Funding arrangement options tailored to your needs
With Kaiser Permanente, you have a range of funding arrangement options to choose from. We can help you create a health care solution for your employees based on your needs and overall benefits strategy. Regardless of which solution you choose, you’ll enjoy coordinated, cost-effective care that focuses on better health outcomes for your employees.
Learn more about our funding arrangement options below.
Fully insured: For any group size in any region
With our fully insured plans, small and large groups get the financial security of a set monthly rate and Kaiser Permanente assumes the financial risk. The monthly premiums are established before each contract period and protect you from unexpected claims costs. This makes financial planning easier, since you won’t need to cover large fluctuations in your health care costs.
How fully insured works
You pay a predictable monthly premium (and get robust reporting and consulting if you have more than 150 employees). We assume all financial risk by paying your employees’ claims and taking responsibility for surpluses and deficits.
Self-funded: For large groups with 1,000+ employees
Improved cash flow and flexibility aren’t mutually exclusive. Self-funding makes it easy to create a benefits package that meets your needs. With this option, you assume financial risk and have more flexibility around benefit design to control claims costs. This option also offers streamlined administration, the expertise of a knowledgeable third-party administrator, and transparent, in-depth reports that help you understand your employees’ health care costs.
How self-funded works
You pay a monthly PEPM (per employee per month) service administration fee instead of a premium and receive comprehensive monthly reporting for management of your plan. Your organization isn’t subject to certain taxes and state mandates, and you retain savings from lower-than-expected claims. We provide your members with the same best-in-class experience as a fully insured plan.
Level Funded: For groups with 5 to 500 enrolled employees*
Level Funded is a self-funded solution that gives small and midsize businesses financial protection and more visibility into health care costs. It also provides access to Kaiser Permanente’s value-based integrated care model, which delivers healthier outcomes while making care more affordable.
How Level Funded works
As a stable, predictable option, our set monthly payment includes fixed costs (administrative services and stop-loss insurance) and claims costs, with the opportunity for a credit if claims costs are lower than expected.
Risk-sharing arrangement (RSA): For large group employers
Kaiser Permanente’s risk-sharing arrangements offer you the opportunity to benefit from surplus sharing through lower health care use, with the peace of mind that comes with a fully insured plan. Costs are linked to actual expenses, so you can benefit from favorable claims without taking on the full risk of your health care costs.
How risk-sharing arrangements work
You pay a predictable premium each month, while selecting the amount of financial risk you’re willing to take above and below that total monthly amount (your risk-sharing corridor). At the end of the year, your total costs are reconciled against your total earned premium, based on the details of each arrangement. You may receive a surplus if your plan performance is better than expected. In the event of a deficit, you may owe Kaiser Permanente within the agreed-upon shared risk.
For groups with fewer than 1,000 enrolled members, Kaiser Permanente offers a Surplus Only option. With this option, if your total expenses for the year are less than your total premium, you may be eligible to share in a portion of the surplus.
Learn about other product offerings
Get preventive care services at little or no cost to you, and online features that let you manage your care.
Give your employees more choice and flexibility when they need care.
Pair a Kaiser Permanente health plan with one of our Health Payment Accounts.
Find the right plan for your business 1-877-305-7933
Footnotes:
*For enrolled employees currently in Colorado and Georgia (and in Mid-Atlantic States and Northwest in 2025).