Predictable Costs with Savings Potential through Level Funded Insurance
Get the stability of traditional insurance with the cost-saving potential of self-funding. Level funded plans offer predictable monthly costs, claims transparency, and potential premium refunds.
Level Funded Advantages
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Predictable Payments
Fixed monthly costs for budgeting
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Potential Refunds
Get money back for good claims experience
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Claims Transparency
See your actual claims data and trends
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Stop-Loss Protection
Protected from catastrophic claims
Save an average of 10-20% vs fully funded
How Level Funding Works
Level funded plans combine the best aspects of fully funded and self-funded insurance to provide predictability with upside potential.
Claims Fund
Expected claims costs based on your group demographics
Stop-Loss Premium
Insurance protection for claims exceeding expectations
Admin Fees
TPA services, network access, and plan management
Your Fixed Monthly Payment = Claims Fund + Stop-Loss + Admin Fees
If Claims Are Low
You receive a refund at year-end!
When your group's actual claims are lower than the claims fund you paid into, you receive a premium refund. Many employers see refunds of 10-30% of their annual premium.
Example:
Claims Fund Paid: $100,000
Actual Claims: $75,000
Refund: $25,000
If Claims Are High
You're protected by stop-loss!
When claims exceed your claims fund, stop-loss insurance kicks in to cover the excess. Your costs never exceed your fixed monthly payments.
Example:
Claims Fund Paid: $100,000
Actual Claims: $150,000
Your Cost: $100,000 (stop-loss pays $50k)
Best of Both Worlds
Level funded plans combine the advantages of fully funded and self-funded approaches.
| Feature | Fully Funded | Level Funded | Self-Funded |
|---|---|---|---|
| Predictable Costs | |||
| Potential Refunds | |||
| Claims Transparency | |||
| Risk Protection | Partial | ||
| Easy Administration | Complex | ||
| Cost Savings Potential | Low | Medium-High | High |
Is Level Funding Right for You?
Perfect For:
- Businesses with 25-200 employees
- Companies with healthy employee populations
- Employers frustrated with annual rate increases
- Organizations wanting claims visibility
- Businesses ready for more control
- Companies seeking cost reduction opportunities
Key Benefits:
- Average savings of 10-20% vs fully funded
- Cash flow stability with refund potential
- Complete claims data transparency
- No surprise mid-year assessments
- Easier transition to full self-funding later
- Potential PEPM rates under $500
Ready to Explore Level Funding?
Discover how much you could save with a level funded plan. Our group benefits specialists will analyze your current plan and show you the potential savings and refund opportunities.
Common Questions
Level Funded Insurance FAQ
Common questions about level funded group health plans
Get answers about level funded insurance and how it combines the best of fully funded and self-funded plans.
What is a level funded health plan?
How does level funding differ from traditional insurance?
What happens if claims exceed expectations?
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