Three steps to the right plan
One conversation starts it. One licensed agent runs the rest.
Share your census
Headcount, ages, ZIP codes, and your current plan if you have one. About ten minutes, no obligation.
See every route
We model fully insured, level-funded, self-funded, ICHRA, and QSEHRA against your census, with real carrier numbers side by side.
Pick, then hand it off
You choose the route and the plan. We handle carrier paperwork and enrollment, and stay on as your team’s contact all year. Carriers pay us, so it costs you nothing.
Start with your census →Three things drive the decision
Before any carrier quote matters, these three facts about your company narrow the field.
How many people you employ
Federal law draws a line at 50 full-time-equivalent employees. Cross it and the employer mandate switches on. Stay under it and you have no legal duty to offer coverage at all.
How healthy the group is
Level-funded and self-funded plans underwrite your group. A young, healthy team can save real money. A higher-risk group is often better off fully insured.
How much risk you’ll carry
A fixed premium buys predictability. Carrying part of the claims risk yourself can cut the real cost, if you can absorb a bad year.
The three ways to fund a plan
Whatever your size, a group health plan is funded in one of three ways. The difference is who carries the claims risk, and what that costs you.
Fully insured
A flat line: your cost never moves with claims. You pay for that certainty in most years, and the carrier eats the bad ones.
You buy the policy. The carrier owns the claims. The traditional route: a fixed premium, and the carrier takes all the risk. A terrible claims year is their problem, not yours. Predictable and simple, and because the insurer prices in that risk plus its margin, often the most expensive per dollar of coverage.
Level-funded
Level payments fund claims up to a cap. Spend less and the difference comes back. Spend more and stop-loss pays.
Self-insured underneath, predictable on the surface. The fast-growing middle path for smaller groups: a self-insured plan wrapped in stop-loss and a fixed monthly bill. Stay healthy and money comes back at year end. The catch: the group is medically underwritten, and a high-risk one can be declined or rated up.
Self-funded
Your cost tracks actual claims until stop-loss attaches. Good years are yours to keep, and so are the swings.
You run the plan and keep the good years. What most large employers do: pay actual claims, hire a third-party administrator to run the plan, and buy stop-loss to cap catastrophic cases. More risk and more work, and for a stable group usually the lowest real cost, with freedom from most state mandates under ERISA.
Disclosures. This is general educational information for employers, not legal, tax, or benefits advice. Rules, thresholds, and IRS-set figures change; confirm the current specifics for your situation and state with a licensed advisor before you decide. Reviewed by Matthew T. Giberti (NPN 20698856). Last updated: 2026-07.
Where does your company fit?
Under 50 employees, start with the 2 to 49 guide. At or above 50, or bouncing around that line, read the 50+ guide and start with the mandate section. Either way, the census template is where the real comparison begins.
