Top 9 Reasons to Self-Fund Your Healthcare Benefits Plan with Prairie States

There are plenty of great reasons to have Prairie States administer your self-funded healthcare benefits plan. Some affect your bottom line, some will resonate with your analytical thought processes, and others will provide a sense of warmth and well-being. On their own and all together, the reasons make partnering with Prairie States a smart business decision.

Financial Reasons

Lower Administrative Costs - The administrative costs for a self-funded plan are lower than a carrier’s fully-insured plan. Carriers offer premium-based services. Most are trying to meet Wall Street expectations. When administering self-insured plans, they push massive numbers of transactions through the system without careful review and then expect provider discounts to disguise any problems. The primary focus of Prairie States’ administrative work is to meet your needs. We work for you, we respond to you and we are proactive on your behalf. There is no other agenda.

Claims Review and Audit - Fully 31% of the cost savings that Prairie States achieves is through responsible claims management. Hospital bills and outpatient surgery bills are subject to a full audit against the patient’s chart before payment. Licensed clinicians – who know exactly what to look for – audit each and every hospital bill in excess of $5,000. We spot and correct billing errors to prevent you from paying for them. It’s just one of the many ways we’ve fine-tuned our integrated claims and clinical services to get to a financial accuracy rate of over 99%.

Strategic Reasons

Customized Plan - We tailor your plan to your company needs and goals. Extensive plan options combined with our robust data analysis enables us to design a plan that will meet and exceed expectations. We’ll also work with you to ensure your plan helps attract and retain top talent.

Transparency – Every aspect of your plan belongs to you. Your plan information is your information, and you’ll have access to all of it. In-depth data reports outline every detail, from how employee-per-month costs are running to how quickly our team answers calls from members. All of it is tracked, available for review and measured against benchmarks.

Ability and Flexibility to Work with Complex Plans

We’re known for our ability to nimbly and easily administer complex plans. This is especially beneficial for companies offering a variety of plan choices to employees—whether it’s in one state or many. Enjoy the flexibility to structure your plan as you see fit across departments and locations, include built-in plan incentives for wellness activities, structure the handling of payments based upon episodes of care, and more.

Impassioned Reasons

Customer Service – Rivaling our cost-savings capabilities is our ability to deliver one of our company’s core values—compassionate service. Plan members are always amazed and pleased to have their calls answered by a real person and their specific questions answered by someone who is truly knowledgeable and caring. It makes a difference to them and of course, their satisfaction and comfort with the administration of their benefits plan will make a difference to you.

No Surprises – You and your broker always have access to data reports and financial statements that address plan performance compared to expectations. When it’s time to renew, this ensures any renewal changes are not a surprise and things go as smoothly as possible.

It’s a Partnership – Your company culture and goals will be at the heart of how we serve you. You’ll see that focus as we administer your plan, communicate with you and anticipate your future needs. Talk to us about your health benefits plan. Not matter what your specific reasons for starting with us or switching to us, we’re sure we can meet your expectations.


Prairie States Enterprises, Inc. is a third-party health benefits plan administrator that brings industry expertise and a clinical focus to self-insured companies. Our in-house claims administration, health management services, wellness programs, plan analysis and predictive modeling tools result in remarkable and unprecedented cost control for employers. We also provide the most compassionate and personalized level of service for plan members.
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