Allstate Benefits' Level-Funded Health Plan is a versatile and cost-effective insurance solution designed to offer businesses and their employees a stable and predictable healthcare experience. This innovative plan provides the flexibility of self-funding while reducing the financial risks associated with traditional health insurance. With Level-Funded Health, employers can customize their coverage and enjoy the potential for surplus premium refunds at the end of the year. It offers a transparent and straightforward approach to healthcare financing, making it an attractive option for businesses seeking to control healthcare costs while providing comprehensive coverage to their employees. Allstate Benefits' Level-Funded Health Plan brings peace of mind to both employers and employees, ensuring access to quality healthcare without the unpredictability of traditional insurance plans.
group benefits
Level-funded benefit plans (Major medical)
What is level-funding?
A level-funded plan is a type of self-funded plan in which the employer contributes a steady monthly payment to cover costs for administration, claims payments, and stop-loss insurance. Level funding has its advantages when compared to fully insured plans and programs. Level-funded plans often cost less, making it easier for small- and mid-sized employers to offer their employees high-quality health care benefits at a more affordable price.
Allstate Benefits offers small- to mid-sized employers an opportunity to have a level-funded plan for their business through the Self-Funded Program.
Fully Insured vs Level Funding: What's the Difference?
With fully insured plans, premiums are paid directly to the insurer.
CLAIMS ACCOUNT
A claims account is exactly what it sounds like. A portion of the monthly payment is used to pay for claims submitted by plan members.
STOP-LOSS INSURANCE
Stop-loss is an employer's safety net. This protects the employer against higher-than-expected claims. With level-funding, employers will never have to pay more than the amount they are responsible for funding the claims account each year. After that, stop-loss insurance kicks in.
ADMINISTRATIVE COSTS
Administrative services are provided to the employer so they can spend their time focusing on their business while a third-party administrator handles plan management such as paying claims, customer service, and other administrative tasks.
OPPORTUNITY FOR A REFUND
Say a group submits fewer claims than expected in a year. A portion (or all, depending on the plan selection) of the difference between the group's anticipated and actual claims is refunded back to the employer. Not only can employers potentially reduce their health care costs by switching to a level-funded plan, but the potential refund acts as additional savings on top of that.
WHAT ELSE IS DIFFERENT?
The basis of level-funded plans is the accuracy of the rates that are unique to each group. Employers should not pay more for health coverage than is needed.
Self-funded plans are not subject to certain Affordable Care Act requirements, however, employer-established self-funded plans with Allstate Benefits meet minimum essential coverage standards and preventive services are paid at 100% when received from in-network providers, as recommended by the Affordable Care Act.
Who is a level-funded plan for?
Level funding might be a great option for the group if:
They're a startup, small, or mid-sized business.
A fully insured model is too expensive but they want to offer employees quality health benefits.
They want more control over their health care costs.
They want a predictable monthly payment for the plan.
Transparency on where their monthly payments are going is important to them.
ARE THERE DIFFERENT PLAN OPTIONS?
A variety of plan options, such as PPO, network-only, and reference-based pricing, are available, and they can be customized to fit the needs of the business.
WHAT ELSE CAN BE INCLUDED IN A PLAN TO SAVE ON HEALTH CARE COSTS?
Some carrier offerings may include access to additional health programs like telemedicine and wellness programs.
Telemedicine services are designed to encourage plan members to make informed health care decisions. Visits through a designated virtual health care service often cost less than a doctor's office or urgent care visit, which helps save money on health care costs.
Wellness programs can help plan members start and maintain healthy habits that help them get and stay healthy. Healthier employees may be more likely to have lower health care claims costs.
What is REFERENCE-BASED PRICING?
Reference-based pricing (RBP) is a reimbursement method that uses Medicare reimbursement rates (or a derived equivalent) as a reference and prices claims based on a multiple of that rate.
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Are there any suggested add-ons with these plans?
YES, we HIGHLY recommend adding a CHAMPION PLAN to any AllState Level-Funded Plan. It will aid GREATLY in keeping renewals low.
