
Healthcare is probably one the most expensive line items on your balance sheet. For decades now, small
businesses have been conditioned to look at health insurance in 12-month intervals, instead of with a
long-term strategical lens. What if there was a way to look at health insurance as a vehicle to sustainably
lower long term operational costs?
Most employers have a strategy for growth, a strategy for sales, a strategy for their workers
comp/business insurance and everything in between but not health insurance. Large companies have
the resources and infrastructure on their side to help control healthcare costs. They also have carriers
and brokers at the ready offering them preferential treatment. All while small businesses question if
they can even afford to offer health insurance.
As a small business, it's understandable that you have not had the time or the resources to dedicate to
establishing and adhering to a strategy to lower your healthcare costs. Luckily through NAPS, you now
have the tools and the expertise to do so! The question isn’t how do I pay the lowest amount over the
next 12 months but what do I do to consistently lower my long-term costs in the coming years.
One way to start lowering healthcare coverage cost is by looking at plan options like level funding. Level
Funding is an out of the box risk financing vehicle that is a steppingstone between fully insured and self-
insured options. Level funded plans typically include three main components: administrative costs,
individual/aggregate stop loss coverage, and claims. (We know this sounds confusing; we promise to
explain.)
Level Funded plans give small businesses the freedom and autonomy of self-insurance with the financial
protection of a fully insured plan. The company funds their small claims to the carrier monthly at their
maximum liability. If the insured exceeds that maximum, then the carrier steps in and covers the
payments. This is known as your ‘stop loss’.
At year end, the carrier does an audit of the insured’s incurred small claims vs the amount that was
funded throughout the year to see if there is a surplus or deficit. If there is a surplus the employer can
receive some of the unused claim funds back! A team of proactive experts, a bundle of supplemental
tools, and employee educational content throughout the year can help you adhere to your strategy and
see potential return of claim funds.
Level funded plans deliver several benefits for small employers: Cost savings, plan design flexibility, less
red tape bureaucracy, lower health insurance taxes (employer facing) and access to claims data. How
can this help me realize the strategy I need?
Claims are basically the holy grail to determine whether your insurance carrier is profiting off your
employees or whether you are costing them money. This is why most carriers refuse to share this
information if you are a small business. When you have access to your claims, it makes creating a
healthcare coverage strategy simple.
Level Funded plans offer flexibility that is unmatched by its fully insured counterparts. There are less
restrictions on what an employer can do with a level funded plan, offering you flexibility with plan
designs. By having more freedom with a Level Funded option, you are more likely to have plan
continuity year to year which would not restrict access to care for your employees. Furthermore, by funding your claims in small increments (without paying the fully insured overhead of an insurance
carrier), you get increased flexibility with improved cash flows throughout the year. If those things
weren’t enough, level funded plans also allow employers to lower their state health insurance taxes!
If you are a small business and are tired of the cookie cutter overpriced fully insured options, level
funding could fit your needs. As an NAPS member you have exclusive access to NAPS360Healthcare.com
where you can learn more about your healthcare coverage options and speak with a licensed consultant
to see if level funding could help you build the right healthcare coverage strategy.