SlideShare a Scribd company logo
What is level funded health insurance?
Will it work for your group?
This Photo by Unknown Author is licensed under CC BY-SA
With Traditional Health
insurance, premiums
continue to skyrocket
annually!
With Traditional Health insurance, premiums
continue to skyrocket annually!
Source: Kaiser Family Foundation
Problem is, the employer
has little to no control
over “what goes into” the
benefits, and thus the
costs.
This Photo by Unknown Author is licensed under CC BY-SA
Increased mandates
and regulations just
keep adding to the
premiums.
This Photo by Unknown Author is licensed under CC BY-SA
Nowadays, even younger and
healthier groups suffer higher
costs because healthier
lifestyles do not reflect in the
health insurance rates
This Photo by Unknown Author is licensed under CC BY-NC
Worse the employer has no
choice but to either pass along
the increases or reduce the
benefits to offset the increased
premiums or both. This Photo by Unknown Author is licensed under CC BY-SA
Can level funded self
insurance be the answer?
This Photo by Unknown Author is licensed under CC BY-SA-NC
Is your group…
Relatively healthy?
Younger workforce?
More health conscious?
Then level funding may be for you!
How it works:
The simple version
Your group pays a monthly
fixed cost, just like your
current premiums
This Photo by Unknown Author is licensed under CC BY-NC-NDThis Photo by Unknown Author is licensed under CC BY-NC
The costs are divided into three buckets
• The administrative
fee bucket to run
the plan functions
• The stop loss
insurance premium
to insure against
catastrophic claim
numbers
• The claim funding
bucket
The administrative
fee bucket runs
the plan.
This Photo by Unknown Author is licensed under CC BY-NC-ND
The stop loss
insurance bucket
pays premium to
insure against
catastrophic
claims
The claim
funding bucket
Pays the medical
claims
This Photo by Unknown Author is licensed under CC BY-NC-ND
Behind the scenes the
administrator has already arranged
for the network contracts, the stop
loss insurance and the technology
platform. it’s all ready to go!
This Photo by Unknown Author is licensed under CC BY-SA-NC
This Photo by Unknown Author is licensed under CC BY-SA
Your employees use
the plan like they do
now! So what’s the
difference?
If your members are relatively
healthy you have a surplus in
the claim funding bucket at
the end of the year. That’s
your money!
Imagine incentive programs that actually drive down
premiums and keep your workforce healthier!
When was the last time you
got money back at your
health plan renewal? Ask us
today if a level funded self
insurance plan could be a fit
for your group!
This Photo by Unknown Author is licensed under CC BY
Your Total Benefit Solutions Team
Is experienced and ready to help you with your health insurance!
How Level Funding Group Health Insurance Plans Work

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How Level Funding Group Health Insurance Plans Work

  • 1. What is level funded health insurance? Will it work for your group? This Photo by Unknown Author is licensed under CC BY-SA
  • 2. With Traditional Health insurance, premiums continue to skyrocket annually!
  • 3. With Traditional Health insurance, premiums continue to skyrocket annually! Source: Kaiser Family Foundation
  • 4. Problem is, the employer has little to no control over “what goes into” the benefits, and thus the costs. This Photo by Unknown Author is licensed under CC BY-SA
  • 5. Increased mandates and regulations just keep adding to the premiums. This Photo by Unknown Author is licensed under CC BY-SA
  • 6. Nowadays, even younger and healthier groups suffer higher costs because healthier lifestyles do not reflect in the health insurance rates This Photo by Unknown Author is licensed under CC BY-NC
  • 7. Worse the employer has no choice but to either pass along the increases or reduce the benefits to offset the increased premiums or both. This Photo by Unknown Author is licensed under CC BY-SA
  • 8. Can level funded self insurance be the answer? This Photo by Unknown Author is licensed under CC BY-SA-NC
  • 9. Is your group… Relatively healthy? Younger workforce? More health conscious?
  • 10. Then level funding may be for you!
  • 11. How it works: The simple version
  • 12. Your group pays a monthly fixed cost, just like your current premiums This Photo by Unknown Author is licensed under CC BY-NC-NDThis Photo by Unknown Author is licensed under CC BY-NC
  • 13. The costs are divided into three buckets • The administrative fee bucket to run the plan functions • The stop loss insurance premium to insure against catastrophic claim numbers • The claim funding bucket
  • 14. The administrative fee bucket runs the plan. This Photo by Unknown Author is licensed under CC BY-NC-ND
  • 15. The stop loss insurance bucket pays premium to insure against catastrophic claims
  • 16. The claim funding bucket Pays the medical claims This Photo by Unknown Author is licensed under CC BY-NC-ND
  • 17. Behind the scenes the administrator has already arranged for the network contracts, the stop loss insurance and the technology platform. it’s all ready to go! This Photo by Unknown Author is licensed under CC BY-SA-NC This Photo by Unknown Author is licensed under CC BY-SA
  • 18. Your employees use the plan like they do now! So what’s the difference?
  • 19. If your members are relatively healthy you have a surplus in the claim funding bucket at the end of the year. That’s your money! Imagine incentive programs that actually drive down premiums and keep your workforce healthier!
  • 20. When was the last time you got money back at your health plan renewal? Ask us today if a level funded self insurance plan could be a fit for your group! This Photo by Unknown Author is licensed under CC BY
  • 21. Your Total Benefit Solutions Team Is experienced and ready to help you with your health insurance!