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Your Guide to Navigating Hybrid Level-Funded Health Plans

Mike Rohlmeier • September 11, 2023

Elevate your advisory approach by integrating Level-Funded Plans into your offerings.

Are you an employee benefit advisor seeking clarity amidst the intricacies of Level-Funded Health Plans? The allure of predictable monthly payments, potential refunds, and lowered risk can be enticing yet perplexing. Elevate your advisory game by embracing a balanced and tailored approach to benefits. In this blog post, we'll demystify the mathematics behind Level-Funded Plans, empowering you to reshape your strategy and enhance your client offerings.

Level-Funded Health Plans lie at the intersection of self-funding and traditional insurance. They provide a middle ground that offers the advantages of self-funding, such as cost transparency and flexibility, while mitigating the risk through stop-loss protection. These plans offer a unique opportunity for advisors to tailor benefits precisely to their clients' needs.


One of the key attractions of Level-Funded Plans is their predictability. As an advisor, it's crucial to explain to your clients that the monthly payments are predetermined based on projected claims and administrative costs. This predictability grants financial stability to businesses, enabling them to allocate resources more efficiently.


Level-Funded Plans introduce an innovative dimension to benefits -
potential refunds!  If claims remain lower than projected, all, or a portion of the unused funds can be returned to the company. This potential for refunds can be an enticing prospect for businesses aiming to optimize their healthcare expenditure. As an advisor, highlighting this feature can set you apart and pique the interest of your clients.


Navigating the complexities of self-funding can be intimidating for businesses concerned about high claim expenses. This is where stop-loss protection steps in. It serves as a safety net, capping the maximum liability a business faces for large claims. Effectively, this reduces the risk exposure, making Level-Funded Plans an attractive proposition for companies seeking self-funded benefits with a safety buffer.


Elevate your advisory approach by integrating Level-Funded Plans into your offerings. Understanding the nuances of these plans allows you to provide tailored recommendations to each client. Rather than adopting a one-size-fits-all strategy, you can create customized solutions that align with the specific needs and risk appetite of each business.


To master the art of advising on Level-Funded Plans, it's essential to grasp the layers of self-funding. Self-funding empowers companies to take control of their healthcare expenditure by directly funding employee claims. By combining this with stop-loss protection and potential refunds, you can assist clients in crafting a benefits package that harmonizes financial prudence with comprehensive coverage.


As an employee benefit advisor, your expertise lies in steering your clients towards optimal benefits solutions. Level-Funded Health Plans offer a compelling avenue to explore. By offering a balanced approach that integrates the benefits of self-funding and traditional insurance, you can empower businesses to take charge of their healthcare expenses while minimizing their risk.


If you are interested in learning more about the Carepath Solution or helping a client make the transition to level funding reach out at
mike@carepathbenefits.com, I would be happy to help.  Your clients' employees deserve nothing less than the best, and Level Funded plans can help you deliver just that.


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