Broader medical coverage
A plan design closer to comprehensive major-medical benefits, generally with a higher cost of funding because it covers more care.
Level-Funded Health Plans
Predictable monthly funding. Potential to benefit from lower claims.
Level-funding is a form of self-funding that combines expected claims funding, administration fees and stop-loss premiums into regular monthly payments.
Specific products and availability are subject to confirmation.
Why employers consider it
Explore a more structured way to fund employee healthcare, with visibility into plan spending and potential access to a share of unused claims funds where the contract provides for it.
- Monthly payments are set in advance and reconciled against actual claims after the plan year.
- Stop-loss insurance protects the employer against specified excess costs. It does not remove every possible liability.
- Plan spending reporting can show where healthcare dollars are going.
Stop-loss insurance is a policy held by the employer. It reimburses the employer for specified excess claims costs above a stated level, subject to its terms. It does not eliminate every possible liability, and it does not change what employees are covered for.
Important consideration
Surplus refunds, funding obligations, renewal terms and stop-loss protection depend on the contracts. Savings are not guaranteed.
Two benefit-design pathways to discuss
Funding and benefits are separate decisions. Within a level-funded arrangement, these are the two directions we would talk through.
Limited-day plan options
A design with specified limits on certain medical benefits, such as covered hospital days or visits. Lower cost reflects narrower coverage.
Both pathways
These are pathways to evaluate, not automatically available products. Neither can be described as meeting minimum value without plan-specific confirmation.
Limited-day coverage
Limited-day coverage is not the same as comprehensive major medical coverage. Services beyond the stated limits may not be covered. Minimum essential coverage and minimum-value status must be confirmed for the specific plan.