Wellvana Small Business — Level-Funded

As market uncertainty becomes more common, small groups everywhere are facing increasingly complex and costly challenges, including rising costs and complicated legislative factors tied to their benefits strategies. But the fact is, health coverage by far still remains the most important benefit for employees. Historically there have been few options for small businesses that adequately support cost containment initiatives while still offering the coverage employees want.

Wellvana is solving this problem through aligning a powerful network of providers with level-funded health plans. This combination empowers small businesses to take greater control of their benefits strategy.

Level-Funding 101 – What is Level-Funding?

Level-funded health plans bring together the benefits of both fully-insured and self-insured plans, without the risk. Employers pay “level” premiums every month, and at the end of the year if claims come in less than the pool of premiums a portion of the unused funds may be returned to the employer. This approach gives employers the consistency and cost containment they need to provide great health benefits for their employees at a predictable price. 

When compared to traditional fully-insured plans there are several key differences:

Traditional Health Insurance

Traditional insurance plans split premium dollars between plan administrative expenses and actual claims costs.

Level-Funded Plan

Studies have shown employers can save up to $120 per employee, per month, when coming from traditionally fully-insured plans. *

 

 
TRADITIONAL HEALTH PLANS
LEVEL-FUNDED HEALTH PLANS
RISK >
Insurance company assumes the risk.
Employer assumes the risk, bust reaps the rewards.
CONTROL >
Based on insurers’ plan options and design.
More control and freedom in plan design than traditional insurance.
REGULATION >
Must comply with state and ACA regulations.
ERISA-built plans, preempts state regulations.
COST >
Varies based on plan choice and market.
Cost effective way to self-fund for small groups and mid-size businesses.
SAVINGS >
N/A.
Portion of unused funds may be returned to employer.
RENEWALS >
Varies.
The better the plan performs, the lower the renewal costs.

 

*Milliman White Paper

PROGRAM OVERVIEW

What do you get when you combine a high-performing clinically integrated network with a powerful level-funded product? Healthy employees. Healthy business. Great outcomes.

Wellvana Level-Funded Health Plans combine the benefits of level-funded health plans with a clinically integrated network that is directly accountable for the cost, experience and quality of the care provided to all beneficiaries. This approach, coupled with industry relationships, a seamless quoting process, and options for plans with as few as five lives is a powerful health insurance solution for employers of all sizes.

Level-Funding Plan Feature
Benefit to Employer

“Level” premiums, consistent throughout the year.

With consistent premiums every month you’ll have greater visibility into the costs of your business. This approach mitigates the risk of increasing premiums so you can keep costs down.

Comprehensive stop-loss, reinsurance coverage.

Mitigate financial risk with stop-loss coverage that covers the difference between the premiums paid and claims submitted in years where there are higher-than-anticipated claims.

Refundable claims dollars.

In years where claims submitted are less than the amount of level premiums paid, a surplus may be shared with the employer directly – opposed to the carrier. This makes businesses with healthy populations perfect candidates for level-funded programs.

Flexible plan design.

Level-funded plans, being a form of self-funding and ERISA-based, are exempt from some ACA mandates which can lead to less of an administrative burden for small companies. The plan design also allows for state tax exemption on premiums.

 

ILLUSTRATION

Over 80% of our clients will see savings by switching to a Wellvana Level-Funded Plan.  Of those that switch, we see an average of $1160 in savings per employee per year.

Many of these businesses are under 50 employees. These businesses can immediately re-invest tens of thousands of dollars into their employees or other areas of need.

HAND DOLLARS

SAVINGS PER EMPLOYEE $1160

OVER 80% OF CLIENTS SAVE

FREQUENTLY ASKED QUESTIONS – 

LEVEL-FUNDED PLANS

1] How many employees need to be on the plan?

One of the unique and powerful elements of these plans is they cover down to 5 covered lives. It doesn’t matter if 5/5 are covered or 5/20 are covered.

2] What if I have a particularly bad year when it comes to claims?

Level-funded plans have stop-loss insurance that kicks in at the right time to cover claims that exceed what you’ve paid into the premium fund. The max you will pay is based on your premiums.

3] What kind of businesses are best for level-funding?

Although level-funded plans can be for employers of all sizes, typically small businesses with 5-150 employees benefit the most from these types of plans. The group is relatively healthy with few outlying conditions. Groups that are currently on a fully-insured plan could see the most value from level-funding.

4] How does the Wellvana network partner with level-funded plans?

Wellvana is a clinically integrated network that brings together providers, technology and care coordination to ensure patients are getting high-quality care through clinical excellence. Our programs aim to decrease employee absenteeism, improve satisfaction, and produce quality outcomes. We bring together top-quality care providers and settings to serve patients with a more effective and connected healthcare experience.

5] What is the process for obtaining a quote?

You can request a rate illustration which is an estimate at the costs your business will face. If the rates are attractive, you can move forward with a quote which requires you to submit claims or personal health questionnaires for your employees. Wellvana partners with experts in the industry to ensure this process is seamless.

6] What if I’m on a renewal schedule with another provider at this time?

If you’re coming from a fully-insured plan you can transition to a level-funded plan with minimal risk. Fully-insured carriers cover claims prior to the date of termination.

Wellvana has partnered with experienced brokers in the level-funded space. Fill out the form below to connect with one today or email us at employers@wellvana.com