Dialysis performed with little or no professional assistance except in an emergency situation by an end-stage renal disease patient who has completed an appropriate course of training in a dialysis facility or at home.
Insurance Encyclopedia
Self-disclosure
Act of admission or to give information about one’s own appropriate, inappropriate, lawful, or unlawful action.
Self-drive hire
Hiring out of vehicles for short periods allowing customers to drive. The self-drive policy defines acceptability in terms of both vehicles and drivers. See WAIVER OF DAMAGE.
Self-employment
To work for oneself, with direct control over work, services, and fees. This may be the operation of a trade or business by either an individual or by a partnership in which an individual is a member.
Self-Employment Contribution Act (SECA) payroll tax
Federal law that provides for the obligation of the self-employment tax by a self-employed worker. Medicare’s share of SECA is used to fund the health insurance trust fund. Also referred to as SECA.
Self-funding
See: self-insurance .
Self-Help Groups (SHGs)
Self-Help Group (SHG)
Self-Insurance
US: (1) A program for providing group insurance with benefits financed entirely through the internal means of the policyholder, in place of purchasing coverage from commercial carriers. (2) A form of risk financing through which a firm assumes all or a part of its own losses.
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A form of risk financing through which a firm assumes all or a part of its own losses.
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An alternative to insurance through an insurer that is generally only available to very large organizations. A self-insured company must make arrangements to meet future risks by setting aside enough money for the anticipated losses and even those that cannot be anticipated.
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An insurance-like strategy for handling one’s own exposures to loss supported by the financial wherewithal to meet expected losses. Not to be confused with a decision to forego insurance.
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REINSURANCE: Setting aside of funds by an individual or organization or ceding company to meet his or its losses and to absorb fluctuations in the amount of loss, the losses being charged against the funds so set aside or accumulated
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MEDICAL, US: System or program of insurance for employees and their dependents in which employers (generally companies with 500 or more employees) establish a plan and assume the functions, responsibilities, and liabilities of an insurer. Health care expenses are paid through a special fund established by the employer. Such plans may be self-administered or the employer may contract with a third-party administrator (TPA) for administrative services only (ASO). Self-insured plans are exempted by the Employee Retirement Income Security Act (ERISA) from state insurance laws, state-mandated requirements for employer health benefit programs, state taxes on insurance premiums, and participation in state risk pools or uncompensated care plans. Also called self-funding, self-insured, employer self-insured program, or partially self-funded .
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UK: The payment of losses as they become due by an individual, partnership or corporation that retains all or part of its own risks. High frequency/low impact losses are paid out of cash flow. In other cases the firm retains the first portion of other losses to be paid out of reserves and insures the excess of the retention. Self-insurance is distinguished from non-insurance because it represents a formalised accrual of liabilities. See PLANNED RISK ASSUMPTION; CAPTIVE INSURANCE COMPANY.
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The retention of risk by an individual or organization, as distinct from obtaining insurance cover. Large commercial concerns may opt for self-insurance on the grounds that they are avoiding the extra expenses and profit loadings of an insurance policy and have sufficiently strong finances to cope with their likely losses. In practice, they will typically still seek insurance against very large losses by having insurance contracts with very high excesses. Effectively, having any non-zero excess implies a level of self-insurance. Owning a captive insurance is a means of arranging for self-insurance, with cover for every large losses being arranged by the captive by means of reinsurance.
Self-insured
Individual or organization that assumes the financial risk of paying for health care. Also see self-insurance .
Self-insured employer
Employer that offers health insurance coverage to its employees and pays for the medical expenses directly instead of contracting with an insurance company.