My employee is considering self insured health care...

200 employees is a good size to start thinking about self-insured, especially if your group is pretty healthy. The key, more than number of employees, is number of covered lives. I have a client with about 130 employees, but over 500 covered lives (i.e. employees and dependents on the insurance policy).

There is usually a benefits consultant and a plan administrator. It's generally run through a major insurer. The plan details - what is covered, etc, may change, or may not change much. Otherwise, to the employee, it's pretty much business as usual. You deal with the administrator/insurer, so if it's Cigna, you will get an insurance card from Cigna, deal with Cigna customer service, networks, website, EOB, etc.

Behind the scenes, the administrator gets an actuary each year to determine what the premiums need to be for the benefits wanted. Usually the plan also buys reinsurance that kicks in at a high level for any major situations.

This plan seems to good to be true.