Level-Funded Plans

EMI Health offers an innovative mechanism for groups to blend the flexibility of self-funding with the risk protection of being fully-insured.

Level-Funded header

Right in the sweet spot

Our level-funding model gives you the flexibility of self-funded plans, with the risk protection of fully-insured plans. Our unique solution effectively gives you stable renewals year after year, and we have options for both large and small groups to take advantage of it.

Here’s the cherry on top: if claims are higher than collected premiums in a year, you don’t have to pay a cent more to cover it. And if claims are lower? Great news! You are eligible to get 100% of the surplus paid back to you.

There’s strength in numbers

Small groups are often at a disadvantage in the insurance market because it’s harder to spread risk on a smaller population. But we have an innovative solution at EMI Health to give small groups access to our level-funding model. To achieve this, we “pool” similar organizations together and underwrite the combined population’s risk. Instead of being a group of 50 members, you can be qualify to be part of a pool that has 500+ members!

The large claims effect

The benefit of joining an EMI Health pool is easy to see in these three charts using actual claims from pools of different sizes over a 10-year period. With a smaller population, large claims have a huge impact. But when that risk is spread out over multiple groups pooled together, the large claims effect is decreased – leading to more predictable rates year after year.

Pay close attention to the green line – it represents the overall cost of claims per employee per month. The flatter it gets, the more stable the renewal rates are. (Yellow line = small claims cost PEPM. Red line = large claims cost PEPM. Green line = average of the red and yellow lines)

100-member population

You can see by the roller-coaster ride of the green line that large claims have a substantial impact on the overall population, resulting in high renewals to cover the volatile risk.

Under 100 slide image

500-member population

With a larger population, the green line starts to flatten out. Large claims are still happening, since health needs are unpredictable, but the risk of high renewal rates is significantly lowered.

Under 500 slide image

1,000-member population

At 1,000 members, we now have an easy going trend line. Stability has been achieved here, and the groups in this pool are able to forecast their benefits costs with confidence year after year.

Under 1000 slide image
Under 100 slide image

100-member population

You can see by the roller-coaster ride of the green line that large claims have a substantial impact on the overall population, resulting in high renewals to cover the volatile risk.

Under 500 slide image

500-member population

With a larger population, the green line starts to flatten out. Large claims are still happening, since health needs are unpredictable, but the risk of high renewal rates is significantly lowered.

Under 1000 slide image

1,000-member population

At 1,000 members, we now have an easy going trend line. Stability has been achieved here, and the groups in this pool are able to forecast their benefits costs with confidence year after year.

Presentation Pool Meeting

Have a seat at the table

At EMI Health, we believe in transparency and data-driven decisions. When you join a pool, you are invited to join in semiannual pool meetings where our expert team goes over everything new from EMI Health, how the pool is running, upcoming market changes, and more. Pool reporting can be shared with you and can help determine plan choices for the next year. Get all your questions answered and have your voice heard.

Learn more about level-funding with EMI Health

This short video helps explain our level-funded pools in general.
Click on your state to learn more about how it works in your region.

Arizona, Georgia, Texas, Utah