What You Should Know:

Level Funding combines the cost control features of self-funding with the stability of fully insured plans.

How It Works:

You pay a consistent monthly fee covering anticipated claims, administrative expenses, and stop-loss insurance.

Here’s the Advantages:

 Predictability: Fixed monthly payments aid in budgeting.

 Customization is King: Tailor plans to meet your employees’ unique needs.

 Cost Savings: Potential refunds for unused claims savings.

 Flexibility: Offers transparency and control over healthcare costs.

Protection: Stop-loss insurance mitigates financial risk.

 Transitional Step: It’s great as an alternative to more costly fully insured programs, and is ideal for businesses considering moving to self-funded plans.

 

Stop Loss Insurance Is an Essential Element of Level Funding:

A requirement of level funding, specific stop loss is a type of coverage with a fixed premium that protects level or self-funded employers from large, unexpected claims by reimbursing them when individual claim costs exceed a predetermined threshold, known as the specific stop loss level. Aggregate stop loss coverage protects against high total claims for the group.

Cost Control Features and Strategies:

 Transparent Claims Data: With level funding you have access to detailed claims data can help you track and analyze use patterns to identify cost savings opportunities. This can help with premium negotiations.

 International Drug Sourcing: Employers can help reduce their overall claim spend with programs that purchase prescription drugs outside of the U.S. less expensively. Employee incentives to participate include reduced or eliminated copays.

 Wellness Programs: These incentive program participants benefit from early detection of issues, better outcomes for patients and reduced absenteeism. These can add up to overall claims savings and easier renewals.