Services Self Funding/Alternative Funding
Michael Donahoe Jr.

Patrick Donahoe

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Amwins-M.T. Donahoe & Associates is proud to announce our partnership with Starmark, a Trustmark Company. A leader in self-funding for small groups and serving more than two million members, Starmark is available for groups of 5-50 lives in Maryland/Virginia and for groups of 51+ in DC.

Choose from traditional PPO self-funding plan designs (utilizing Cigna or Aetna national networks) or the new Reference-Based pricing model which allows members to see any doctor they choose and without balance-billing from the provider. These plan designs provide stop-loss protection - employer pays the monthly premium only and they are not on the hook for any extra funding at year end.

Potential surplus money back to the employer at year end

Easy quoting/underwriting: We will need a complete census and individual medical questionnaires can be done via paper, phone, or using a secure web-based portal or any combination of these.

Broker Commissions: up to $75 PEPM!

Self-Funded and Stop-Loss Plans

Since self-funded plans are not impacted by all of the ACA provisions, small businesses that have not traditionally offered self-funded plans are now considering this approach. Available to groups 5-50 and 51+.

Self-funded plans are not subject to the ACA rules regarding:
  • Providing Essential Health Benefits
  • Modified Community Rating
  • The Health Insurance Industry Fee
Employers with self-funded plans and stop-loss insurance can gain a number of benefits:
  • Flexibility to tailor benefits to meet employee's needs
  • Plan costs may be less than a fully insured plan
  • Employers have more control over health care expenditures
  • If health care costs are low in a particular plan year, the employer—not the insurer—may keep the savings
  • Employers pay for the cost of their employees' care; a set amount each month
  • Stop-loss insurance protects against higher, unexpected costs

Self-funded plans are administered by Starmark and stop-loss insurance is provided by Trustmark Life Insurance Company.


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