UnitedHealthcare

A different kind of health plan
that may deliver a refund*

It’s possible with a level funded health plan from UnitedHealthcare. That’s because level funded plans are based on your actual plan participants’ medical claims — so if they’re lower than expected, your health plan may get a surplus refund at year-end.* In fact, 36% of UnitedHealthcare’s level funded business customers received a refund,* the average of which was

Designed to help you get back to business faster

With a level funded health plan, your business: 

May be exempt from many Affordable Care Act regulations and state premium taxes

Has access to up-to-date reporting on your group's claims costs, network utilization and more

Is free to choose from a variety of plan designs and provider networks

Is protected from unexpected high medical claims with stop loss insurance

May be eligible for a surplus refund for your health plan at the end of the year if medical claims are lower than expected*

Can offer wellness programs and services designed to help plan participants get healthier at no additional cost

Programs and services built to help plan participants get healthier

Real Appeal®

With online coaching, a Success Kit and more, this program is designed to help participants lose weight and keep it off.

24/7 Virtual Visits

Plan participants can connect with a doctor — anytime, anywhere — for nonemergency care right from their computer or mobile device.**

$0 Kids Copays

Available with copay-based plan designs, $0 copays for kids’ primary care physician visits may help lower families’ out-of-pocket costs.1

Frequently asked questions

Yes, but they differ from a purely self-funded arrangement in important ways. Level funded plans provide additional protection from large catastrophic medical claims with a stop loss insurance policy. So you won’t have to pay more for medical claims throughout the year or at the end of your plan year, even if you have high medical claims costs.

Your costs don’t change month to month. Level funded plans lock in a fixed monthly payment for the plan year, regardless of your actual plan participant medical claims.

Your fixed monthly payment goes toward 3 things:

  1. Your health plan that pays plan participants’ covered medical expenses. Every month, when you send in your regular payment, part of it is set aside to pay for your plan participants’ covered medical bills. In other words, when your plan participants go to the doctor, their eligible medical claims are paid straight from the money that was set aside. If the money that goes in during the year is more than what comes out, your health plan may get money back after you renew your plan. If your plan participants have low medical claims, that refund could be substantial.
  2. Administrative services for your plan, including plan participant onboarding, customer service, billing and medical claims processing, all done for you.
  3. A stop loss insurance policy that protects your business if medical claims are higher than expected.

Every month when you make your payment, part of it goes toward stop loss insurance. This provides coverage for unexpected high medical claims.

Yes. And they’re included in your plan at no additional cost to you or your plan participants. Because they’re designed to help your plan participants get healthier, they may help lower medical claims and provide more savings for everyone.

The 2 biggest reasons: more potential savings and more control. With a fully insured plan, your health care costs are based on a wider pool, including businesses that may have higher overall medical claims. A level funded plan is based only on your plan participants’ medical claims. So when their medical claims are lower than expected, your health plan may get a surplus refund at year-end.*

And because a level funded plan is a type of self-funding, your business may be exempt from many Affordable Care Act regulations and state premium taxes that can be costly for some small businesses.

With a variety of plan designs and provider networks available, a level funded plan can be truly customized to fit your business. It’s worth your time to compare these health plans with your traditional (fully insured) plan to see which may be the better fit.

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