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 Warner Pacific, 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.

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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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39North | Level Funded Medical

39North | Level Funded Medical

Aetna | Level Funded Medical

Aetna | Level Funded Medical

Allied National | Level Funded Medical

Allied National | Level Funded Medical

AmeriHealth | Level Funded Medical

AmeriHealth | Level Funded Medical

Angle Health | Level Funded Medical

Angle Health | Level Funded Medical

Anthem Blue Cross Blue Shield | Level Funded Medical

Anthem Blue Cross Blue Shield | Level Funded Medical

Anthem Blue Cross | Level Funded Medical

Anthem Blue Cross | Level Funded Medical

Antum | Level Funded Medical

Antum | Level Funded Medical

Apex Management Group | Level Funded Medical

Apex Management Group | Level Funded Medical

Assured Benefits Administrators | Level Funded Medical

Assured Benefits Administrators | Level Funded Medical

Banner | Aetna | Level Funded Medical

Banner | Aetna | Level Funded Medical

BCBS Alabama | Level Funded Medical

BCBS Alabama | Level Funded Medical

Blue Cross Blue Shield of AZ | Level Funded Medical

Blue Cross Blue Shield of AZ | Level Funded Medical

BlueCross BlueShield of Illinois | Level Funded Medical

BlueCross BlueShield of Illinois | Level Funded Medical

BlueCross BlueShield of TX | Level Funded Medical

BlueCross BlueShield of TX | Level Funded Medical

Boulder Admin | Level Funded Medical

Boulder Admin | Level Funded Medical

Cigna | Level Funded Medical

Cigna | Level Funded Medical

Clearwater | Level Funded Medical

Clearwater | Level Funded Medical

Contractor's Health Trust | Level Funded Medical

Contractor's Health Trust | Level Funded Medical

Florida Blue | Level Funded Medical

Florida Blue | Level Funded Medical

Gravie | Level Funded Medical

Gravie | Level Funded Medical

Healthcare Highways | Level Funded Medical

Healthcare Highways | Level Funded Medical

HealthPartners | Level Funded Medical

HealthPartners | Level Funded Medical

Horizon | Level Funded Medical

Horizon | Level Funded Medical

IBA | Level Funded Medical

IBA | Level Funded Medical

Kaiser Permanente | Level Funded Medical

Kaiser Permanente | Level Funded Medical

Memorial Hermann | Level Funded Medical

Memorial Hermann | Level Funded Medical

MotivHealth | Level Funded Medical

MotivHealth | Level Funded Medical

Nationwide | Level Funded Medical

Nationwide | Level Funded Medical

Optimyl Benefits | Level Funded Medical

Optimyl Benefits | Level Funded Medical

Redirect Health | Level Funded Medical

Redirect Health | Level Funded Medical

Sana | Level Funded Medical

Sana | Level Funded Medical

SBMA Benefits | Level Funded Medical

SBMA Benefits | Level Funded Medical

Select Health | Level Funded Medical

Select Health | Level Funded Medical

Texicare | Level Funded Medical

Texicare | Level Funded Medical

Trustmark | Level Funded Medical

Trustmark | Level Funded Medical

UnitedHealthcare Oxford | Level Funded medical

UnitedHealthcare Oxford | Level Funded medical

UnitedHealthcare | Level Funded Medical

UnitedHealthcare | Level Funded Medical

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Frequently Asked Questions

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.

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

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

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.

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. 

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.

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.

Broker Resources

Resources to Support You

With personalized service, Warner Pacific helps brokers find the right plans for their clients. Access Level Funded plan resources here, or connect with us directly to discuss your clients’ needs. 

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  1. Download and save the Large Group / Level Funded RFQ Excel file.
  2. Enter the information required in the two tabs.
  3. Save the Excel file.
  4. Email (COLargeGroup@warnerpacific.com) the Excel file to our Level Funded specialists
  5. Be sure to attach your completed form to the email before sending.
Download

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Surest is the fastest-growing employer-sponsored health plan at UnitedHealthcare — and worth getting to know.

There's no deductible, no cost-shifting. Instead, Surest is a copay-only plan where members shop and compare care before making an appointment. That transparency makes all the difference.

The Surest level funded health plan is now available for small group with five or more employees beginning on 5/1.

Watch Now

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Launched recently by our partner HealthEZ, this product offers the simplicity of an all-in-one health benefit plan with the transparency and cost efficiency of a self-funded plan.

Their solution provides a range of features, including:

  • Competitive network pricing
  • Stop-loss protection from Nationwide
  • Transparent Rx and medical costs
  • And more
Watch Now

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Discover Sana: A Smarter Small Group Solution Has Entered the Chat

Watch Now

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This course is designed to go over the basics of level funding and the requirements needed to make it successful. It also includes important information about which clients are appropriate for this health plan solution and how you can incorporate it into your portfolio, as well as the difference in employer responsibilities for fully insured vs. level funded plans.

Watch Now

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Grow with a Partner Who's Got Your Back - March 19, 2026 - 11:00 AM (ET)

You’ve probably noticed it for years: Employers’ needs are becoming increasingly complex, and they’re relying more on you for help. But who’s helping you with your growing needs?

Warner Pacific is here for you, with solutions designed to provide:

  • Efficient, hands-on assistance, from pre-sale support, to quoting, to enrollment and beyond.
  • Intuitive technology tools that make your life easier
  • Additional team members who tackle different aspects of your work, saving you time

Learn more by joining our exclusive webinar, designed for brokers who want to stay ahead in today’s competitive market.

Register Now

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Why Warner Pacific?

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

Learn more

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Stay Informed

Compliance Chronicle Compliance

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Warner Pacific's March Compliance Chronicle

Ready To Consider Level Funded Plans For Your Clients?