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Level-Funded Health Plans: A Broker’s Guide to Tackling the Escalating Healthcare Cost Crisis


Level Funded Health Plans

In today's fast-evolving landscape of healthcare, insurance brokers find themselves at the forefront of the battle against skyrocketing healthcare expenses. Employers, seeking financial stability and flexible options, are turning to brokers for guidance. With a projected 7% increase in median healthcare costs for 2024, brokers must be well-equipped to offer solutions that address both affordability and adaptability. This is where level-funded health plans come into play as a powerful tool in the broker's arsenal, providing a sustainable and customizable path forward. In this comprehensive guide, we delve into the challenges brokers face, the drivers of healthcare cost inflation, and how level-funded health plans can be the beacon of hope in these turbulent waters.


The Challenge: Soaring Healthcare Costs


The Inflation Equation


The healthcare cost landscape is evolving rapidly, with a looming 7% cost increase projected for 2024. This follows a similar increase in the preceding year, according to data from the International Foundation of Employee Benefit Plans (IFEBP). For brokers, this trend is cause for concern as it directly impacts their clients - employers. The IFEBP survey reveals that U.S. corporate employers foresee a median health care cost increase for the second consecutive year, putting immense pressure on their budgets.


Specific Cost Drivers


A myriad of factors contributes to this alarming cost spike, with chronic conditions, catastrophic claims, and expensive treatments and therapies taking center stage. The IFEBP survey pinpoints chronic conditions as a primary driver of costs, with 22% of employers emphasizing this issue. The urgency for a sustainable solution is evident as the healthcare landscape becomes increasingly complex.


Balancing Act: Employee Benefits vs. Costs


Employers face a delicate balancing act between providing attractive benefits to remain competitive in labor markets and managing rising healthcare costs. Shifting the financial burden to employees is a risky proposition, making it essential for brokers to offer viable alternatives that ensure employees receive the care they need while keeping costs under control.


Level-Funded Health Plans: The Broker's Strategic Weapon


A Rising Star Among Options


Level-funded health plans have emerged as a game-changer in the healthcare benefits arena. According to the Kaiser Family Foundation 2022 Employer Health Benefits Survey, 42% of small businesses adopted level-funded plans in 2021, marking a remarkable increase from just 7% in 2019. This surge in popularity underscores their growing appeal and potential as a solution.


Balancing Act: Costs and Flexibility


Level-funded plans strike a harmonious balance by incorporating features from both fully insured and self-funded plans. They offer the stability of fixed premiums while allowing for flexibility in plan design. For brokers, this flexibility can be a compelling selling point, aligning with employers' needs for predictable costs and customizable benefits.


The Case for Cost Containment


One of the standout advantages of level-funded plans is their ability to enhance cost management through transparent claims data. This data serves as a valuable resource for future premium negotiations and educating employees about cost-effective healthcare choices. Brokers should emphasize this advantage when presenting options to their clients, highlighting the potential for long-term cost savings.


Compliance Demystified


While level-funded plans bring added responsibilities concerning compliance, brokers can ease this burden by guiding employers through the intricacies. This reinforces the pivotal role brokers play in the benefits selection process, offering expertise and support in navigating compliance hurdles.


Customization and Suitability: Tailoring Plans to Fit Your Clients


The Small to Midsize Business Sweet Spot


Level-funded plans are particularly well-suited for small to midsize businesses seeking a blend of cost efficiency and customization. Brokers can carve out a niche by specializing in advising these types of companies, providing tailored solutions that align with their unique needs and budgets.


Versatility for Larger Clients


Larger enterprises should not be overlooked, as level-funded plans can strategically target specific classes of employees within these organizations. Brokers can guide larger clients in using these plans effectively to address the diverse needs of their workforce.


Utilization Insights


Level-funded plans provide comprehensive utilization data, enabling more targeted cost-containment strategies. Brokers can add significant value by helping employers analyze this data, turning it into actionable insights that benefit both the company and its employees. This data-driven approach contributes to long-term cost savings and better healthcare outcomes.


The Broker’s Role: Beyond Intermediary


More Than Just Insurance Sales


As a broker, you are not merely a salesperson but a trusted advisor. Your role extends beyond recommending insurance plans; it encompasses providing peace of mind and ensuring financial sustainability for your clients. Leveraging your expertise to navigate compliance challenges and helping employers make sense of utilization data sets you apart from the competition.


Crafting a Holistic Healthcare Strategy


Your mission is not just about selecting a health plan; it's about crafting a holistic healthcare strategy that resonates with your clients' needs while maintaining cost efficiency. This strategic approach enhances the value you bring to the table, demonstrating your commitment to your clients' well-being and financial stability.


The Future is Level-Funded


Meeting Ongoing Challenges


The persistent challenges posed by escalating healthcare costs underscore the value of brokers who can adeptly guide their clients toward adaptable and cost-effective solutions like level-funded health plans. These plans offer an optimal balance between cost containment and plan flexibility, positioning brokers and their clients for mutual success.


Be the Go-To Broker


By making level-funded health plans a cornerstone of your advisory portfolio, you become the go-to broker who not only understands the market but also knows how to adapt to its ever-changing dynamics. Your ability to offer sustainable solutions in a rapidly evolving healthcare landscape will be in high demand.


About Fundamental Care®


Fundamental Care® offers Affordability-Based Medical Plans designed to meet the unique needs of various niche markets, including small businesses and their employees, part-time and hourly workers at enterprise-level companies, independent contractors, gig-economy workers, and association members. Our mission is to provide access to unique and affordable health insurance benefits on a guaranteed issue basis. Learn more about Fundamental Care® and how we can help your clients navigate the challenging healthcare landscape.


About Coterie Advisory Group, Inc.


Fundamental Care® is managed by Coterie Advisory Group, Inc., an insurance program manager and national marketing agency. Our founders are a team of insurance and benefits professionals with extensive experience in the benefits marketplace. They have held leadership and executive roles at multiple insurance carriers, agencies, and platform administrators. Our drive has helped thousands of service-industry employers and millions of individuals obtain quality, affordable care. Coterie focuses on Affordability-Based Medical Plans and holds life and health insurance licenses in all 50 states.


In conclusion, the challenges posed by rising healthcare costs demand innovative solutions, and level-funded health plans offer a beacon of hope for employers seeking affordability and flexibility. Brokers who embrace these plans and tailor them to their clients' needs will not only thrive in the ever-changing healthcare landscape but also play a pivotal role in securing the financial well-being of their clients and their employees.



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