Level-funded plans are what we do best.
A fixed monthly cost, your own claims data, and stop-loss behind it. For a mid-size employer it is usually the best structure available — and it is the one we know inside out.
What a level-funded plan actually is
You pay a fixed amount every month, the way you would with a fully insured plan. That amount covers three things: expected claims, administration, and stop-loss insurance.
If your group’s claims come in under what was funded, you may get a share of the surplus back at the end of the plan year. If claims run high, stop-loss absorbs it and your monthly cost doesn’t move mid-year.
The practical difference from fully insured is that you can see your own claims experience instead of being rated on a pool you’ll never get a report on.
How it compares
| Fully insured | Level-funded | |
|---|---|---|
| Monthly cost | Fixed | Fixed |
| See your claims data | Rarely | Yes |
| Surplus if claims run low | Carrier keeps it | May be refunded to you |
| Bad claims year | Hits your renewal | Stop-loss absorbs it |
| Renewal predictability | You find out in the letter | You can see it coming |
General comparison only. Plan design, stop-loss terms, and surplus arrangements vary by carrier and by group.
Who it usually fits
An employer big enough that being rated on somebody else’s pool has started to feel arbitrary, but who still wants a bill that is the same number every month. If you are fully insured today and have never been shown your own claims experience, that is worth a conversation.
Timing matters more than most employers expect. Carriers typically release renewals only 60 to 90 days out, which is a short window to evaluate alternatives, negotiate, and implement a change without disrupting your employees. The groups that do best started looking before the renewal letter arrived.