As an alternative to traditional, Affordable Care Act (ACA) health plans, Blue Cross and Blue Shield of Kansas offers BlueEdge level-funded plans. Designed for groups with 3-50 employees, BlueEdge plans are small business friendly, designed to help you share in the savings good health brings.
Basically, level-funded means your payment is capped at a set amount. Blue Cross will help you evaluate your maximum claims risk, then blend additional insurance coverage that begins paying after that amount. As a result, you’ll have peace of mind knowing your employer group can avoid unexpected high fees and can more accurately predict your healthcare budget.
How is level-funding different than traditional ACA plans?
- Rates reflect your group’s claims experience. With a traditional ACA plan, rates reflect the experience of the entire small group market.
- Risk is capped through additional coverage. With a traditional ACA plan, risk is capped through your fully-insured premium.
- Reimbursement is possible when claims are lower than expected. With a traditional ACA plan, risk and reward is pooled and shared among the entire pool.
With a level-funded plan, the fixed employee monthly premium is made up of three parts:
- Claims costs. This covers the medical and pharmacy claims made by employees and their dependents. It is the maximum amount you will have to pay for any claims.
- Administration fees. This covers claims processing, customer service and billing.
- Built-in additional coverage. Also known as stop loss, this pays for costs above the annualized claims expense. It is financial protection for unexpected claims and ensures there are no additional expenses.
A level-funded plan may work for you if:
- You’re a startup, small or midsize business with 5 to 50 employees who are generally in good health.
- You want to give your employees more options to fit their budgets and their healthcare needs.
- You want more flexibility and predictability from year to year.
Let us help.
Browse our BlueEdge level-funded plans and talk to one of our Small Group Account specialists to see if it’s the right plan for you and your employees. You can call us at 866-481-5783, Monday through Friday, 8 a.m. to 4:30 p.m., or email your questions to firstname.lastname@example.org.