The Movement Is Already Here
I've been in the stop loss industry for 26 years—20 years with TPAs, four years in brokerage, and the last two focused on self-funding marketing and education. In that time, I've seen a lot of changes. But what's happening right now feels different.
The Affordable Care Act opened employers' eyes to just how many rules and regulations are tied to fully-insured plans. That sparked the first real wave of self-funding among smaller groups. But what we're seeing now goes beyond regulatory frustration. Employers are tired of the lack of transparency. They're tired of rate increases that consistently outpace inflation. They're tired of having their second-largest expense be a complete black box.
And they're ready for something better.
The question is: Are brokers ready to help them find it?
The Data Problem No One Talks About
Here's something that should bother every employer—and every broker advising them:
Most companies know everything about their largest expense, which is payroll. They know who they employ, how many hours each person works, what their salaries are, what their benefits costs are. They have complete visibility into every dollar spent on compensation.
But their second-largest expense—employee benefits? For most fully-insured groups, they have almost no data. They don't know what drugs their employees are taking. They don't know what's driving their claims. They don't know where the money is actually going. They just get a bill and a rate increase every year.
That's insane.
And it's not sustainable. Not when rate increases are averaging 9-10% annually. Not when employers are desperate to control costs without shifting the burden entirely to employees. Not when there are real, proven alternatives that offer transparency, flexibility, and meaningful cost containment.
The Broker's Dilemma: The Easy Button vs. The Right Thing
I get it. Fully-insured is the easy button. You've got four major carriers to market. You know the process. You get your quotes, you present them, the client picks one, and you move on. It's comfortable. It's what you've always done.
But here's the reality: That comfort is costing your clients thousands—sometimes hundreds of thousands—of dollars every year.
When you move a group to self-funding, you suddenly have access to 30+ stop loss carriers instead of four fully-insured options. That might sound daunting. I've had brokers tell me, "How am I supposed to get 30 quotes? That's impossible."
Here's the thing: You don't have to.
That's where we come in. As a stop loss consultant and partner, my job is to be an extension of your team. Think of me as just a few cubicles away. You bring me the group, we work together to understand their needs, and I handle the heavy lifting of navigating that marketplace.
I help you choose the right network. I help you evaluate TPAs. I guide you through PBM selection. And yes, I get you competitive stop loss quotes from the carriers that make the most sense for your client.
You don't have to become a self-funding expert overnight. You just need to be willing to learn—and to partner with people who've been doing this for decades.
What's Possible When You Think Outside the Box
Let me give you a real-world example of why this matters.
A few weeks ago, I learned about a solution I'd never encountered before: the Samaritan Fund Program. I actually just called the 800 number on their website, and the President and CEO answered the phone. That's the kind of company we're talking about.
Here's how it works: For groups with high-cost, lasered individuals—hemophiliacs, cancer patients, people on extremely expensive specialty drugs—Samaritan Fund Program helps transition those members to individual plans that provide comparable (or better) coverage with zero out-of-pocket costs for the member.
The group pays a flat fee of $55,000, but only if the transition is successful. If Samaritan Fund Program can't find a suitable individual plan and get the member enrolled, there's no charge.
Now compare that to what happens with a fully-insured group. I'm working with a broker right now on a 150-employee construction company. They're fully insured. They have one employee with hemophilia. And they're facing a 42% renewal increase because of that single claimant.
With self-funding and Samaritan Fund Program, we can potentially:
- Get that employee on an individual plan with zero out-of-pocket costs (better for the employee)
- Save the employer hundreds of thousands of dollars compared to that 42% increase
- Provide better benefits for the entire employee population with the savings
And here's the kicker: Some carriers—will actually give you a premium discount just for offering Samaritan Fund Program, even if no one takes it. It's that valuable as a risk mitigation strategy.
This is just one example. There's also Leap Health for home infusion therapies. Dialysis programs. Reference-based pricing. PBM strategies for high-cost medications. These solutions don't exist in the fully-insured world. You can't access them unless you're self-funded.
And your clients don't even know these options exist unless you tell them.
The Choice: Learners vs. The Learned
There's a quote I love from philosopher Eric Hoffer:
"In times of change learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists."
That's where we are right now in the benefits industry. The brokers who are willing to learn—who are willing to step outside the comfort of the fully-insured easy button—are going to thrive. They're going to win business. They're going to keep the clients they have and attract new ones who are desperate for someone to actually advocate for them.
The brokers who aren't willing to evolve? They're going to find themselves perfectly equipped for a world that no longer exists.
And here's what I want younger brokers especially to hear: This is your moment.
Most experienced brokers already have their established relationships. They've got their GAs, their carrier reps, their comfortable routines. But they're also vulnerable. Because when a group gets a 42% increase and their broker's only answer is "let me shop it with the other three carriers," that group is one phone call away from finding someone who will introduce them to ideas their current broker never mentioned.
If you're a newer broker and you come to the table with self-funding expertise—even if that expertise is really just a strong partnership with a consultant like me—you have a massive competitive advantage.
What This Partnership Looks Like
When brokers work with me and the XL Benefits team, here's what we bring to the table:
Network Selection: We help you evaluate which networks make sense for your client's geography and employee population.
TPA Evaluation: We guide you through the TPA landscape and help you match groups with administrators that fit their needs and capacity.
PBM Strategy: We help you navigate the pharmacy benefit manager selection process, including rebate transparency and formulary optimization.
Cost Containment Programs: We introduce solutions like Samaritan Fund Program, Leap Health, dialysis programs, and other strategies that simply aren't available in fully-insured plans.
Stop Loss Placement: We market your groups to 30+ carriers and bring you competitive options—not just quotes, but strategic recommendations based on what we know about each carrier's appetite and underwriting philosophy.
Ongoing Support: We're not just there for the sale. We're there through implementation, renewals, and when challenges arise. Think of us as part of your team.
You don't have to figure all of this out alone. That's the whole point.
The Bottom Line
Self-funding isn't the future—it's the present. The movement is already happening. Employers are already getting frustrated with fully-insured rate increases and lack of transparency. Competitors are already approaching your clients with ideas you haven't introduced.
The question isn't whether self-funding is going to continue growing. It is.
The question is whether you're going to be part of that growth or watch it happen without you.
We're not asking you to become a self-funding expert overnight. We're offering to be your partner—your extension, your resource, your support system—as you make that transition.
Because we're not just stop loss consultants. We bring solutions.
And in 2026, solutions are what employers are desperate for.
If you're ready to have that conversation—if you're ready to be a learner instead of someone equipped for a world that no longer exists—we're here.
Let's talk about what's possible for your clients. And for your practice.