Level-Funded Health Plans: Pros and Cons for Small Businesses

An aerial view of a woman typing on a laptop beneath "Level-Funded Health Plans" and "Pros and Cons of Small Businesses"In today’s competitive business landscape, providing employee benefits is crucial for small businesses to attract and retain talented professionals. But every small business is unique and shouldn’t settle for a one-size-fits-all approach to health insurance. Traditional plans may not cater to the needs of your small business. That’s where level-funded health plans come in.

Level-funded health plans are the perfect solution for businesses looking for more flexibility and customization. Level funded health plans combine the advantages of self-funding with the financial security of traditional fully insured plans. In this blog post, we will explore the pros and cons of level funded health plans specifically tailored for small businesses, and how they can be a smart choice for employers seeking a cost-effective healthcare solution.


What are Level-Funded Health Plans?

Level-funded health plans are a type of self-funded health insurance that offers employers the opportunity to take control of their healthcare expenses while limiting their financial risk. These plans are typically designed for businesses with 10 to 50 employees and provide a great alternative to traditional fully insured plans.

Pros of Level-Funded Health Plans for Small Businesses

  1. Cost Savings: One of the primary advantages of level-funded health plans for small businesses is the potential for significant cost savings. Unlike traditional fully insured plans, level-funded plans eliminate the risk of overpaying premiums. Instead, The Society for Human Resource Management explains, employers pay a fixed monthly amount based on the expected claims and administrative expenses, along with a stop-loss insurance premium to protect against high-cost claims. Any surplus funds at the end of the year can also be returned to the employer, resulting in potential cost savings!


  1. Customizability: Level-funded health plans offer more flexibility and customization options. Employers can tailor the plan design, benefits, and cost-sharing arrangements to suit their employees’ specific needs. This flexibility enables small businesses to provide attractive healthcare benefits that align with their employees’ wishes without the constraints of standardized plans.


  1. Claims Transparency: With level-funded health plans, employers gain greater transparency into their healthcare spending. Monthly claims reports provide detailed information on employee healthcare utilization, helping businesses identify patterns and trends. You can then use this data to implement wellness initiatives, educate employees about cost-effective healthcare choices, and drive overall healthcare cost containment.


  1. Employee Engagement: By offering level-funded health plans, small businesses can empower their employees to actively manage their healthcare expenses. Employees are more likely to be engaged when they have a financial stake in their healthcare choices. This leads to better decision-making and potentially reduced overall healthcare costs.

Cons of Level-Funded Health Plans for Small Businesses

  1. Financial Risk: Although level-funded health plans provide protection against catastrophic claims through stop-loss insurance, there is still a degree of financial risk involved. Small businesses should carefully assess their financial stability and ability to handle unexpected spikes in healthcare costs before opting for a level-funded plan.


  1. Administrative Burden: Compared to fully insured plans, level-funded health plans require more administrative involvement from the employer. The responsibility of managing claims, negotiating with healthcare providers, and ensuring compliance falls on the business. However, many employers choose to work with third-party administrators who specialize in managing level-funded plans to alleviate this burden. This adds an additional upfront cost.


  1. Limited Availability: Level-funded health plans may not be available in all areas or for all businesses. Insurance carriers determine the eligibility based on factors such as the size of the business, claims history, and employee demographics. Small businesses interested in exploring level-funded plans should consult with insurance brokers or carriers to determine their eligibility.


Level-funded health plans offer a compelling option for small businesses seeking to provide competitive employee benefits while maintaining cost control. The potential for cost savings, plan customizability, claims transparency, and increased employee engagement make them an attractive choice. However, small businesses must carefully evaluate the financial risk and administrative responsibilities associated with level-funded plans. By understanding the pros and cons and seeking expert advice, employers can make informed decisions to secure the best healthcare options for their workforce. 


Implementing a level-funded health plan can be a game changer for small businesses. This option can help employers navigate the complex healthcare landscape effectively. Consider exploring this innovative approach to healthcare benefits. Then take advantage of the cost-saving potential and increased flexibility it offers to businesses like yours.

Picture of Sydney Berry
Sydney Berry

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