Level Funded Medical

Flexible. Transparent. Cost-Smart.

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Your Partner For Transparent, Cost-Controlled Solutions

Level Funding is a strong choice for employers who want transparency and control of healthcare costs, clear insight into claims, and less impact from state mandates. It works best for groups with stable or somewhat predictable claims and for companies that value both benefit flexibility and predictable monthly costs. With stop-loss insurance, your exposure to large, unexpected claims is capped, so your financial risk is limited to fixed monthly payments.

At GBL, our team members are well-versed and experienced in Level Funding. We’ll give you the expert guidance you need to determine which clients are a good fit for this type of plan and how to get started. Contact us today.

What is Level Funding?

Level Funding blends the best of self-insured and fully insured plans. The fixed monthly premiums pair with the potential for a year-end surplus if claims are lower than projected.

Level Funding has three key parts: (1) A fund that pays for employees’ medical claims. (2) Stop-loss insurance that caps financial exposure on high-cost claims, financially protecting employers. (3) Admin fees that pay the carrier or a third party for managing the Level Funding plan.

Level Funded Medical Plan Partners

Our strong partnerships with top carriers give you access to a wide range of exceptional Level Funded plan options, while our experienced Sales Consultants provide the expert guidance and information you need to make confident, informed decisions.

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Aetna | Level Funded Medical

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AmeriHealth | Level Funded Medical

Angle Health | Level Funded Medical

Anthem Blue Cross Blue Shield | Level Funded Medical

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Antum | Level Funded Medical

Apex Management Group | Level Funded Medical

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HealthPartners | Level Funded Medical

Horizon | Level Funded Medical

IBA | Level Funded Medical

Kaiser Permanente | Level Funded Medical

Memorial Hermann | Level Funded Medical

MotivHealth | Level Funded Medical

Nationwide | Level Funded Medical

Optimyl Benefits | Level Funded Medical

Redirect Health | Level Funded Medical

Sana | Level Funded Medical

SBMA Benefits | Level Funded Medical

Select Health | Level Funded Medical

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Trustmark | Level Funded Medical

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Frequently Asked Questions

What is a Level Funded health plan?

A Level Funded plan is a hybrid between Fully Insured and Self-Funded coverage, giving employers predictable monthly costs with the chance for a surplus refund.

In a Level Funded plan, each monthly payment includes:

Claims funding
Administrative costs
Stop-loss protection

If claims run lower than expected, the employer may receive a surplus at year-end. If they run higher, stop-loss insurance limits financial exposure to the predetermined monthly premium.

Why are companies choosing level funded plans?

Companies are choosing level funding for the following reasons.

Predictable Costs: Fixed monthly premiums simplify budgeting
Potential Surplus: Lower-than-expected claims may result in year-end surplus
Risk Mitigation: Stop-loss insurance caps exposure to high-cost claims
Employee Satisfaction: Comprehensive coverage options help boost morale and retention

Why is Level Funding gaining traction?

Level Funding is gaining traction for the following reasons:

Flexible Plan Designs: Tailor coverage to fit each client’s unique needs
Regulatory Relief: Reduce exposure to many state mandates
Transparency: Access detailed, ongoing claims reporting
Consistency Nationwide: Offer the same benefits across all states
Shared Success: Keep surplus funds at year’s end if claims are lower than expected
Tax Advantage: Enjoy lower premium taxes

How does Level Funding differ from Fully Insured plans?

Level Funding keeps monthly payments predictable like Fully Insured coverage, but it adds transparency and the potential for savings.

Key differences:

Fully Insured premiums are fixed — the carrier keeps any unused funds.
Level Funded plans share performance — employers may get a surplus refund.
Level Funded plans provide clearer insight into claims data and more cost-control opportunities.
Underwriting process

It’s a middle ground for employers who want stability with upside potential.

Which employers are a good fit for a Level Funded plan?

Level Funded plans work particularly well for small to midsized groups that want the opportunity to share in a potential surplus of healthcare funds while gaining access to more coverage options.

What are the main advantages of Level Funded health plans?

Level Funded plans give employers cost stability, transparency and the opportunity to reduce total healthcare spend.

Top benefits include:

Consistent monthly premiums
Potential year-end surplus refunds
Access to detailed claims reporting
More flexible plan designs
Opportunities for long-term cost management

These features make Level Funding a compelling alternative to traditional Fully Insured coverage.

What are key considerations with Level Funded plans?

Here are a few of the important considerations when considering level funding:

Surplus refunds are not guaranteed
Renewal rates may fluctuate based on group claims
Early termination provisions vary by carrier
Employers assume compliance considerations (ERISA, ACA, PCORI and transparency rules).

Warner Pacific works closely with carriers to ensure programs are structured for minimal volatility and strong support.

Understanding Funding

Understanding the different ways a health plan can be funded is key to helping employers choose the right strategy for their needs. Fully Insured, Level Funded, and Self‑Funded arrangements each offer distinct levels of risk, flexibility, and cost control. By knowing how each model works, brokers can guide clients toward the option that best aligns with their budget, risk tolerance, and goals for employee benefits.

Fully Insured

Fully Insured health insurance is a traditional model where an employer pays a fixed monthly premium to an insurance carrier, and the carrier assumes all financial risk for employees’ healthcare claims.

The premium is set for a year and covers the cost of claims, administration, and carrier profit.

This option offers predictable budgeting and minimal financial exposure for the employer, making it a simple, hands‑off solution.

Level Funded

Level Funded health insurance blends features of both Fully Insured and Self‑Funded plans.

Employers pay a stable, “level” monthly amount that covers expected claims, stop‑loss insurance, and administrative costs.

If claims run lower than expected, the employer may receive a surplus refund; if they run higher, stop‑loss protection limits the financial risk. This approach gives employers more cost control and potential savings while maintaining predictable monthly expenses.

Self-Funded

Self‑Funded health insurance allows employers to take full control of their healthcare plan by paying for employees’ medical claims directly as they occur, rather than paying a fixed premium to a carrier.

Employers typically partner with a carrier or third‑party administrator and purchase stop‑loss insurance to protect against large or unexpected claims.

While self‑funding offers maximum flexibility and potential long‑term savings, it also comes with higher financial responsibility and variability.

Why GBL, A Warner Pacific Company?

Offering the right employer‑sponsored health plans means giving clients access to a wide range of quality options. Warner Pacific partners with an extensive network of carriers to deliver Level Funded health plans that provide:

Cost predictability
Claims transparency
Reduced exposure to state mandates

With GBL, you’ll be equipped to find the best fit for every client.

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