Level-Funded & Self-Funded Group Health Plans for Employers
Lower-Cost Alternatives to Fully Insured Group Health Plans
Level-funded and self-funded health plans give employers more control over their group health insurance costs. Instead of paying a fixed premium to an insurance company, you pay for your employees’ claims directly, with administration and stop-loss protection built in to help manage risk.
For many small and mid-sized businesses in West Virginia, these funding strategies can provide access to strong benefits, claims transparency, and potential cost savings compared with traditional fully insured plans—when they are structured and managed correctly.
- Monthly level-funded payments that feel like a premium but are based on your group’s risk
- Potential refund or surplus if claims run better than expected
- Access to national carrier networks and negotiated discounts
- Claims data and reporting that improve long-term benefit decisions
- Stop-loss coverage to help protect against large, unexpected claims
- Plan designs tailored to your workforce, budget, and risk tolerance
Explore Level-Funded & Self-Funded Options
Related Employer Services
- Level-Funded Group Health Plans
- Self-Funded (ASO) Health Plans
- Traditional Fully Insured Group Health Plans
- Stop-Loss Insurance Strategy
- HRAs, HSAs & Ancillary Benefits
- Ongoing Renewal & Claims Strategy Support
What Are Level-Funded and Self-Funded Health Plans?
How Level-Funded & Self-Funded Plans Work
With a traditional fully insured plan, you pay a fixed premium and the carrier takes on most of the claims risk. With level-funded and self-funded arrangements, your company pays for claims more directly. A third-party administrator or carrier partner handles claims processing, networks, and support while stop-loss insurance helps protect your business from unusually high claims.
Level-funded plans are designed to make costs more predictable, using a set monthly payment that covers expected claims, fixed administrative fees, and stop-loss premiums. Self-funded plans can offer even more flexibility and transparency, but also come with greater risk if claims are higher than expected.
➡️ Potential Advantages for Employers
For the right employer, level-funded and self-funded plans can provide more control, better data, and opportunities for long-term savings. The key is matching the funding strategy to your group’s size, health profile, and risk tolerance—and partnering with the right plan administrator and stop-loss carrier.
- More insight into claims trends and healthcare spending
- Opportunity to share in savings when claims are favorable
- Plan design flexibility compared with many fully insured options
- Ability to target wellness and cost-management programs using claims data
- Customized stop-loss strategy to help protect against catastrophic claims
- Potential long-term cost control for growing, stable groups
Songer Insurance helped us evaluate fully insured, level-funded, and self-funded options side by side. We ended up with a level-funded plan that gave us strong benefits, more transparency, and long-term cost control.
About Songer Insurance
Beckley-based independent agency helping health beneficiaries compare health Advantage, Part D, and Supplement plans across West Virginia.
Service Provided
Independent, Beckley-based agency helping West Virginia employers compare fully insured, level-funded, and self-funded health plan strategies.
Enrollment Timeline
Enroll during your Initial Enrollment Period (around age 65) or during the Annual Enrollment Period (October 15–December 7). Songer Insurance provides year-round guidance for coverage reviews and plan changes.
Download Employer Funding Strategy Guide
Download our free employer guide to understand the differences between fully insured, level-funded, and self-funded health plans, including how stop-loss coverage works and which questions to ask when evaluating options.
Our Other Services
Level-Funded & Self-Funded Plan FAQs
QUESTIONS & ANSWERS
Common questions about level-funded and self-funded health plans.
Funding strategies can be confusing if you are used to fully insured group health plans. These answers cover the basics so you can better evaluate whether level-funded or self-funded options might fit your business.
A level-funded health plan is a hybrid between fully insured and self-funded coverage. Your company pays a fixed monthly amount that covers estimated claims, administrative costs, and stop-loss premiums. If claims run better than expected, you may receive a refund or credit at renewal, depending on the arrangement.
With a fully insured plan, the insurance company assumes most of the risk and sets your premium. With self-funding, your company pays claims directly and uses stop-loss insurance to help protect against large or unexpected claims. This can provide more flexibility and transparency, but also more financial risk.
Many level-funded programs are available to employers with as few as a handful of enrolled employees, while traditional self-funded plans are often a better fit for larger groups. The right approach depends on your group’s health profile, cash flow, and long-term strategy. We can help you evaluate your specific situation.
Stop-loss insurance reimburses the plan when claims exceed certain thresholds. Specific stop-loss protects against very large claims for a single individual, while aggregate stop-loss protects against unexpectedly high claims for the group as a whole. The structure and attachment points are key parts of your funding strategy.
Most employer health plans, regardless of funding arrangement, still need to comply with key federal requirements, including certain Affordable Care Act provisions, ERISA rules, and other regulations. We coordinate with carriers, TPAs, and your legal or tax advisors as needed to help you stay compliant.
The main risk is that claims may be higher than expected, which can increase your costs over time. Choosing the right stop-loss structure, monitoring claims, and adjusting your plan design at renewal are all important. We help you understand these trade-offs before you move away from a fully insured plan.
Still Have Questions About Funding Your Group Health Plan?
Every employer is different. If you are unsure whether level-funded or self-funded coverage is right for your business, we are happy to review your claims history, budget, and goals and talk through your options.
Songer Insurance helps employers across West Virginia evaluate group health funding strategies and choose the right mix of benefits and risk protection.
Frequently Asked Questions About Working With Songer Insurance
How We Help Employers With Funding Strategies
We act as an extension of your HR and leadership team—helping you compare carriers, funding arrangements, and plan designs so you can make informed, long-term decisions.
We gather your current plan and claims information, model fully insured versus level-funded and self-funded options, and present side-by-side comparisons. We explain the numbers and contract details so you can see the real-world impact on your budget and employees.
Yes. We work with carriers and administrators to help design plan options, contribution strategies, and wellness or cost-management programs. We can also assist with employee education so your team understands their benefits and how to use them effectively.
We stay involved throughout the year to review claims trends, address service concerns, and prepare for renewal. For level-funded and self-funded clients, ongoing monitoring is important to keeping the plan on track.
In most cases, our compensation is built into the carrier or administrator arrangement, so you receive strategic support and ongoing service without separate consulting fees. We will always be transparent about how we are compensated.
Contact Us About Level-Funded & Self-Funded Plans
READY TO GET STARTED?
Get Help With Level-Funded & Self-Funded Group Health Plans
If your fully insured premiums keep climbing, it may be time to explore alternative funding strategies. We will help you compare options and decide whether a change makes sense.
Our Location
330 Haper Park Suite A. Beckley, WV 25801
Our Phone
304-252-2158
Mail Address
info@songerinsurance.com
Talk With a Local Group Health Advisor
Schedule a conversation with Songer Insurance in Beckley, WV to review your group health plan and funding options. We are here to support employers across West Virginia.
OUR TESTIMONIAL
⭐ 100+ Local Google Reviews ⭐
See what real clients across West Virginia are saying about their experience with Songer Insurance.
Songer Insurance showed us the differences between fully insured and level-funded plans in plain language. We felt confident making a change that improved benefits and stabilized our costs.
David L., Oak Hill WV
CUSTOMER
Steven helped our company evaluate several self-funded and level-funded options and guided us through the implementation process. The ongoing support has been excellent.
Patricia W., Princeton WV
CUSTOMER
Professional, responsive, and strategic. If you are considering a new approach to funding your group health plan, Songer Insurance is a great partner.
Mary S., Beckley WV
CUSTOMER
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