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self-funded medical plans
self-funded medical plans

Self-Funded Employee Benefits

Success in Self-Funded Insurance

Looking for a benefit plan that promotes healthy and productive employees? Nova helps you control the cost of health care, formulating strategy to optimize opportunities for savings without compromising benefits, and offers transparent reporting. Health care plans have to be functional — anything else is a waste of time and money. That is the benefit of self-funding.

A great benefit plan starts with expert support. We're solutions people informed by data but driven by a passion to help your members live better. That's how we make health care plans that work for you.

The Benefit of Self Insurance

In a self-funded plan, TPAs focus on the 82.5% of controllable spend to improve health outcomes and manage the cost of your plan. Improved health outcomes improves presenteeism. And, when employees find value in their medical benefits your plan becomes a vehicle for recruitment and retention.

According to AHIP data, 82.5% of every health care dollar is spent in prescription drugs, health care providers and services.

Partnership, Integration & Reporting for Self-Funded Medical Plans

Network Partnerships

Nova works closely with our partners and clients to understand business goals and develop affordable access-to-care solutions to meet their needs. Our solutions analyst recommends the best network strategy for any organization —  your members deserve the right care, at the right time, in the right setting. We work with plan sponsors to cultivate in-network savings by making it easy to find convenient participating providers. Explore our list of network partners.

Stop-Loss Management

We work with some of the industry's leading stop-loss carriers. We manage reporting for specific and aggregate stop-loss policies, including filing claims for reimbursement or advance funding, when applicable. We also offer the flexibility to serve as the stop-loss broker of record or provide reporting to the stop-loss broker of record designated. Check out the list of our preferred partners.

Network Alternatives

We support clients with Reference-Based Pricing (RBP) and Direct Primary Care (DPC) solutions. From narrow network arrangements to customized partnerships with vendors, we work with each client and their partners to support member education and optimize plan utilization. We meet you where you are on the spectrum of network solutions to help you make wiser choices when it comes to managing risk, cost and care outcomes. Explore our spectrum of network solutions.

Reporting & Analytics

Nova understands the importance of providing transparent, actionable health plan data. Backed by a team of analysts and clinicians, our reporting explains not only the reason behind cost drivers, but also how to control those drivers for the long term.

PBM Partnerships

The right pharmacy benefit management solution can assist plan sponsors in managing costs. Nova takes pride in partnering with best-in-class vendors, including PBMs, and we provide flexibility for clients to work with their vendor of choice.

Can I Use My Preferred Vendor?

Nova collaborates with best-in-class point solution partners to support a plan's unique needs. We have the ability to partner with your vendors of choice but we've done the hard work for you. Learn more about our preferred partners.


Nova's Level Funded Plans

Not ready to make the leap to self-funding but still looking for a sustainable solution to the rising cost of health care for small business? Level funded plans are a great option to mitigate financial risk and control cost for medical benefits. 

Our level funded plans provide control, flexibility, and savings on medical claims bridging the gap between commercial health insurance and a self-funded plan. Bonus: with Nova's level funded solution, 100% of excess claims funding can be returned to the plan. Are you ready to start saving on benefits for your small business?

Looking to Incorporate Direct Primary Care?

Direct Primary Care (DPC) arrangements for self-funded plan sponsors offer an alternative to traditional network solutions with a flat-monthly fee for provider access and concierge care. Nova partners with DPC providers and plan sponsors to help round out the full picture of care with comprehensive data and support for optimal care and cost outcomes. Nova can help you get the most out of your DPC solution.