Security Health Plan focuses on flexibility with Insite

Matthew Day

Staff

May 12, 2025

MARSHFIELD – As insurance providers nationwide seek to broaden their options, Director of Sales Jim Fries said Marshfield-based Security Health Plan has positioned itself “at the forefront of the insurance industry’s shift toward self-funding” by rebranding its third-party administration product. 

Formerly known as Security Administrative Services, Fries said the third-party administrator (TPA) was rechristened as Insite earlier this year to better reflect “our dedication to filling a real need in the market and making a long-term commitment to our customers and our community.”

“Self-insured decision-makers choose us because we support their critical need for advanced analytics,” he said. “Together with effective cost controls and exceptional service, we drive better decisions and better health plan performance and savings, ultimately leading to better healthcare results for our clients.” 

Security Health Plan’s clientele, Regional President Jennifer Shermo said, spans the Upper Midwest, currently serving about 220,000 members across a full spectrum of plans. 

“We do Medicare/Medicaid for the State of Wisconsin, (and) we have plans for individuals and families who don’t get insurance through their employers,” Shermo said. “We also have a pretty robust set of employer-based plans – and this is where Insite comes in.” 

Fries said though the name is new, the concept isn’t, as Security Health Plan has been offering a TPA for nearly 25 years. 

“Over the last five to 10 years, we’ve started to expand and enhance the services, and the (former) name really didn’t dictate all of the value that we were providing, (like) flexibility and data analytics,” he said. “We wanted to capture the value… and ‘Insite’ does that.” 

TPAs 101 

Why would a company go the way of a TPA? 

Shermo said some employers choose to handle their own insurance and fund it from their own budgets.

“They need a partner to help administer that because, of course, they don’t have an insurance back office to process claims and enrollments and all of those nuances paid providers,” she said. “So, they work with what we call third-party administrators like Insite to make that possible.” 

For certain companies, Fries said TPAs are the wisest option for health benefits. 

“Typically, it’s your larger employers who are looking to be able to self-insure their healthcare plan through their own administration or their own budget, and basically pay out of their checkbook rather than on a fully insured basis, where the health plan – like a Security Health Plan – takes on all the risk and is the insurance behind that for them,” he said. “On a self-funded basis with the third-party administration, we’re looking at employers who are a little bit more innovative in the way they’re looking to manage healthcare costs. They’re large enough to be able to spread the risk and be able to withstand potential up-and-down medical expenses on a monthly basis.” 

These employers, Fries said, are usually “more established,” have more than 100 employees and are looking for opportunities to see additional cost savings in the healthcare plan or health plan administration.

The 100-employee guideline, he said, provides assurance that “one big (health insurance) claim doesn’t basically take down the whole plan.” 

“Of course, every employer is going to be a little bit different in what they can sustain and what they’re looking to do,” Shermo said. 

Compared to fully insured employers, which “can be a bit more hands-off,” she said self-insured employers must work more closely with trusted agent partners. 

“(The agents) can be a good resource for (self-insured employers), but because it is their own risk, it does tend to be a bit more resource-intensive,” she said. “So, it’s a very unique proposition for each employer, and they’ll have to examine the advantages and disadvantages that come with (a TPA), and how it applies to their specific business, and what they’re trying to gain out of it.” 

Chief among TPAs’ advantages, Fries said, is its flexibility. 

“If (self-insured employers) want to bring in a different pharmacy benefit manager than what we offer, they can do that,” he said. “If they want to put in a direct-access-provider relationship or a separate-vendor relationship, outside of what Insite has, they’re able to do that. They’re also able to manage, under ERISA (Employee Retirement Income Security Act), benefits differently than they would maybe under a fully insured basis, and that gives them some changes that they want to be able to create.” 

Fries said TPAs encourage employers to work closely with broker partners “to build a plan that fits their needs effectively.” 

“Going to a self-funded arrangement gives (employers) some more flexibility in terms of how they set up the benefit design, compared to when they’re fully insured or fully funded, (and) we (insurance providers) set the benefit plan designs for them,” he said. 

TPAs can be most impactful, Fries said, in rural communities. 

“We’re strong in the rural health area and being able to make sure there’s enough access to quality health care when they need it,” he said. “But also, (we’re strong in) providing those preventative services, well check-ups and other things that are important to keep people healthy and mitigate any type of long-term cost claims.” 

