01 Is this just another self-funded experiment? +
No. This is structured risk with financial backing.
Level Health is a level-funded structure supported by A-Rated AM Best stop-loss carriers. Maximum liability is defined, risk is protected, and underwriting is disciplined.
This is not speculative risk transfer. It is a proven framework built on actuarial discipline and carrier-grade protection.
02 What happens if claims spike? +
Risk is the risk. That is what stop-loss is for.
Stop-loss protection caps exposure, and maximum annual liability is defined upfront. There is no carrier margin hidden in premium that suddenly expands at renewal.
If claims increase, the data explains it. If claims perform, surplus may return. Renewals are grounded in experience, not guesswork.
03 Won't members get confused with something different? +
Operationally, it feels completely familiar.
ID cards, networks, and claims processing follow familiar patterns. The member experience is recognizable and intuitive.
The difference is in economics and incentives, not in member chaos. Tier 1 is intentionally designed around direct-contracted systems in local markets.
04 Is this just reference-based pricing in disguise? +
No. These are negotiated agreements, not repriced claims.
In local markets, Tier 1 is built on direct-contracted hospital systems with clear negotiated terms.
Outside local markets, PPO structures preserve access and continuity. This is not a reimbursement gamble.
05 Fully insured feels safer. +
Fully insured feels predictable, but the carrier controls the math.
Level Health provides A-Rated stop-loss protection, defined maximum liability, and a transparent funding structure without surrendering visibility.
CFOs keep security while gaining clear insight into what is actually driving costs.
06 Is this complicated to install? +
The framework is pre-engineered. You are deploying, not assembling.
Plan designs are standardized and vendor integrations are established. You are not assembling a custom stack from scratch.
Consistency drives cleaner implementation, faster onboarding, and fewer surprises at go-live.
07 What if pharmacy blows up the plan? +
Pharmacy is fully transparent. The black box is gone.
100% of rebates are passed through and there is no spread pricing hidden in the structure.
This removes one of the largest opaque cost drivers in traditional plans.
08 Why not just stay fully insured? +
Because fully insured bundles margin invisibly and keeps employers in the dark.
Fully insured plans control renewal math, retain underwriting leverage, and capture surplus when claims perform. The economics optimize for carrier outcomes.
Level Health separates those components so brokers can explain renewals with data, not apologies.
Have a question we did not cover?
Our team can walk through underwriting, implementation, pharmacy model design, and renewal strategy in detail.