt;<\/button>\n\t\t\t\t\t\t<span class=\"btn btn-outline-primary disabled offplan-comparison-carousel-status\" data-offplan-carousel-status aria-live=\"polite\" aria-disabled=\"true\">1 of 6<\/span>\n\t\t\t\t\t\t<button class=\"btn btn-outline-primary\" type=\"button\" data-offplan-carousel-next aria-label=\"Next card\">&gt;&gt;<\/button>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\t\n\t\n\t\t\t\t<\/div>\n\t\t<\/div>\n\t\n\t\n<\/div>\n<\/section>\n\n<div id=\"the-renewal-math\" class=\"anchor\"><\/div><section class=\"pt-lg-6 bg-op-light-gray\"><div class=\"container\">\n\n\t\t<div class=\"text-center\">\n\t\t\t\t\t<p class=\"section-eyebrow mb-2 reveal reveal-up\">The Renewal Math<\/p>\n\t\t\n\t\t\t\t\t<h2 class=\"fs-1 fw-bold text-op-navy text-balance reveal reveal-up mb-3\">Why stop-loss carriers price this differently.<\/h2>\n\t\t\n\t\t\t\t\t<p class=\"lead mb-5 reveal reveal-up\">Carriers price risk based on what they see in the claims data. When OffPlan physicians manage the 80%, the data changes:<\/p>\n\t\t\t<\/div>\n\t\n\t\t\t<div class=\"row g-4 reveal-stagger text-center pt-5\" data-reveal-stagger=\"90\">\n\t\t\t\t\t\t\t<div class=\"col-12 col-md-6 px-lg-5\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"offplan-icon-badge offplan-icon-badge-bare\">\n\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"http:\/\/offplancare.com\/wp-content\/uploads\/2026\/08\/icon-er-util-drop.svg\" alt=\"\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<p class=\"text-op-navy-lighter text-uppercase mb-0\">ER Utilization<\/p>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"h4 fw-bold text-op-navy text-balance offplan-icon-title\">ER utilization drops.<\/h3>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<p class=\"mb-0 px-0 px-lg-4 text-balance\">The employee with the earache at 10pm texts their physician instead of driving to the ER. The $3,000 to $8,000 ER visit that was never medically necessary never happens.<\/p>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"col-12 col-md-6 px-lg-5\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"offplan-icon-badge offplan-icon-badge-bare\">\n\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"http:\/\/offplancare.com\/wp-content\/uploads\/2026\/08\/icon-chronic-stabilize.svg\" alt=\"\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<p class=\"text-op-navy-lighter text-uppercase mb-0\">Chronic Conditions<\/p>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"h4 fw-bold text-op-navy text-balance offplan-icon-title\">Chronic conditions stabilize.<\/h3>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<p class=\"mb-0 px-0 px-lg-4 text-balance\">The diabetic whose A1c is climbing gets caught in a routine 45-minute visit, not after a hospitalization. The pre-hypertensive employee never becomes hypertensive.<\/p>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"col-12 col-md-6 px-lg-5\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"offplan-icon-badge offplan-icon-badge-bare\">\n\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"http:\/\/offplancare.com\/wp-content\/uploads\/2026\/08\/icon-specialist-costs.svg\" alt=\"\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<p class=\"text-op-navy-lighter text-uppercase mb-0\">Specialist Costs<\/p>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"h4 fw-bold text-op-navy text-balance offplan-icon-title\">Specialist costs drop.<\/h3>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<p class=\"mb-0 px-0 px-lg-4 text-balance\">Referrals route through curated cash-pay providers at transparent rates. No PPO markup. No facility fees. No surprise bills. eConsults deflect unnecessary in-person visits entirely.<\/p>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"col-12 col-md-6 px-lg-5\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"offplan-icon-badge offplan-icon-badge-bare\">\n\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"http:\/\/offplancare.com\/wp-content\/uploads\/2026\/08\/icon-catastrophic-events.svg\" alt=\"\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<p class=\"text-op-navy-lighter text-uppercase mb-0\">Life Changing Events<\/p>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"h4 fw-bold text-op-navy text-balance offplan-icon-title\">Life changing events become rarer.<\/h3>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<p class=\"mb-0 px-0 px-lg-4 text-balance\">When care is managed upstream, fewer conditions escalate to the point where they generate a high-cost claim. The stop-loss layer gets cleaner every year.<\/p>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\n\t\n\t\n<\/div>\n<\/section>\n\n<section class=\"py-lg-6 bg-op-light-gray\"><div class=\"container\">\n\n\t\n\t\n\t\t\t<div class=\"row g-4 offplan-card-grid justify-content-center reveal-stagger\" data-reveal-stagger=\"90\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"col-12 col-lg-10\">\n\t\t\t\t\t<div class=\"offplan-card p-4 p-lg-5\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<h3 class=\"offplan-card-heading h4 fw-bold\"><span class=\"offplan-card-kicker\">The Underwriting Advantage<\/span><span class=\"text-op-navy\">This is not lower risk because of plan design tricks or network restrictions. It is lower risk because the care model changes outcomes before they reach the claims system.