Level Funded Premium A simple, predictable funding solution for large business employers

Selecting the right funding option for your company is a big responsibility. There are many factors to consider and options to choose. Are you looking for a simple solution to self-fund your medical plan? One that gives you predictable and easy-to-budget costs? One that limits your financial exposure? Then Level Funded Premium may be right for you.

What you can expect

  • Predictability: You'll have consistent payments month over month – no surprises
  • Savings: With a positive claims experience, you could benefit from a settlement refund at the end of the plan year
  • Simplicity: Choose any of Humana's standard plans and avoid dealing with customized benefits

How it works

Level Funded Premium is available with a unique type of self-funding to groups with 100 to 300 eligible employees. It can increase your cash flow through fixed monthly payments – giving you consistent and easy-to-budget cost.

Fixed monthly payments cover:

  • Administrative fees
  • Stop-loss premium
  • Claims funding

Level Funded Premium also limits your financial exposure to unforeseen costs. Because of the self-funded features, Humana will take care of any claims that go over the stop-loss limit. And, if your annual claims total is less than your funded amount, you'll receive a settlement refund at the end of the plan year.

You will also receive detailed monthly reports to help you manage your employee's benefits.

What is a Level Funded Premium Plan?

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level funded premium

Level Funded Premium offers three administrative options

1. Basic administrative services

  • Basic plan administration such as group set-up, paying claims, billing, and enrollment
  • Claim administration including all decisions regarding eligibility of claims for payment and working with members to resolve any claims issues
  • Medical management services including preauthorization for medical services, and case management for members who become hospitalized, are at risk for readmission, or who have special needs after discharge
  • Integrated medical behavioral healthcare uses clinical strategies like motivational interviewing, positive psychology, and a solution-oriented plan to address members with concerns that involve both medical and behavioral issues
  • Network access to our negotiated physician and facility discounts offered through Humana's network of contracted providers
  • COBRA administration for eligible employees
  • HIPAA compliance to protect the privacy of members' personal health information

2. Full administrative services

Includes the basic administrative services, plus these additional valuable programs

  • HumanaFirst® Nurse Advice Line – a toll-free, 24-hour health information line to call and speak with a registered nurse about illnesses or injuries
  • HumanaBeginnings® – helps mothers find out more about their pregnancy, follow their baby's development, and practice healthy habits along the way
  • Integrated chronic condition management

3. High administrative services

Includes the basic and full administrative services, plus these additional exciting programs

  • HumanaVitality® – a science-based wellness solution that encourages healthy behaviors to reduce long-term healthcare costs by rewarding members for improved health
  • Radiology Consultation – a program to educate doctors on the entire radiation treatment plan. Doctors can call a toll-free number or visit the website to initiate the consultation and schedule any CT, CTA, MRI, MRA, or PET procedure.
  • Telephonic counseling
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