Paul H. Flowers Jr.Senior Business Consultant, Superior Insurance Advisors, LLC · 2024 Hot 100 honoree. 2026 Health Value Award. Fiduciary process documented. 30 to 40 percent health-plan savings for 100 to 2,000 employee CFOs. 3x number one bestseller.

Understanding Fully Insured Plans

8 Apr 2025 · 1 min

Watch on YouTube

0:50

In this concise YouTube presentation, the speaker explains the fundamentals of employer‑provided health insurance, focusing on fully insured bundled plans versus self‑funded models. Fully insured plans are described as a “black box” where all costs are bundled, resulting in 100% cash‑in and virtually no cash‑out, with only minimal claim payouts and generally lower quality of care. The speaker contrasts this with self‑funded arrangements, highlighting that employers can shift to self‑funding and achieve significant cost reductions—typically 20‑30% in the first year and potentially up to 40% over time. The talk also introduces the common starting design for many employers, the BUCA plan (an internal acronym for a specific service‑based design), and notes that companies using fully insured plans are often accountable to shareholders for cost increases.

Chapters

Most companies are on what's called a fully insured plan. Now I know many of you didn't come here planning to get an education about health insurance, so I wanna make this really, really simple. Fully insured bundled plans, it has a bunch of stuff that's all put together in kind of like a black box. Main point to note is that it's 100% cash in and no cash out. There are very small amounts of claims that come out and usually the quality of care tends to be a little bit less. As opposed to employers shifting over to what's called a self-funded model. But this can be done and have significant amounts of savings, anywhere from 20 to 30% first year to well into the 40% range. Most employers start in that fully insured space with what's called a BUCA plan design. B-U-C-A is the acronym that we use internally. Services, but they're responsible to their shareholders for increased