Cost effectiveness, Fries said, can be another advantage of TPAs, as opposed to more rigid, “take it or leave it” plans. 

“You’re seeing more employers take the initiative to not only control costs, but be able to provide a variety of choices, whether it’s a tiered benefit structure or an opportunity to access more wellness, more prevention, more disease management cases and those types of things,” he said. “It offers more flexibility in terms of being able to assist those employees in managing their health care more favorably.” 

Though TPAs represent just one “valuable tool” in mitigating rising healthcare costs, Shermo said they have become popular over the years. 

“About 50% of Wisconsin employers have chosen to either self-fund or do what’s called a mixed-funded plan option, but it is growing,” she said. “I think even just 10 years ago, that number was significantly less. But for all the (aforementioned) reasons, there is kind of a strong movement in that direction in Wisconsin and nationwide.” 

More than a new name 

Rebranding Security Health Plan’s TPA from Security Administrative Services to Insite, Shermo said, bears more significance than simply shedding syllables. 

“The (new) name is a signal to the market that there’s a change to be aware of – but the proof is in our actions every day, and the results that we’re delivering to our employers and our agents,” she said. “(Insite) is bringing those additional tools – analytic tools; transparency to employers;… more self-service; better integration opportunities for whatever services that employer feels like they need to manage their population; being flexible to work with a number of different options in other health and wellness type vendors, data vendors or incentive vendors – whatever they feel is appropriate.”  

For Insite, Shermo said Security Health Plan has also improved other details, such as reporting and portal access. 

“But really… (the rebrand) is about (highlighting) cost containment, transparency, network options, analytics and flexibility to tailor our administrative services to what the employer needs,” she said. 

The decision to rebrand, Shermo said, was primarily driven in response to the market. 

“Given the changes in our environment and the shifting needs of employers and agents in our area, we really heard the ‘ask’ for reinvention or enhancements of what TPAs are providing to the market – so that was what drove the need,” she said. “We did extensive research with employers in our area, clients and non-clients, as well as our valuable agent partners. It took all of that feedback – and (we) sort of are still in the process – but over the last two years (or) 18 months, we have been investing significantly in enhancing our services and offerings for employers and agents.” 

Fries said the rebrand also served as a timely reminder. 

“The market was so focused on fully insured (plans), and Security Health Plan had a huge presence and brand awareness in the market on the fully insured side, (that) a lot of our broker partners and agency partners almost forgot that we had this service available,” he said. “As they started to move many of their clients from fully insured to self-funded, it reminded them that those services are available and they could still build on the strength in the relationship that they had with Security Health Plan.” 

With the company well established and part of the Marshfield Clinic Health System, Shermo said Insite is able to leverage resources to benefit Insite members. 

“We can bring all of that experience to an employer, in addition to all of the normal TPA services of processing claims and all of those operational aspects,” she said. “So, it’s sort of like you get the best of both worlds: the experience of a fully insured plan, but all of the great capabilities of a third-party administrator.” 

Shermo also said with Insite, Security Health Plan has an advantage over TPAs, which typically don’t own their own network. 

“Because we are an insurance plan (provider), we have our proprietary networks that bring additional value above and beyond what you will find with any sort of rental network or third-party contracted network,” she said, “so that’s a unique differentiator, really, for what Insite is bringing to the market.” 

Another improved strength of Insite, Fries said, is greater data analytics capabilities. 

“‘Data analytics’ has become not only a buzz word, but it’s become a very strong component of how our broker partners and our clients are utilizing the information to set up the right structure (and) the right benefit plan offerings, identifying controlling costs and disease states early on,” he said. “(We utilize data) to be able to provide the right services; to help ensure that those members are getting the right access to care (and) they’re compliant in their care and their routine; and to minimize those big expenses that can occur by not taking care of yourself or delaying care.”  

Though the rebranding has resulted in a new name and improved capabilities, Shermo said Insite will carry on the quality of care associated with Security Health Plan and the Marshfield Clinic Health System, while upholding an endless mission to serve the region. 

“That (improvement) will be a continuing goal for us as we want to get ahead of where the trends in the employer market are going, what the needs of our Wisconsin employers are and (how we can) continue to be the best partner for them,” she said. 

To learn more, visit www.InsiteTPA.org .