Employee Benefits
Unveiling the Key Differences between Level Funded and Self Funded Plans
Discover the differences between level-funded and self-funded employee health insurance plans.
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The Centers for Medicare & Medicaid Services (CMS) announced earlier this month that plans sold on the Health Insurance Marketplace (Marketplace) will receive quality ratings using a five-star system (with 5 stars representing the highest quality plan). CMS has been piloting the five-star rating system for plans sold on the Marketplace in Michigan, Montana, New Hampshire, Virginia and Wisconsin, and it will expand it to all plans sold on the Marketplace for the coverage year beginning in 2020.
The intent of the new quality rating system is to help consumers more easily pick a plan that meets their needs. Plans will be rated based on three categories:
1. Member experience – Based on surveys of member satisfaction with:
2. Medical care – Based on how well the plans’ network providers manage member health care, including:
3. Plan administration – Based on how well the plan is run, including:
All health plans ratings will be calculated the same way, using the same information sources. However, in some cases, a plan sold on the Marketplace may not have a rating. This doesn’t necessarily mean the plan has a low-quality rating. The lack of a star rating may be the result of the plan being newly offered or having low enrollment.
Discover the differences between level-funded and self-funded employee health insurance plans.
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IXSolutions brings over 30 years of combined experience to the market as Employee Benefits Consultants. We’ve been bringing creative solutions and alternatives to the market since the inception of the Affordable Care Act.
Today, we work with companies, individuals, and Medicare eligible individuals to provide solutions to the complex insurance industry. We are a trusted partner to thousands of clients, brokers, and associations across the country.
