Level Funded

Providing small and mid-sized employers with captive options that make healthcare costs more predictable.

Helping brokers and their clients stay competitive with level funding.

Small and medium-sized businesses are looking for cost-effective benefits in a tight labor market. To get more control over health plan design and expenses, more people are opting for level-funded plans.

Amwins Group Benefits has more than 30 years of experience working with pricing and administration of level-funded captives. We customize benefit designs and provide private-label programs for Third Party Administrators (TPAs) and General Agents (GAs). We currently offer 26 different level-funded, private-label programs.

Level-funded offerings help brokers stay competitive by addressing some of their clients' most pressing concerns. Employers who use level funding can count on predictable costs while only paying for their employees' actual healthcare bills while stop-loss insurance covers their financial liability for claims beyond a specific threshold.


Standard level-funded stop-loss program provisions include:

  • 12/18 contract for specific and aggregate stop-loss coverage for groups under 100 medical lives; otherwise traditional stop-loss product options are available
  • Monthly Aggregate Accommodation Amendment included for optimal cash flow
  • Simultaneous Specific Reimbursement Rider included for optimal cash flow
  • Prescription drug claims covered under the plan track to the specific deductible
  • 100% of remaining end of year plan claim funds are still returned to the plan sponsor, unlike many products on the market today
  • Only administered by approved preferred Third Party Administrators
  • Maximum claim funding is required on level-funded business
  • 125% Agg Corridor


Why level funding?

There are several reasons to consider level funding:

Cost savings

A self-funded health benefit plan can be less expensive than a fully insured plan.

Potential excess claim fund refund

The plan may issue a refund to the employer if claims are lower than expected.


Plan designs include multiple benefit options.

Fixed monthly premiums

Employers fund their maximum liability through 12 equal monthly payments based on consistent enrollment.

Financial protection

Stop-loss insurance helps protect against the financial impact of being hit with many claims or a single catastrophic claim.

Claims insights

Detailed claims data allows employers to zero in on the performance and utilization of their benefits and use that information to target ways to save the plan money and improve the overall health of participants.


Lower premium taxes

It’s only paid on stop-loss premium, not the claims fund or administrative fees.


Renewal negotiation

Premium and claim fund calculations can typically be negotiated to provide the best pricing available.


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