Hire Virtual Assistants for
Self-Funded Plan Consultants.
Eliminate stop-loss RFP census scrubbing, monthly claims fund reconciliation backlogs, 50% spec threshold filings, and RxDC reporting bottlenecks. Get vetted self-insurance and ERISA operations specialists managed by a dedicated Project Manager at $0 additional charge. Starting at just $6/hour.
Dedicated Project Manager
Free Tier $0"I enforce HIPAA de-identification rubrics, QA stop-loss quote spreadsheets, oversee monthly claims fund audits, and verify Form 5500 filings."
Trusted by Self-Funded Plan Consultants, TPA Partners & Stop-Loss Brokers
See how independent benefits consultants, captive managers, and self-insurance advisory firms scale client capacity without taking on management drag.
"We manage 22 self-funded employer groups across UMR and Meritain. Monthly claims fund reconciliation and monitoring 50% specific stop-loss threshold triggers used to consume my entire first week of every month. Our SageDoer assistant pulls TPA billing, balances funding accounts, and flags potential lasers with zero errors."
"During Q4 stop-loss quoting season, we send out RFPs for dozens of groups to Sun Life, Symetra, and Tokio Marine. Scrubbing employee census files, normalizing tier splits, and creating side-by-side spec deductible comparison models used to burn out my team. SageDoer packages these RFPs in hours."
"The single dedicated Project Manager is what makes SageDoer completely distinct from hiring contractors on Upwork. In self-funding, mixing up specific stop-loss with aggregate corridors or mishandling PHI creates huge liabilities. SageDoer's PM trains them on our playbooks with zero handholding."
"Compiling annual Form 5500 Schedule A data from stop-loss carriers and filing federal RxDC reporting used to be an administrative nightmare. Our full-time VA at $6/hour coordinates carrier files, verifies participant counts, and organizes our audit packages months ahead of deadlines."
"We manage 22 self-funded employer groups across UMR and Meritain. Monthly claims fund reconciliation and monitoring 50% specific stop-loss threshold triggers used to consume my entire first week of every month. Our SageDoer assistant pulls TPA billing, balances funding accounts, and flags potential lasers with zero errors."
"During Q4 stop-loss quoting season, we send out RFPs for dozens of groups to Sun Life, Symetra, and Tokio Marine. Scrubbing employee census files, normalizing tier splits, and creating side-by-side spec deductible comparison models used to burn out my team. SageDoer packages these RFPs in hours."
"The single dedicated Project Manager is what makes SageDoer completely distinct from hiring contractors on Upwork. In self-funding, mixing up specific stop-loss with aggregate corridors or mishandling PHI creates huge liabilities. SageDoer's PM trains them on our playbooks with zero handholding."
"Compiling annual Form 5500 Schedule A data from stop-loss carriers and filing federal RxDC reporting used to be an administrative nightmare. Our full-time VA at $6/hour coordinates carrier files, verifies participant counts, and organizes our audit packages months ahead of deadlines."
Exact Self-Funded Plan Operations Handled Daily
From stop-loss market quoting and census scrubbing to monthly claims fund balancing and federal RxDC reporting, our trained virtual assistants handle the heavy administrative workload so you stay focused on plan architecture, cost containment, and fiduciary advisory.
Stop-Loss RFPs & Census Scrubbing
Spotless employee census files and carrier market submission packaging.
- Census Cleansing & Tier Mapping: Normalizing DOB, gender, zip codes, and enrollment tiers (EE, EE+SP, EE+CH, Family).
- COBRA & Disabled Dependent Scrub: Flagging continuation members, shock claims history, and special underwriting tags.
- Market Submission Staging: Dispatching RFP specifications across carriers (Sun Life, Tokio Marine, Voya, Symetra).
- Side-by-Side Quote Modeling: Building comparative grids for Specific Deductibles ($50k–$250k), contract types (12/12, 12/15, 24/12), and aggregate attachment factors.
Monthly Claims & Fund Reconciliation
Keep employer claims accounts balanced against TPA billing schedules.
- TPA Claims Audit: Reconciling medical, pharmacy, and administrative fees against employer trust bank drafts.
- Level-Funded Surplus/Deficit Logs: Tracking monthly claims funding corridors and projected year-end refund balances.
- Stop-Loss Reimbursement Tracking: Verifying carrier reimbursement deposits against filed specific claims.
- Monthly Financial Packets: Compiling executive dashboards (PEPM costs, loss ratios, fixed vs. variable fees).
Large Claimant & Laser Tracking
Protect stop-loss recovery rights and manage high-cost catastrophic claims.
- 50% Spec Threshold Monitoring: Flagging claimants approaching 50% of the specific deductible for timely stop-loss carrier notice.
- Trigger Diagnosis Logging: Auditing ICD-10 high-risk trigger diagnosis codes (oncology, transplants, NICU, specialty injectables).
- Laser Underwriting Records: Tracking individual deductible lasers, conditional lasers, and laser-free renewal riders.
- Filing Proof Management: Archiving formal carrier notice confirmations to satisfy stop-loss policy reporting clauses.
PBM Carve-Outs & Rebate Audits
Verify transparent pass-through pricing and manufacturer drug rebates.
- PBM Invoicing Reconciliation: Verifying ingredient costs, dispensing fees, and administrative charges against contract terms.
- Rebate Distribution Schedules: Tracking quarterly manufacturer rebate remittances and credit distributions to the employer trust.
- Specialty Drug Sourcing Logs: Tracking international sourcing, copay assistance, and 340B carve-in savings programs.
