Voices of Self Funding: Jonathan Socko, President of East Coast Underwriters, LLC

In this episode of Healthcare NOW Radio's Voices of Self-Funding, host Ramesh Kumar interviews Jonathan Socko, President of East Coast Underwriters LLC, a Managing General Underwriter specializing in stop-loss insurance. Socko shares deep insights into the challenges and strategies for sustaining small group self-funded health plans, particularly for employers with 25–50 employees. He highlights the dramatic increase in claim sizes since the Affordable Care Act, the risks of short-term savings from level-funded products, and the critical importance of data transparency, partner cohesion, and proactive cost management. A standout case study features a 30-employee group that has successfully self-funded for 10 years with only a 10% increase in PMPM costs, thanks to disciplined underwriting, a non-BUCA PPO network, strong pharmacy cost controls, and consistent data sharing among broker, TPA, and stop-loss carrier. Socko emphasizes that long-term success hinges on continuous monitoring, early intervention, and philosophical alignment across all stakeholders. The episode underscores that sustainable self-funding for small groups is not about luck but about a well-orchestrated ecosystem of expertise and discipline. Key takeaways include the necessity of monthly data reviews, the value of reference-based pricing (when feasible), and the need for brokers and TPAs to be deeply involved in ongoing claims management. Socko warns against relying on short-term savings from level-funded plans and stresses that renewal success depends on locking in data early and being prepared for volatility. The conversation concludes with actionable advice: don’t wait until renewal to assess performance—monitor claims and costs continuously. The overall tone is constructive, insightful, and empowering for plan sponsors and advisors navigating the complexities of small group self-funding.