1.How well does your group size (typically 10–200 employees) align with the typical level-funded market sweet spot?
Level-funded plans are most common for groups of 10–200 employees. Smaller groups face higher stop-loss costs relative to premium savings.
2.How favorable is your group's recent claims history and loss ratio relative to fully insured rates?
Groups with loss ratios below 80% are typically strong level-funded candidates. High-cost claimants may be lasered by stop-loss carriers.
3.How thoroughly have you reviewed the stop-loss contract terms, including specific and aggregate attachment points, lasering provisions, and run-in/run-out coverage?
Stop-loss contract quality varies significantly. Laser provisions can exclude high-cost claimants from coverage, creating unexpected employer liability.
4.How well does your organization's cash flow support the level-funded monthly payment structure and potential stop-loss settlement timing?
Level-funded plans require consistent monthly payments and may have settlement timing that affects cash flow planning.
5.How experienced is your broker or advisor in level-funded plan design, carrier selection, and stop-loss negotiation?
Level-funded plan quality depends heavily on advisor expertise in stop-loss markets, carrier evaluation, and claims run-out management.
This tool provides educational decision support only. Results are not legal, tax, actuarial, or insurance advice. Validate all outputs against current plan documents, applicable law, and qualified professional guidance. Scoring version 1.0 · Reference year 2026.
