How Level Funded Works

4 Reasons Grocers Choose SMB

Employee Benefits Tailored to Your Grocery Business & Workforce

How Level Funded Works

Attract Top Talent · Comply With ACA · Manage Benefits Expenses

Caps Risk • Consistent Plan Costs • Handles Benefits Administration for You

The Grocer’s Level-Funded Program combines the best features of traditional group health insurance and self-funded plans.

Employer’s Claim Fund

  • You set aside cash for projected healthcare costs in your Employer’s Claim Fund
  • When employees have covered medical claims, they are paid out of your employer’s claim fund

Excess Stop-Loss Coverage

  • You will never be obligated to pay more than the monthly pre-determined set amount of your employer’s claim fund
  • If your claims exceed the amount in your employer’s claim fund, your “excess stop-loss” policy will cover any additional eligible claims. At the end of the policy year, we’ll review your claims vs the employer’s claim fund. One of two things will happen:
  • If your claims are less than what you set aside, you keep the remaining funds
  • Your excess stop-loss coverage kicks in if your claims exceed what you set aside

Monthly Plan

  • You pay consistent monthly plan costs

Benefits Administration

  • We’ll handle the administration such as paying claims through a TPA