A level-funded health plan is a hybrid financing arrangement combining a relatively small self-funded component with stop-loss insurance. It has grown particularly popular with small and mid-market employers who want some of the advantages of self-funding without the full cash-flow unpredictability of a traditional self-funded plan.
37% of covered workers at firms with 10 to 199 employees are now covered by a level-funded plan, per KFF's 2025 survey. If claims run below the funded amount for the year, the employer may receive a refund of the surplus. Several state regulators have raised concerns that level-funded plans, which can use health status in underwriting, draw healthier groups away from the ACA-regulated small-group risk pool.
37% of covered workers at firms with 10 to 199 employees are covered by a level-funded plan as of 2025, per KFF's survey.
Yes. If actual claims run below the funded amount for the year, the employer may receive a refund of the surplus, which is one of the features that distinguishes level-funded plans from a traditional fully insured premium.
Every term here points to the same gap in healthcare access. See how the CareStation closes it.
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