<\/span><\/h3>\n\t\t\t\t\t\t<p>That is a difference carriers can see in the data, and it is why stop-loss pricing improves year over year.<\/p>\n\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\n\t\n<\/div>\n<\/section>\n\n<div id=\"side-by-side\" class=\"anchor\"><\/div><section class=\"py-lg-6 bg-op-navy-gradient text-white\"><div class=\"container\">\n\n\t\t\t<div class=\"row g-5 align-items-start\">\n\t\t\t<div class=\"col-12 col-lg-4 reveal reveal-left\">\n\t\t\t\t<p class=\"section-eyebrow text-white mb-2 reveal reveal-up\">Side by Side<\/p><h2 class=\"display-5 fw-bold text-white text-balance mb-4 reveal reveal-up\">Traditional self-funded vs. OffPlan.<\/h2><p class=\"lead mb-0 reveal reveal-up\">The structural difference at a glance. Same employer. Same group. Different model underneath.<\/p>\t\t\t<\/div>\n\t\t\t<div class=\"col-12 col-lg-8 reveal reveal-right\">\n\t\n\t\n\t\t<!-- Desktop table -->\n\t\t<div class=\"table-responsive d-none d-lg-block reveal reveal-up\">\n\t\t\t<table class=\"table table-bordered align-middle mb-0 offplan-comparison-table bg-white\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<th class=\"p-4 bg-op-orange text-white\" scope=\"col\" style=\"width:50%\">\n\t\t\t\t\t\t\t\tTraditional Self-Funded\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/th>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<th class=\"p-4 bg-op-orange text-white\" scope=\"col\" style=\"width:50%\">\n\t\t\t\t\t\t\t\tOffPlan\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/th>\n\t\t\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t<\/thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t\t\t\t\t\t\t<tr class=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<td class=\"p-4   text-secondary\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tEvery service generates a claim\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<td class=\"p-4   text-secondary\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t80% of care <strong>never enters the claims system<\/strong>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t\t\t\t\t\t\t\t<tr class=\"offplan-comparison-row-alt\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<td class=\"p-4   text-secondary\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tTPA adjudicates all care\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<td class=\"p-4   text-secondary\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tTPA handles coverage for large and unexpected medical expenses only\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t\t\t\t\t\t\t\t<tr class=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<td class=\"p-4   text-secondary\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tPPO repricing at 200 to 350% of Medicare\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<td class=\"p-4   text-secondary\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tCash-pay specialists at <strong>transparent rates<\/strong>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t\t\t\t\t\t\t\t<tr class=\"offplan-comparison-row-alt\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<td class=\"p-4   text-secondary\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tPBM earns on spread and retained rebates\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<td class=\"p-4   text-secondary\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tTransparent PBM. <strong>Full rebate pass-through.<\/strong>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t\t\t\t\t\t\t\t<tr class=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<td class=\"p-4   text-secondary\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tCare is unmanaged until claims arrive\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<td class=\"p-4   text-secondary\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tCare is managed upstream by dedicated physicians\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t\t\t\t\t\t\t\t<tr class=\"offplan-comparison-row-alt\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<td class=\"p-4   text-secondary\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tCarrier, TPA, PBM all profit from volume\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<td class=\"p-4   text-secondary\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tEvery partner aligned on outcomes\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t\t\t\t\t\t\t\t<tr class=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<td class=\"p-4   text-secondary\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tYou manage a claims system\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<td class=\"p-4   text-secondary\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<strong>You manage healthcare directly<\/strong>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t\t\t\t\t\t<\/tbody>\n\t\t\t<\/table>\n\t\t<\/div>\n\n\t\t<!