Level funding: a midway approach

If true self-funding seems too big a leap from fully insured, level funding – technically, a type of self-funded arrangement – offers a compelling option for employers that want to move away from a fully insured plan but aren't ready to completely self-insure. Highlights include:

Consistent monthly payments. Like an all-in self-funded plan, the employer is responsible for paying claims. But instead of the typical pay-claims-as-you-go self-funded model, an employer in a level-funded plan pays a set monthly amount to cover the estimated cost for expected claims, plus any premiums for stop-loss insurance and plan administration costs – just like the budgeting consistency fully insured to which employers are accustomed.
Stop-loss guardrails. Level-funded plans include extra controls at the stop-loss level that self-funding plans don't require. If plan members have more claims than planned for, stop-loss kicks in to cover any costs over the preset capped amount – making level funding an attractive middle ground between fully insured and self-insured.
You don't lose what you don't use. If total claims costs are lower than expected, employers may get a rebate or refund from their carrier or third-party administrator (TPA) – something they won't find in a fully insured arrangement.
Decision-making data. Just like self-funding, level funding gives companies more access to robust claims data (not typically provided in a fully insured arrangement). Such transparency allows benefits consultants and employers to manage risk more effectively.

Find the right fit

If your company or your clients are looking to explore level funding, it's also important to acknowledge that not all carriers are created equal. Some important considerations include whether companies get to reap the full benefit of any plan year savings, and whether the plan is a good fit for employees overall.

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