Should we consider self-funding or level-funding as a cost-control strategy?

Yes. Self-funding and level-funding can both help employers manage healthcare costs more effectively than fully insured plans. They offer greater control, transparency, and flexibility, though each comes with its own balance of financial risk and administrative responsibility.

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• Fully Insured (Traditional Model): You pay fixed monthly premiums to a carrier, which assumes all claims risk. It’s simple and predictable, but you have little control over annual rate increases or insight into what drives your costs.
  
  • Best for: Small teams prioritizing predictability with minimal admin work.
• Self-Funded (Maximum Control, Higher Risk): Employers pay actual claims as they occur and purchase stop-loss insurance to cap catastrophic costs.
  
  • Pros: Full transparency, potential savings if claims are low, and flexibility to customize benefits.
  • Cons: Higher financial exposure if claims spike; requires strong cash flow and administrative support.
  • Best for: Mid- to large-size employers (100+ employees) seeking long-term cost control.
• Level-Funded (A Predictable Hybrid): Employers pay a fixed monthly amount that covers projected claims, admin costs, and stop-loss protection. If claims are low, you may receive a refund or credit.
  
  • Pros: Predictable costs, access to claims data, and potential savings.
  • Cons: Some exposure to claims risk and possible participation requirements.
  • Best for: Small to mid-size employers (25–200 employees) looking for balance and transparency.
• Where primary care fits in: No funding model can fully control costs without strong preventive care. Built-in, $0 access to primary and mental health care reduces ER visits, hospitalizations, and unmanaged chronic conditions (the main drivers of premium growth).

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Vitable pairs seamlessly with both self-funded and level-funded plans, offering flat-rate, $0 access to primary, preventive, and mental health care. This structure stabilizes costs, reduces claim frequency, and supports a healthier workforce, without adding complexity.

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• Self-funded: Maximum control and transparency, higher financial exposure.
• Level-funded: Predictable costs, savings potential, and flexibility.
• Fully insured: Simple but limited control and higher renewal volatility.

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No matter which structure you choose, pairing it with Vitable’s primary-care-first model creates the cost stability and engagement that traditional plans can’t.

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