- What is a level funded medical program?
Level funding offers employers a practical alternative to traditional insurance, where the employer can choose from a variety of plan designs and customized benefits to fit the needs of their employees. In a typical self-funded health plan, the employer accepts the full responsibility for the risk of health care for their employees. However, Level Funded plans are fully funded and reinsured, competitively priced and conservatively managed in order to provide the best plan available. Level funding health plans work similar to fully insured plans with a major difference; the employer owns the claims reserves instead of the insurance carrier and may receive claims money back.
Level Funded medical insurance programs are medically underwritten and require each employee to complete an Individual Medical Questionnaire (IMQ) prior to obtaining a Final Quote. Obtaining IMQ is made easy through our secure website that is accessed by selecting "Get a Final Quote".
- What are the advantages to level funded medical program?
Level funding offers several key advantages over traditional health insurance, including:
- Lower Fixed Costs: Most businesses realize immediate monthly saving
- Lower Claims Costs: If claims are lower than expected, you would enjoy even greater savings.
- Limited Risk: Stop-loss insurance protects you against individual or total claims exceeding your annual budget.
- Who is eligible for a level funded medical program?
Employer groups with employee size 2+ are eligible to participate in the plans. Current employees, spouses and dependents are also eligible to participate in the plans. Newly hired employees are eligible to enroll 30 – 60 days after Hire Date. Must be a chamber member to be eligible for the Level Funded Health Plan.
- What is the minimum participation from employers to participate in a level funded program?
Medical insurance carriers have specific participation requirements for coverage to be finalized. Some of the participation's requirements are provided below but final coverage acceptance is dependent upon Insurance Carrier approval.
- What is an Individual Medical Risk Questionnaire (IMQ)?
Level funded medical programs are medically underwritten and require all eligible employees of a company to complete a short risk questionnaire. The risk questionnaire consist of questions pertaining to the individual’s health. All risk questionnaires must be completed before a final medical quote can be obtained. Preliminary quotes can be obtained without them.
- How do I get a preliminary quote?
To get a preliminary quote (not binding and no obligation to request one) the employer will need to complete and provide an employee Census report that include list of eligible employees with associated information (date of hire, date of birth, etc.)
- What are my financial responsibilities as the business owner?
Each employer group will receive a bill for all employees enrolled in the level funded medical plan and are responsible for payment. Employer is responsible for payment as billed and is subject to coverage termination if not paid within 30 days of invoice. Employer is responsible for any employee contributions and payroll deductions. All adjustments will appear on the next month invoice.
- How are employees that terminate employment cancel coverage?
Employer should contact the brokers to notify them of any employee terminations.
- How are new hire employees added to the medical coverage?
Employer should contact the brokers to notify them and have the employee complete an election form.
- How does invoice work?
Employers will receive a monthly invoice around the 10th of each month that must be paid in full by the end of the month.