Kaiser Permanente Level Funded is available for businesses in Colorado, Georgia, Maryland, Virginia, and Oregon.
Kaiser Permanente Level Funded is available for businesses in Colorado, Georgia, Maryland, Virginia, and Oregon.
Level Funded offers small-to-midsize employers the predictable features of a fully insured plan but with the cost savings opportunities and flexibility of a self-funded plan. Level Funded offers more insight into health care costs and an opportunity for cost savings (through a potential surplus) if claims are less than expected.
Employers can benefit from predictable monthly payments covering claims funding, administrative services, and stop loss insurance. If claims are lower than expected, then renewing Level Funded businesses receive a surplus credit toward a future invoice. Monthly total costs are based on enrollment and remain stable. Stop loss insurance protects against unexpected claims costs.
Level Funded is a self-funded plan, but predictable monthly payments (including claims and administrative costs) and stop loss insurance protect an employer from unexpected claims costs. This is what keeps monthly payments ‘level.’
Our value-based care model is designed to identify potential health risks and diagnose existing health issues before they become serious and costly. Through our integrated, proactive approach, we help your employees better manage chronic conditions and serious illnesses — or even avoid them altogether.
Paired with our value-based care model, Level Funded creates cost-saving opportunities for employers, potential for surplus credit, and more insight into health care costs. Also, stop loss insurance provides risk mitigation.
Kaiser Permanente Level Funded is for small and midsize businesses with 5 to 100 enrolled employees. It is ideal for businesses with a stable and healthy workforce who are looking for budget predictability and the potential for cost savings. As a self-funded plan, Level Funded requires more administrative oversight for an employer. The employer must be comfortable with assuming additional duties and added financial risk.
Kaiser Permanente Level Funded is available for businesses in Colorado, Georgia, Maryland, Virginia, and Oregon.
We work hard to keep your employees healthy. If they do get sick, Kaiser Permanente makes it easy for them to get the care they need, when and where they need it. Options include in-person routine and specialty care, 24/7 virtual care, urgent, and emergency care. We also prioritize personalized treatment plans tailored to individual needs.
You will also have peace of mind because part of your monthly payment goes to stop loss insurance, which covers unpredictable medical and pharmacy claims above set thresholds.
Kaiser Permanente can administer a variety of plans and will work with you to select plan designs to meet your business needs. Go to levelfunded.kp.org to review our Level Funded Portfolio or contact your Kaiser Permanente representative to find a plan that is right for you.
We can administer plans within our service area, as well as out-of-area plans. Please discuss your needs with your Kaiser Permanente representative, and they can provide you with available options.
If your company surpasses 100 employees, Kaiser Permanente will not require an immediate switch to another funding option. However, if your business growth exceeds the underwriting guidelines specified in the quote proposal, Kaiser Permanente Underwriting reserves the right to adjust the rates. Kaiser Permanente underwriting will work with you during renewal to determine appropriate plan options.
Yes. Employers can choose from these options:
Note: The pay-to-provider option is not available with Kaiser Permanente Level Funded.
Renewing employers who are eligible for a surplus will receive a credit up to 6 months after the contract period ends. The surplus amount appears as a credit to the claims funding portion of a future invoice.
Kaiser Permanente provides a monthly standard set of financial reports to Level Funded Plan Sponsors. The report includes enrollment adjustments, medical and pharmacy claims year-to-date, stop loss claims, and the large claims report.
We will contact businesses at least 60 days before the plan effective date.
ISL offers vary by state. Please contact your Kaiser Permanente representative to discuss your options.
Yes, prescription claims are included. Brokers and employers can check the impact of drug costs based on various Level Funded plans through our website. Choose members in the upper right, then select your region and scroll down to pharmacy options. Be sure to select Self-funded/Level Funded on the drug formulary page.
Kaiser Permanente Level Funded uses 4 tiers including Eligible Employee (EE), Employee + Spouse (ES), Employee + Spouse + Child/Children (ESC), Employee + Child/Children (EC).
Implementation resources are provided to make the transition easy for you. We know changing health plans can be challenging, but our new member onboarding program will help make the transition to Kaiser Permanente seamless for your employees.
The following forms are required:
We will also need the employer to review and sign a BAA with KPIC, the ASO agreement, and Cigna provider agreement. Your Kaiser Permanente representative will help you with this process.
The Kaiser Permanente Level Funded member experience is like a fully insured member experience. Here are the differences: