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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 enterprise organizations 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.

Employer leadership team reviewing healthcare funding options
38%

Highest single renewal increase we have helped a client avoid

22 to 27%

Healthcare cost reduction in year one across published engagements

$380K

Largest annual savings captured in a single engagement

74 days

Fastest self-funded implementation, completed across six states

Figures are drawn from Nortex Health client engagements published on our case studies page, where the full detail behind each number appears. They describe those specific engagements and are not a projection for any other employer. Results vary by group size, census, claims history, plan design, funding structure, carrier, and market. Past results do not guarantee future outcomes.

Our Funding Strategies Include

  • Self-Funded Health Plan Structures
  • Level-Funded Health Plans
  • Reference-Based Pricing (RBP) Models
  • Captive & Group Captive Arrangements
  • CHOICE Arrangement (formerly ICHRA) & Defined Contribution Strategies
  • Specialty Pharmacy & High-Cost Claim Carve-Outs
  • MEC & Alternative Minimum Essential Coverage Solutions
  • Healthcare Cost Containment Strategies
  • Claims Analytics & Utilization Review
  • Stop-Loss Strategy & Risk Mitigation
  • Population Health & Workforce Risk Analysis
  • Integrated Payroll Tax Reduction Strategies
  • Custom Employer Contribution Modeling
  • Multi-State & Complex Workforce Funding Solutions

We don’t just recommend a funding model. We analyze the financial impact, evaluate risk exposure, and build a strategic implementation roadmap alongside your leadership team.

Advisor walking an employer through funding strategy options
Employer team reviewing alternative funding performance data

What You Get With an Alternative Funding Strategy

Changing how a plan is funded only works if the operating detail is handled. Here is what comes with the move.

Full Spend Visibility

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:

  • 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:

  • 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.

Your Benefits Program Should Work as Hard as You Do

If you lead an enterprise organization and you’re ready to replace your current benefits approach with something that actually reduces costs and improves outcomes, let’s talk. One conversation with a Nortex Health advisor will show you exactly what’s possible.

Schedule a Strategy Review

Nortex Health advisor meeting with an employer leadership team

Nortex Health works with enterprise organizations to design self-funded benefit strategies, implement reference-based pricing, and optimize payroll, where most brokers don’t go.

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SOLUTIONS

Strategic Benefits Consulting  ·  Alternative Funding Strategies  ·  Human Capital Administration  ·  Enterprise Cost Optimization  ·  Cost Reduction Strategies  ·  Risk & Compliance Solutions

All Rights Reserved | © 2026 | NORTEX HEALTH   ·   (323) 375-8283   ·   [email protected]

Nortex Health provides workforce and employee benefits consulting. Everything on this site is general information for educational purposes only. It is not insurance, tax, legal, or medical advice, it is not a quote, and it is not an offer or binder of coverage. CHOICE Arrangement is the name adopted by CMS and the SBA on September 3, 2026 for what federal tax guidance still calls an Individual Coverage Health Reimbursement Arrangement (ICHRA); both terms refer to the same benefit and the renaming did not change the governing rules. Plan availability, eligibility, rates, contribution limits, and savings vary by state, carrier, group size, plan design, and employee census, and are subject to carrier underwriting and applicable law. Any figures, examples, or savings shown are illustrative only and your results will differ. Tax outcomes, including any FICA impact, depend on your specific facts; consult your own tax advisor and legal counsel before acting. Coverage is in force only when issued in writing by the carrier. Insurance offered through licensed agents in states where licensed.