Step 2. Find out if your plan is fully insured or self-funded
Do you get health insurance through your work or school?
- If no, you have a fully insured plan and can skip ahead to Step 3.
- If yes, you may have a self-funded plan. Read more
If you get insurance through your (or your parents') work or school—including if you are a government employee—you may have a self-funded plan.
This is important because if your plan is self-funded and has an exclusion or limitation on coverage, it might be more effective to talk to your employer about removing the exclusion, and not to the health insurance company that administers the plan.
"How do I figure out if my plan is self-funded?"
The most straightforward way to find out whether your employee plan is self-funded or fully insured is to ask your human resources department. Another way is to try to find the information on your plan booklet.
Watch: How to determine if your plan is self-funded or fully insured (video source: Transcend Legal)
“My plan is self-funded, what now?”
Get help navigating self-funded insurance plans and transition-related health care, including:
- More information and resources about self-funded plans.
- A template letter to your employer or school asking them to remove an exclusion from a self-funded plan.
- A template letter to a health plan administrator applying for preauthorization.
If your plan isn’t self-funded, move forward to Step 3.