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Alternative Funding Strategies
Stop Transferring Risk to the Carrier. Take Control of Your Healthcare Spend.
Most fully insured plans are designed to benefit the carrier, not the employer. Alternative funding strategies shift that equation. Nortex Health helps employers with 50 to 500+ employees evaluate, design, and implement funding structures that provide greater transparency, measurable cost containment, and long-term financial control.
Schedule a Funding Strategy Review
Fully Insured Plans Are Built for the Carrier, Not for You.
Fully insured plans transfer risk to the carrier and employers pay a premium for that convenience year after year. Alternative funding strategies put greater control back into the hands of the employer, providing increased transparency, claims visibility, and meaningful opportunities for long-term cost containment.
38%
Highest single renewal increase we have helped a client avoid
22%
Average healthcare cost reduction in year one
$140K+
Average annual savings identified per client engagement
74 days
Average implementation timeline
Our Funding Strategies Include
It includes:
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Self-Funded Health Plan Structures
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Level-Funded Health Plans
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Reference-Based Pricing (RBP) Models
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Captive & Group Captive Arrangements
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ICHRA & Defined Contribution Strategies
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Specialty Pharmacy & High-Cost Claim Carve-Outs
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MEC & Alternative Minimum Essential Coverage Solutions
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Healthcare Cost Containment Strategies
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Claims Analytics & Utilization Review
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Stop-Loss Strategy & Risk Mitigation
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Population Health & Workforce Risk Analysis
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Integrated Payroll Tax Reduction Strategies
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Custom Employer Contribution Modeling
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Multi-State & Complex Workforce Funding Solutions
Our mission is to replace fragmented vendor relationships and reactive annual renewals with a unified workforce and healthcare strategy built around the needs of your organization.
Our Funding Strategies Include
Professional services
Full visibility into what you’re actually spending on healthcare
Strategic Cost Comparison
A real cost comparison between your current plan and what’s possible.
Stop-Loss Protection Strategy
Stop-loss coverage structured to protect against worst-case scenarios.
Seamless Transition Planning
A transition plan that handles the move without disrupting employees.
Ongoing Performance Insights
Ongoing claims data so you can see exactly how the plan is performing.
Reference-Based Pricing (RBP)
Pay What Healthcare Actually Costs, Not What a Network Negotiated.
Reference-Based Pricing benchmarks claims reimbursements against Medicare rates rather than inflated carrier network contracts. The result: employers pay what care actually costs, not what a network negotiated.
What Nortex Manages:
Ongoing claims data so you can see exactly how the plan is performing.
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Strategic RBP plan design and financial modeling -
TPA and stop-loss carrier identification and coordination -
Employee communication strategy and open enrollment support -
Balance billing advocacy and member support infrastructure -
Ongoing claims analytics and plan performance reporting -
Compliance-conscious implementation and executive oversight
Employer Outcomes:
Ongoing claims data so you can see exactly how the plan is performing.
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Significant reduction in healthcare spend versus fully insured benchmarks -
Full pricing transparency on every claim -
Elimination of inflated network markups -
Greater plan customization and financial predictability
RBP is not the right fit for every organization, and we will tell you that directly. If it is the right fit, we build the roadmap. If it is not, we identify the strategy that is.
Common Questions
How do we know if self-funding makes sense for our size?
We look at your actual claims history and run the numbers for your specific workforce. Most organizations with 50 or more employees qualify from a size standpoint. Whether the economics work depends on your claims data, and we model that before we recommend anything.
What protects us if we have a bad claims year?
How long does the transition take?
What happens if a provider sends a balance bill to one of our employees?
Is RBP right for every market?
We look at your actual claims history and run the numbers for your specific workforce. Most organizations with 50 or more employees qualify from a size standpoint. Whether the economics work depends on your claims data, and we model that before we recommend anything.
Related Services
Strategic Benefits Consulting
Build a benefits strategy that aligns workforce needs, financial objectives, and long-term organizational growth.
Human Capital Administration
Integrate payroll, benefits, and workforce administration into a more efficient and scalable operating model.
Enterprise Cost Optimization
Identify cost-saving opportunities across healthcare, payroll, compliance, and workforce operations.
Risk & Compliance Solutions
Strengthen compliance oversight while reducing workforce, payroll, and operational risk exposure.