- Formulary Disruption Grids: Pre-populating member disruption analyses when switching PBM vendors.
Form 5500 & Federal RxDC Filings
Stay ahead of DOL, IRS, and CMS annual reporting requirements.
- Schedule A Collection: Gathering insurance and stop-loss fee schedules from carriers for annual 5500 filings.
- EFAST2 Portal Prep: Staging Form 5500 data and Form 5558 extension filings ahead of statutory deadlines.
- RxDC Reporting Logistics: Coordinating P2 and D1-D8 pharmacy reporting files across TPAs and carved-out PBMs.
- Gag Clause & PCORI Fee Tally: Tracking annual CMS Gag Clause Prohibition Compliance Attestation (GCPCA) confirmations.
Plan Document, SPD & OE Collateral
Keep Wrap documents, benefit guides, and enrollment platforms aligned.
- Summary Plan Description (SPD) Proofing: Auditing copays, coinsurance, deductible accumulators, and exclusion riders.
- Summary of Benefits & Coverage (SBC): Formatting standard federal SBC templates for self-funded benefit designs.
- BenAdmin Portal Configuration: Updating enrollment rates and plan structures in Employee Navigator or Ease.
- Employee Open Enrollment Guides: Formatting clean, professional PDF benefit guides in Canva or InDesign.
Self-Funded Analytics & TPA Systems Our VAs Master Daily
Zero training curve on industry software. Our virtual assistants are already fluent in health analytics platforms, stop-loss submission workflows, benefit administration engines, and compliance tools.
Traditional Freelance Portals vs. SageDoer
Self-funded health plan consulting involves strict HIPAA compliance, catastrophic stop-loss liability, and complex actuarial schedules. Here is why unmonitored freelance marketplaces fall short.
| Key Evaluation Criteria | Traditional Freelance Platforms | The Smart Choice: SageDoer |
|---|---|---|
| Platform & Management Fees | Up to 40% in hidden markups, currency exchange fees, bidding charges, and monthly membership costs. |
0% Hidden Fees. Pay strictly for hours of actual work.
|
| Daily Team Management | You must personally supervise, explain stop-loss terminology, audit census files, and check spreadsheets. |
Dedicated Project Manager acts as your single point of contact ($0 cost).
|
| Self-Funded Technical Fluency | Hit-or-miss talent with no grasp of specific stop-loss, aggregate corridors, PBM rebates, or Form 5500. |
Internally vetted, trained in self-funding operations, protected by strict mutual NDA.
|
| Hiring & Deployment Speed | Weeks wasted interviewing candidates, grading mock census scrubbing tests, and dealing with ghosting. |
Instant delegation. We immediately assign the right self-insured operations specialist.
|
| Billing & Invoicing | Messy multiple freelancer time logs, unpredictable currency conversions, and surprise invoices. |
Simple, unified, centralised USD invoicing with clear task-stamped work logs.
|
| Staff Turnover & Coverage | Freelancer drops out right during intense Q4 stop-loss quoting or open enrollment? You panic. |
Seamless internal replacements with zero workflow disruption or retraining overhead.
|
How SageDoer Works in 4 Simple Phases
From your initial consultation to automated daily self-funded plan consulting operations—no complex onboarding hurdles or software setup.
Submit Requirements
Share your client caseload, upcoming stop-loss RFP schedule, TPA platforms, and operational bottlenecks:
Finalise the Deal
Our dedicated project manager will promptly get back to you to review your goals, outline a tailored strategy, and finalise the partnership details.
Expert Execution
Your project manager takes full charge of the operations, getting the work done seamlessly and efficiently through our internal team of vetted experts.
Pay Only for Output
We log and charge exclusively for the virtual assistant's actual working time. Your dedicated project manager's supervision is completely free.
Simple, All-Inclusive Pricing
No contracts, no setup fees, and zero platform tax. A dedicated Project Manager oversees operations at no extra charge.
Flexible Support
Ideal for boutique benefits advisors managing steady monthly claims fund reconciliation, quarterly stop-loss RFP packaging, and SPD compliance proofing.
- Pay only for hours of pure work
- Dedicated Project Manager included
- Free management supervision ($0 extra)
- Zero setup or onboarding fees
- No monthly membership charges
- Consolidated task & hour reports
Cancel anytime • Zero long-term lock-in
Dedicated Powerhouse
Complete operational immersion for regional benefits consultancies, captive plan administrators, and high-volume self-insurance practices managing dozens of groups.
- Pay only for hours of pure work
- Dedicated Project Manager included
- Free management supervision ($0 overhead)
- Zero setup or onboarding fees
- No monthly membership charges
- Seamless internal backup coverage (Zero downtime)
Guaranteed $6/hour locked-in rate
Average Annual In-House Benefits Operations Cost: $85,000+ USD
With SageDoer Full-Time ($960/mo or $11,520/yr), you save roughly $73,480/year while eliminating corporate recruiting fees, healthcare overhead, and technical turnover disruptions.
Frequently Asked Questions
Realistic questions Self-Funded Benefits Advisors, Stop-Loss Brokers, and TPA Executives ask before onboarding.
Let's Build Your Self-Funded Operations Pod Today.
Share your client group volume, stop-loss quoting schedule, and operational bottlenecks. A dedicated Project Manager will evaluate your scope, verify system access protocols, and match you with pre-vetted self-insurance operations specialists within 24 hours.
Submit Your Self-Funded Operations Needs
Tell us what stop-loss, claims, or compliance tasks you need off your plate. We'll reply with an operational roadmap within 4 hours.