What is Level Funded Plus — Powered by Great American Insurance Group?

What is Level Funded Plus — Powered by Great American Insurance Group?

Adam Hawf

Level funded health insurance is an increasingly popular choice for small and medium sized businesses seeking to gain control over their health insurance spending. For groups accustomed to fully insured health plans, the switch to level funding can offer greater transparency and the possibility of savings. With level funded insurance, groups pay a fixed monthly fee to the insurance carrier (just like they would with a fully insured health plan). The carrier then sets funds aside in an account to cover health insurance claims for the business over the course of the contract term (e.g., 12 months). Aside from the predictability of costs with level funded insurance, one of the key benefits of such plans is that groups can receive a refund at the end of the contract term based on their claims performance.

Level funded insurance is growing in popularity —  according to the Kaiser Family Foundation, in 2020, 31% of small firms were using level funded or self funded health insurance. The expanding market for level funded plans means there are more providers and options for companies and brokers to explore than ever before,  so it’s important to understand the different features of the various policies and products now available. In this blog post, we lay out what differentiates Radion Health’s Level Funded Plus from other options in the marketplace. Level Funded Plus isn't the right option for all groups and our goal is that this blog post will help in your due diligence as you consider your options.

What is Level Funded Plus?

Level Funded Plus is Radion Health’s simple and transparent approach to level funded health insurance. Here are some of the main features of Level Funded Plus:

  • Industry leading refund policy: Many level funded plans offer some type of claims fund surplus return (e.g., 50% of the excess funds are refunded to the group and 50% of the funds are kept by the carrier). With Level Funded Plus, groups get a full (e.g., 100%) return of any surplus funds left in the claims fund at the end of the contract's runout period. This means that groups can benefit materially when they they have good years.
  • Proven financial backing: Radion Health’s Level Funded Plus plan is issued by Great American Insurance Group, an established and trusted insurer with a 150 year track record. Great American is a subsidiary of American Financial Group (NYSE: AFG) and has received A.M.’s best ranking of A+ XV. You can read more about Great American's financial strength here.
  • Access to national PPO networks: Some level funded health plans limit what providers and networks consumers can access for healthcare. While this approach works well for some groups, it doesn't work for everyone. With Level Funded Plus, there are no such restrictions. Groups can have access to a national PPO network that is similar to the type of network they likely accessed through their fully insured health plan. This is valuable for businesses, as national network access often allows them to avoid or mitigate disruption associated with employees needing to switch doctors or facilities.
  • Built for small businesses: Level Funded Plus is designed for groups accustomed to fully insured health insurance and suitable for groups as small as 10 enrolled employees. Level Funded Plus is subject to the regulations of individual states and as such is not available for groups under 100 in New York. Radion Health does not provide any coverage in Washington state and operates in California as Radion Health Insurance Services Inc.
  • Increased transparency and reduced spending on prescription drugs: Radion Health works with Capital Rx as the exclusive pharmacy benefits manager (PBM) for Level Funded Plus policies. Capital Rx provides exceptional cost transparency and superior member service. Since all drug rebates and price concessions are credited to each group’s claims fund, groups often experience substantial reductions in prescription drug costs.

Finding the Right Plan for Your Group

We know that Level Funded Plus is not the best option for all groups but we believe it is a great option for many small and medium sized businesses. If you are interested in submitting a group for quoting, you can do so at our website here

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Adam Hawf

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