Most business owners assume their group health renewal is just going to keep climbing every year — because that's all a fully-insured plan is built to do. A level-funded plan restructures how the premium is spent, and in a strong claims year, can return money back to the company and employees instead of disappearing into the carrier's margin.
Slide to your group size and current average monthly premium.
Illustrative only, using a 25% savings estimate consistent with typical level-funded outcomes. Actual savings depend on group claims history, demographics, and carrier — this is a starting point for a real comparison quote, not a guarantee.
Most business owners never see an alternative to their fully-insured renewal — the broker just brings the same carrier's new number every year. From Loudoun and Fairfax to Richmond and Henrico to Lynchburg and Danville, this is for owners and HR leaders ready to actually see a comparison.
Level-funded plans are commonly available starting around 5-10 employees and scale up through larger groups, depending on the carrier and claims history.
Groups with good preventative care habits and lower claims utilization tend to see the strongest savings and surplus potential under a level-funded structure.
A fully-insured plan keeps 100% of any surplus for the carrier — there's no mechanism for a good claims year to ever benefit you directly.
Level-funded plans typically use the same major carrier networks — the savings come from the funding structure, not from a smaller network or worse coverage.
A level-funded plan breaks your monthly payment into distinct pieces instead of one opaque premium number.
A portion of the monthly payment is set aside specifically to cover the group's projected claims for the year.
Covers plan administration, network access, and claims processing — similar in function to what's embedded in a fully-insured premium, just itemized separately.
Insurance that caps the employer's exposure if actual claims exceed the funded amount — protecting against a single bad year, not leaving the business fully exposed.
If actual claims come in under the funded amount for the year, some or all of that surplus can be returned to the employer — money a fully-insured plan would simply keep.
A group that's proactive about preventative care — annual wellness visits, screenings, vaccinations — tends to see stronger claims performance, which directly increases the odds of a surplus at the end of the plan year. Some employers choose to share part of that surplus back with employees as an incentive for staying on top of preventative care.
This is a plan design decision made with your broker, not a guaranteed feature of every level-funded plan.
A group health structure where the employer pays a consistent monthly amount covering estimated claims, administrative fees, and stop-loss coverage — with the potential for a refund if actual claims come in under projection.
A fully-insured plan charges a fixed premium with any surplus kept by the carrier. A level-funded plan separates claims funding from fees, and surplus can be returned to the employer instead.
Not necessarily — level-funded plans typically use the same major carrier networks and can be designed with comparable or identical benefits to your current plan.
Stop-loss insurance caps your exposure — if claims exceed the funded amount, stop-loss coverage absorbs the excess above that threshold.
Commonly available starting around 5-10 employees and scaling up through larger groups, depending on the carrier, claims history, and workforce demographics.
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