Level Funded group Health
Pay for your own group's health, not everyone else's
The option healthy groups
often never hear about.
Smarter.
Fairer.
Rewards good health.
How we got here
2014
The Affordable Care Act required small group plans to price coverage using community rating, not a specific group's own health.
Healthy groups started paying to help cover the cost of less healthy groups in the same pool.
2018 to 2025
Level Funded adoption among small firms climbed from 6 percent to 37 percent.
Healthy groups found a way to base pricing on their own claims experience instead.
What this means for your business
Level Funded premiums are based on your specific group's claims experience, not the entire insurance pool.
Moving from a 60 percent to a 70 percent actuarial value plan can raise your premium by up to 22 percent, so knowing exactly what you are paying for, and why, matters.
One client's own renewal mailer from their previous carrier showed savings up to 30 percent on a matched, gold-to-gold plan comparison, a real result, not a typical one.
Q: What is Level Funded Group Health insurance?
A: A funding model where your group's premium is based on your own group's health and claims experience,
not pooled with every other group your carrier insures.
Q: How is it different from Traditional Group Health?
A: Traditional premiums are based on the entire insurance pool.
Level Funded pricing is based on your specific group's health.
Q: Does Level Funded carry more risk than Traditional coverage?
A: No. Stop-loss protection covers claims above a set threshold,
keeping the predictability of Traditional coverage in place while still
allowing the group to benefit from a healthy claims year.
Q: Is every group a good fit for Level Funded?
A: Not automatically.
A review of your group's claims history and current health profile determines
whether it's a strong fit.
Not sure if Level Funded is the right fit, or if Traditional coverage covers what you need?
Let's talk.
General Disclaimers/Disclosures to Satisfy the Attorneys/Legal Dept
I am a licensed Insurance Agent in any state I do business in
I am not an attorney, I do not give legal advice but I know some if you need one
I am not an accountant, I do not give tax advice but will direct you to talk to one and have some I can introduce
I am not a doctor, I do not give medical advice but I can help look up doctors in your network
I represent multiple carriers so I have more options for you
I mainly do virtual appointments, I live on top of a mountain in the middle of nowhere (about 45 minute to Crossville...you know, the BIG CITY ;)
And an hour north of Chattanooga TN
Some policies are guaranteed issue, some require underwriting
Your privacy is important to me, if you are referred to me by someone, I might tell them "Thank you for the referral" but will not use your name or discuss our conversation
Not all products are available in all states
We do not offer every plan available in your area. Currently we represent 4 organizations which offer 26 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options
AgentDavidCares.com does not provide tax advice. Tax savings vary by individual. Please consult your accountant or tax advisor.
Updated 08/23/2026
© Copyright 2026. AgentDavidCares.com. All Rights Reserved.