Here are some of the most common questions our clients ask us.  If you need further assistance please contact us at marketing@somi.com or visit our contact page for more options.

Q:	Is Sheffield, Olson & McQueen, Inc. an Insurance Company?
A:	No, Sheffield, Olson & McQueen, Inc. is a Full-Service TPA.
Q:	Can clients with self-funded plans design their own benefit structure?
A:	When you are self-funded you can custom design a benefit plan to meet your company’s specific needs and philosophy.  State mandated benefits do not apply to most self funded plans, therefore, you, not the state or an insurance company, determine what level of benefits will be provided to your employees.
Q:	How are claims funded for members of a self-funded plan?
A:	With a self-funded plan, claims must be paid as they are submitted, however, employers have the freedom to decide how to fund your own claim reserve.  Traditional fully insured plans usually establish conservative claim reserves that they, not the insured employer, control.
Q:	Are we a good candidate to self-fund our plan?
A:	You are a good candidate for self-funding your health plan if you have 30 or more employees, a stable and/or growing employee base, and one, or more, of the following applies to you: Your current insured plan is inflexible with respect to benefit plans offered; plan design, and types of benefits. You are looking to reduce costs with respect to health care benefits. You are looking to initiate more effective cost containment solutions. You need better information on where your dollars are going. You are looking to develop a benefit plan that matches your corporate philosophy and financial parameters.
Q:	What is Pharmacy Benefit Manager (PBM)?
A:	More commonly known as your RX vendor, a PBM contracts with independent pharmacies or a chain of pharmacies to provide prescription medicines at a discounted rate for retail and mail order prescription drug programs.