-- Mobile carousel -->\n\t\t\t\t\t<div class=\"d-lg-none reveal-stagger\" data-offplan-carousel data-reveal-stagger=\"70\" data-reveal-stagger-children=\".offplan-comparison-carousel-card\">\n\t\t\t\t<div class=\"offplan-comparison-carousel-viewport\" tabindex=\"0\" aria-label=\"Side by Side comparison cards\">\n\t\t\t\t\t<div class=\"offplan-comparison-carousel-track\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"offplan-comparison-carousel-card border rounded-3 p-4\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"small fw-bold text-uppercase text-secondary mb-1\">Traditional Self-Funded<\/p>\n\t\t\t\t\t\t\t\t\t<p class=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tEvery service generates a claim\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"small fw-bold text-uppercase text-secondary mb-1\">OffPlan<\/p>\n\t\t\t\t\t\t\t\t\t<p class=\"mb-0\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t80% of care <strong>never enters the claims system<\/strong>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"offplan-comparison-carousel-card border rounded-3 p-4\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"small fw-bold text-uppercase text-secondary mb-1\">Traditional Self-Funded<\/p>\n\t\t\t\t\t\t\t\t\t<p class=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tTPA adjudicates all care\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"small fw-bold text-uppercase text-secondary mb-1\">OffPlan<\/p>\n\t\t\t\t\t\t\t\t\t<p class=\"mb-0\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tTPA handles coverage for large and unexpected medical expenses only\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"offplan-comparison-carousel-card border rounded-3 p-4\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"small fw-bold text-uppercase text-secondary mb-1\">Traditional Self-Funded<\/p>\n\t\t\t\t\t\t\t\t\t<p class=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tPPO repricing at 200 to 350% of Medicare\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"small fw-bold text-uppercase text-secondary mb-1\">OffPlan<\/p>\n\t\t\t\t\t\t\t\t\t<p class=\"mb-0\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tCash-pay specialists at <strong>transparent rates<\/strong>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"offplan-comparison-carousel-card border rounded-3 p-4\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"small fw-bold text-uppercase text-secondary mb-1\">Traditional Self-Funded<\/p>\n\t\t\t\t\t\t\t\t\t<p class=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tPBM earns on spread and retained rebates\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"small fw-bold text-uppercase text-secondary mb-1\">OffPlan<\/p>\n\t\t\t\t\t\t\t\t\t<p class=\"mb-0\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tTransparent PBM. <strong>Full rebate pass-through.<\/strong>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"offplan-comparison-carousel-card border rounded-3 p-4\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"small fw-bold text-uppercase text-secondary mb-1\">Traditional Self-Funded<\/p>\n\t\t\t\t\t\t\t\t\t<p class=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tCare is unmanaged until claims arrive\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"small fw-bold text-uppercase text-secondary mb-1\">OffPlan<\/p>\n\t\t\t\t\t\t\t\t\t<p class=\"mb-0\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tCare is managed upstream by dedicated physicians\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"offplan-comparison-carousel-card border rounded-3 p-4\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"small fw-bold text-uppercase text-secondary mb-1\">Traditional Self-Funded<\/p>\n\t\t\t\t\t\t\t\t\t<p class=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tCarrier, TPA, PBM all profit from volume\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"small fw-bold text-uppercase text-secondary mb-1\">OffPlan<\/p>\n\t\t\t\t\t\t\t\t\t<p class=\"mb-0\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tEvery partner aligned on outcomes\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"offplan-comparison-carousel-card border rounded-3 p-4\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"small fw-bold text-uppercase text-secondary mb-1\">Traditional Self-Funded<\/p>\n\t\t\t\t\t\t\t\t\t<p class=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tYou manage a claims system\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"small fw-bold text-uppercase text-secondary mb-1\">OffPlan<\/p>\n\t\t\t\t\t\t\t\t\t<p class=\"mb-0\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<strong>You manage healthcare