Group Health Optimization

Stop Overpaying for Group Health.
Switch to Level-Funded.

Most small employers on fully-insured group health are overpaying 20–30% and don't even know it. Level-funded plans deliver the same coverage at a lower cost — with full claims visibility and potential year-end refunds.

Fully-Insured Group Health Is Costing You More Than It Should

When you buy a fully-insured plan from a carrier like Aetna, CIGNA, or BlueCross, you're paying a fixed premium that bundles actual claims, carrier profit margin, admin fees, and reserves — all hidden inside one number. If your employees are healthy, the carrier keeps the surplus. You get nothing back.

Fully-Insured vs. Level-Funded

✗ Traditional Fully-Insured

Fixed premium — carrier keeps all surplus if claims are low
Zero claims transparency — you never see where money goes
No refund if your group is healthy
Carrier sets renewal rates with limited justification
Premium increases year over year regardless of your claims history
No control over plan design beyond standard options

✓ Level-Funded Plan

Fixed monthly cost — predictable, like fully-insured
Full claims data — see exactly what your group spends
Year-end refund if actual claims are below the funded level
Renewals based on YOUR claims history, not the entire carrier pool
Stop-loss insurance protects against catastrophic claims
Flexible plan design — customize benefits to fit your workforce

Three Steps to Smarter Group Health

01

Benefits Audit

We review your current group health plan, premium history, and employee census. Most employers are surprised by how much they’re overpaying versus what a level-funded alternative would cost.

02

Custom Plan Design

We design a level-funded plan around your specific workforce — employee count, age range, location, and benefit priorities. Stop-loss coverage is layered in to cap catastrophic risk.

03

Seamless Transition

We handle the carrier selection, enrollment, and ongoing administration. Your employees see no disruption — same or better coverage, lower cost to the business.

Level-Funded Plans Work Best For Employers With 5–200 Employees

If you currently offer fully-insured group health and have a relatively stable, moderately healthy workforce — there is almost certainly a level-funded alternative that saves you money. The sweet spot is 10–100 employees, but plans are available for groups as small as 5.

5–25 Employees

Small group level-funded carriers. High-deductible compatible. Often paired with HRA or HSA.

26–100 Employees

Mid-market sweet spot. Full claims data, highest refund potential, most carrier competition.

101–200 Employees

Large group level-funded or partially self-funded with stop-loss. Maximum plan customization.

Frequently Asked Questions

Is a level-funded plan riskier than fully-insured?
No. Level-funded plans include stop-loss insurance that caps your liability at a fixed amount per employee and in aggregate. Your maximum exposure is predetermined — just like a fully-insured plan — but your upside is much better if your group stays healthy.
What happens if we have high claims one year?
Stop-loss coverage kicks in. If an individual employee has very high claims (typically above $20k–$50k threshold), the stop-loss carrier pays the excess. If total group claims exceed the aggregate, that is also covered. You never pay more than your fixed monthly amount.
Can I offer the same benefits my employees have now?
Yes. Level-funded plans can mirror or improve upon your current benefit design — same network, same deductibles, same rx formulary. Employees typically see no change in their day-to-day experience.
How does this work with our retirement plan?
Perfectly. Kandelaki Solutions can manage both your group health and retirement plan together — giving you a unified benefits package, single point of contact, and coordinated compliance for all state and federal requirements.
Does this affect our state retirement mandate compliance?
Group health and retirement mandates are separate. Switching to a level-funded health plan has no impact on your state retirement mandate obligations. If you need both solved, we handle them together.

Ready to See What You Could Save?

Most employers see 15–30% savings in the first year. The review is free and takes 20 minutes.

Book Your Free Benefits Review →

Alex Kandelaki, ChFC, CLU, CPFA — Founder & CEO, Kandelaki Solutions — (848) 400-4886