Plan types & funding

Level-Funded Health Plans

Predictable payments with a shot at a refund

Michael Furman
Reviewed by Michael Furman, COO — 24 years in insurance · MDRT Top of the Table
NovaVida Group licensed team · Updated August 2026

A level-funded plan lets a small business pay a fixed monthly amount — like a fully-insured premium — while functioning like a self-funded plan underneath. If your team’s claims come in low, you can get a refund at year’s end.

How the Money Works

Your fixed monthly payment covers three things: a claims fund, administration, and stop-loss insurance that caps your exposure if claims spike. If the group uses less than expected, a portion of the unused claims fund can come back to you. If claims run high, stop-loss protects the business — your monthly cost stays level for the year.

Fast Facts

  • One steady monthly payment, easy to budget
  • Bundles claims funding, admin and stop-loss insurance
  • Potential year-end refund if claims are low
  • Often a good fit for small, healthier groups

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Quick answers

Frequently Asked

Who should consider a level-funded plan?

Small businesses with a relatively healthy team that want predictable costs and the chance to share in savings. Underwriting looks at the group’s health, so results vary — we’ll compare level-funded against fully-insured quotes for you.