Funding Structure Analysis
Finding the right funding mechanism
Evaluating fully-insured, level-funded, self-funded, and alternative funding approaches
Why does funding structure matter?
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Funding structure determines who bears risk, how cash flows, and what control employers have over their health plan. The right structure for a 50-person company differs from what works for 500 employees. Getting this decision right is foundational to cost management.
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See where your benefit plan is leaking
Find out what gaps exist — and what you can do without changing your plan.
We'll show you where money is leaking, risks are growing, and what you can fix within your current structure. No pressure to change brokers, carriers, or benefit design. Just clarity.
- Gap analysis based on your actual plan structure
- Clear findings you can share with your broker
- Recommendations that layer on — no disruption required
Fully-Insured Evaluation
Understanding when fully-insured makes sense—transferring risk to insurers in exchange for predictable premiums.
Level-Funded Analysis
Analyzing level-funded arrangements that blend fully-insured predictability with some self-funded characteristics.
Self-Funded Assessment
Evaluating self-funding for organizations ready to take on risk in exchange for control and potential savings.
Alternative Structures
Exploring group captives, reference-based pricing, direct primary care, and other innovative funding approaches.
What is Funding Structure Analysis?
Funding Structure Analysis evaluates the spectrum of funding mechanisms available to employers—from fully-insured to fully self-funded—to identify optimal approaches for specific situations.
Each funding mechanism has different characteristics: risk exposure, cash flow patterns, control over plan design, access to claims data, and regulatory requirements. What works for one employer may be wrong for another.
Analysis matches funding mechanisms to organizational characteristics—size, risk tolerance, cash reserves, administrative capacity, and strategic objectives.
Why Is Funding Structure Such an Important Decision?
Most employers renew their health plans year after year without questioning the underlying assumptions. Brokers present options, carriers set rates, and leadership approves budgets based on incomplete information.
The result? Companies overpay for benefits employees don't use while missing coverage gaps that create real risk. They accept premium increases as inevitable rather than addressable. They lack visibility into where their money actually goes.
A Healthcare Risk Assessment changes that. It gives you the data and insight to make informed decisions, negotiate from a position of strength, and take control of one of your largest operating expenses.
How It Works
Funding analysis evaluates options against your specific situation.
Organizational Assessment
Understanding your organization: size, financial position, risk tolerance, administrative capacity, and strategic priorities.
Current Structure Review
Reviewing your current funding structure—what it costs, what risks exist, and what limitations it creates.
Alternative Modeling
Modeling alternative funding approaches: projected costs, risk scenarios, cash flow implications.
Recommendation & Planning
Recommending optimal structure and planning transition if change is warranted.
When Should Employers Evaluate Funding Structure?
Evaluation is valuable when:
• Approaching renewal with rising premiums
• Organization has grown (or shrunk) significantly
• Cash reserves or risk tolerance have changed
• Current structure creates frustrations
• You haven't evaluated alternatives recently
• Considering strategic changes to benefits approach
Where Does Funding Analysis Apply?
Analysis applies to employers across the spectrum:
• Fully-insured employers considering alternatives
• Level-funded employers evaluating next steps
• Self-funded employers optimizing structures
• Any employer questioning current approach
Who Should Consider Funding Analysis?
Employers open to structural optimization:
• Those with 25+ employees (some alternatives require scale)
• Organizations with stable workforce and cash reserves
• Employers frustrated with annual premium increases
• Those wanting more control over plan design
• Any employer seeking cost management opportunities
See What Our Customers Are Saying
"What could have been data driven, was soon a conversation. Over 3 years with the best coaches, listeners, advisors you could ask for. If Monique didn't have an answer readily, she would note it, research it, and then update you on the answer. Always a positive meeting. Highly recommend!"
— Sue D.
“Our Medical Insurance Premiums were Out of Control! Thanks to Weltrio and their amazing team of healthcare experts, Weltrio is my single most-profitable cost center!”
— Cayuse CEO
Everything You Need to Know
At Weltrio, we are a medically trained team that works with HR and benefits partners at companies of all sizes to improve healthcare quality, reduce risk exposure, and optimize costs. We work within your existing plan structure—providing employers with clarity, trust, and transparency at every step. Whether you're upgrading your benefits plan or building from scratch, we've got you covered.
Is this the same as telemedicine?
No. Clinical support provides guidance and triage, not diagnosis or treatment. We help employees decide when and where to seek care.How many nurses will be assigned to our company?
Assignment depends on your company size and typical utilization. Smaller companies may share a primary nurse with backup coverage. Larger organizations get dedicated teams. Either way, employees experience consistent relationships with clinical professionals who know them.Who answers calls in the middle of the night?
Board-certified nurses from your Weltrio clinical team. We staff night shifts with experienced nurses who have full access to your company's benefits information and employee interaction history. It's not an outsourced answering service.What protocols do nurses use for triage?
Our nurses use evidence-based clinical decision support protocols developed from emergency medicine and primary care best practices. These protocols are regularly updated based on current medical guidelines and are customized for telephone/virtual assessment settings.How much does an unnecessary ER visit actually cost?
Average ER visits cost $2,200 or more—even for minor issues. Add lab work, imaging, or specialist consultation and costs climb quickly. The same conditions treated at urgent care typically cost $150-300, and telehealth visits run $50-75.
