Funding models
Level-funded plan
A hybrid between fully-insured and self-funded. Employer pays a fixed monthly amount that bundles projected claims, TPA fees, and stop-loss premium. At year-end, if claims plus expenses came in under the funded amount, the employer typically receives a refund. Suits 25-150 employee groups.Last reviewed: · TMRW Benefits is a benefits brokerage, not a tax or legal advisor. Consult a CPA or attorney for situation-specific guidance.
More in Funding models
Fully-insured plan
Carrier takes claims risk. Fixed premium.
Self-funded (self-insured) plan
Employer pays claims directly. Stop-loss limits risk.
Stop-loss insurance
Caps employer exposure on catastrophic claims.
Specific stop-loss
Caps individual-claimant exposure.
Aggregate stop-loss
Caps total annual group claims.
MEWA (Multiple Employer Welfare Arrangement)
Health plan covering employees of multiple unrelated employers.
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