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What is a level-funded group health insurance plan?

Level Funding can help employers save premiums, control healthcare spending, and offer more benefit rich health plans to employees.

A Level Funded group health insurance plan is a popular strategy for small to mid-sized Nebraska employers who want to move away from higher cost small group ACA “age-rated” health plans. A level funded plan is built similar to a self-funded plan, while including additional safety nets so employers will never have to pay more than the monthly set premium rates. According to a recent KFF Survey (Kaiser), 42% of small businesses reported having a level-funded health plan. Here are a few additional key points:

  • A Level Funded plan is generally underwritten for final rates. Health insurance carriers will review the census demographics of enrolling employees to determine health risks and propose final quoted premium rates. Many health insurance carriers offer simplified underwriting that only requires enrollee names, zip codes, and dates of birth to determine final rates.

  • Level Funded plans provide more insight on claims utilization. Employers will have access to monthly claims reports that will display total monthly claim amounts and certain pharmacy data. This information helps employers understand employee claims utilization and how that drives premium rates.

  • Opportunity for a refund. A low claims utilization plan year could result in a claims excess check being refunded back to the employer. In addition to lower fixed premium costs and improved employee access to better health plan options with level-funded plans, the employer year end refund potential is an added bonus.

Strategic Benefits has partnered with top rated health insurance carriers in Nebraska to offer level funded health plans to small & mid-sized employers which include Blue Cross, United Healthcare, Aetna, Medica, Allstate, and Trustmark. Please contact us to learn more about the advantages of level-funded health plans for your business. (Learn More)


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