directly<\/strong>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\n\t\t\t\t<div class=\"offplan-comparison-carousel-nav mt-4\">\n\t\t\t\t\t<div class=\"btn-group offplan-comparison-carousel-pill offplan-comparison-carousel-pill-dark\" role=\"group\" aria-label=\"Side by Side carousel controls\">\n\t\t\t\t\t\t<button class=\"btn btn-outline-primary\" type=\"button\" data-offplan-carousel-prev aria-label=\"Previous card\">&lt;&lt;<\/button>\n\t\t\t\t\t\t<span class=\"btn btn-outline-primary disabled offplan-comparison-carousel-status\" data-offplan-carousel-status aria-live=\"polite\" aria-disabled=\"true\">1 of 7<\/span>\n\t\t\t\t\t\t<button class=\"btn btn-outline-primary\" type=\"button\" data-offplan-carousel-next aria-label=\"Next card\">&gt;&gt;<\/button>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\t\n\t\n\t\t\t\t<\/div>\n\t\t<\/div>\n\t\n\t\n<\/div>\n<\/section>\n\n<div id=\"the-engine\" class=\"anchor\"><\/div><section class=\"pt-lg-6 bg-op-light-gray\"><div class=\"container\">\n\n\t\t\t<div class=\"text-center mb-5 reveal reveal-up\">\n\t\t\t\t\t\t\t<p class=\"section-eyebrow mb-2\">The Engine<\/p>\n\t\t\t\n\t\t\t\t\t\t\t<h2 class=\"fs-1 fw-bold text-op-navy text-balance mb-3\">Reclassify\u00ae. The analytical layer underneath.<\/h2>\n\t\t\t\n\t\t\t\t\t\t\t<p class=\"lead col-lg-10 mx-auto mb-0 text-balance\">Not every TPA, PBM, or stop-loss carrier is built to work with this model. Before any of this is real for your group, OffPlan runs your current spend through Reclassify.<\/p>\n\t\t\t\t\t<\/div>\n\t\n\t\n\t<div class=\"offplan-prose reveal reveal-up offplan-prose-columns\"><p><strong>The claims analysis layer that powers the OffPlan model.<\/strong><\/p>\n<p>Reclassify maps where your dollars actually go. It identifies what moves out of the claims system entirely, what gets repriced through curated cash-pay, and what genuinely belongs in stop-loss. <strong>The output is the residual figure your group actually needs to fund.<\/strong><\/p>\n<p>For self-funded employers, Reclassify produces something specific: a partner-by-partner read on your existing stack. If you are self-funded through a large carrier&#8217;s ASO product with a bundled TPA and a PBM that uses spread pricing, those partners may be part of the cost problem, not the solution. Reclassify tells you what works, what needs to change, and what we keep.<\/p>\n<p>Where 80% of care runs outside the claims system, we will recommend a TPA that can handle that. If your PBM retains rebates and earns on spread, we will recommend a transparent alternative. The goal is not to replace everything. It is to replace what is working against you.<\/p>\n<p>Keep what works. Replace what doesn&#8217;t.<\/p>\n<p><strong>Let the data prove the model. Then decide how far you want to go.<\/strong><\/p>\n<\/div>\n\n\t<\/div>\n<\/section>\n\n<section class=\"py-lg-6 bg-op-light-gray\"><div class=\"container\">\n\n\t\n\t\n\t\t\t<div class=\"row g-4 offplan-card-grid justify-content-center reveal-stagger\" data-reveal-stagger=\"90\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"col-12 col-lg-10\">\n\t\t\t\t\t<div class=\"offplan-card p-4 p-lg-5\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<h3 class=\"offplan-card-heading h4 fw-bold\"><span class=\"text-op-navy\">OffPlan works with your advisor, not around them.<\/span><\/h3>\n\t\t\t\t\t\t<p>OffPlan is not insurance. We work alongside your advisor to restructure the benefits stack, not around them. We provide co-selling support, ROI modeling, and the clinical data that makes the renewal conversation easier.<\/p>\n\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\n\t\n<\/div>\n<\/section>\n\n<section class=\"py-lg-6 bg-op-navy-gradient text-white\"><div class=\"container text-center\">\n\t<div class=\"row justify-content-center\">\n\t\t<div class=\"col-12\">\n\n\t\t\t\n\t\t\t\t\t\t\t<h2 class=\"fs-1 fw-bold text-white text-balance mb-3 reveal reveal-up\">Stop defending the increase.<br \/>Start changing the math.<\/h2>\n\t\t\t\n\t\t\t\n\t\t\t\t\t\t\t<p class=\"lead mb-5 reveal reveal-up\">Side-by-side cost model using your current plan data. No commitment. <strong>Just the math.<\/strong><\/p>\n\t\t\t\n\t\t\t\t\t\t\t<div class=\"d-flex flex-wrap justify-content-center gap-3 reveal reveal-up\">\n\t\t\t\t\t<a href=\"#\" class=\"btn btn-lg btn-outline\" data-bs-toggle=\"modal\" data-bs-target=\"#analysisModal\">Request a Custom Cost Analysis<\/a>\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t<\/div>\n\t<\/div>\n<\/div>\n<\/section>","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":35,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-54","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Self-Funded - OffPlan<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/offplancare.com\/es\/business\/employers\/self-funded\/\" \/>\n<meta property=\"og:locale\" content=\"es_MX\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Self-Funded - 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