Level Up is the level funded, customizable healthcare plan that lets small businesses up their savings.
Level Up is the ideal middle ground between fully insured plans and traditional self-insured plans. It lets companies with 50 to 200 plan members confidently, safely and easily move away from expensive fully insured plans.
You’ll have a completely customized plan with coverage that fits your company’s needs.
Pay For What You Use
The fixed payment is like a fully insured plan, but because you’re self-insured, you only pay for the medical care actually incurred by your employees.
Stop-loss insurance is fully integrated with your plan to protect you from higher-than-expected claims. If claims costs are more than your monthly payment, stop-loss insurance will cover it.
Level Up is a simple, predictable and budget-friendly plan that makes cash management easy.
How It Works
With Level Up, your maximum healthcare plan cost is determined up front and you pay a level, or fixed monthly rate.
The money goes into a bank account you control (and not to an insurance carrier). The monthly rate covers everything—the cost of expected healthcare claims, administrative fees and stop-loss insurance.
At the end of the year, if all the money allocated to pay claims has not been spent, you keep 100% of what’s left. It’s yours.
How You’ll Save
All About You
Your fixed monthly payment rate is determined by the characteristics of your group. That means your rate will be much lower than premiums based on community rates.
The Industry Leader That Saves You Money
We are an industry leader in claims administration because we have both experienced examiners and clinicians working together. Our unique, coordinated approach saves our customers an average of 59% off submitted claims charges.
Good Data For Good Decisions
We conduct comprehensive and vigorous data collection and analysis. Combined with predictive modeling tools, you’ll have insights into the conditions and diagnoses that drive up costs, as well as healthcare overspending within your company. Those issues can then be addressed and your plan fine-tuned to enable the greatest savings potential.
Level funded plans have fewer governmental regulations than fully insured plans. For example, they don’t have to offer a package of state mandated benefits and can be written to the company’s specifications instead. They’re also exempt from the Health Insurance Tax that’s part of the Affordable Care Act. With Level Up, all regulatory benefits specific to your business will be explored.
Our Wellness Program is Included
Healthy employees are more productive. So Level Up includes a complimentary wellness program to all members and their spouses for the first year. You’ll be able to measure how our program improves the health of your workforce, reduces absenteeism and claims costs, and increases productivity. The wellness program includes the following features:
Personal Wellness Profile
A health risk questionnaire, biometric screening and integration of all claims activity to create a personal wellness profile that can be used to set wellness goals and measure success.
Access to the Prairie States online Wellness Portal where they can view all their health information, access health education materials and contact their health coach.
One-On-One Health Coaching By Phone
Health coaching sessions by phone with a Prairie States licensed clinician to ask all their health-related questions and receive guidance in how to reach goals.
We have a long history of bending the trend of rising healthcare costs. And we can do it for you.
“They work hard and their in-house claims management, case management and disease management is excellent.”Julie Meyer, Employee Benefits Account Executive Maritime Insurance Group
“I’ve worked with lots of TPAs and they are the best of the best.”Linda Mont, Senior Benefit Consultant Key Benefit Concepts
We know that when we call, we can talk to a real person who can give us answers. There’s a real personal touch with Prairie States.”Charlie Malingowski, Executive Vice President Sheboygan Paint Company
Compare Your Options
|Level Up||Fully Insured|
|Customized plan to meet employer’s needs and goals|
|Fixed monthly rate|
|Free wellness program for all members in the first year|
|99%+ financial accuracy|
|Employer group keeps 100% of money not spend on claims|
|Employer group controls the plan’s bank account and|
|Significant cost savings potential|
|Fewer governmental restrictions and taxes|
|Cost savings potential from wellness programs|
|Reporting and Analytics|
|Customized and comprehensive claims reporting|
|Unlimited access to plan performance data|
|Optimized plan design using employer’s data|
|Personal service for all plan members|
|All calls answered in an average of two rings by a real person during business hours|
My current fully insured plan options are limited. Can Level Up be customized for my company?
Yes! We review data, conduct analytics and discuss your goals, needs and expectations to ensure your plan is just right for you.
Fixed monthly payments go into a bank account. Who controls the account?
You establish and maintain the account. It’s always under your control.
What happens if healthcare expenses exceed my fixed monthly payment?
When expenses exceed your monthly contribution, your stop-loss insurance kicks in to cover the difference. What you pay does not change.
If the money allocated for claims is not spent, how much do I get back?
With Level Up, you get 100% of what’s left. It’s your money.
I understand why Level Up is better than being fully insured, but why is it better than being traditionally self-insured?
Level Up is better because you get a customized plan like self-insured plans, but the fixed monthly payment makes cash flow predictable and stop-loss insurance removes the risk. That makes Level Up a great choice for small businesses.
Are wellness programs standard with level-funded plans?
No, wellness programs are not at all standard. But at Prairie States we believe in promoting a culture of prevention and wellness, so we include a complementary wellness program for the first year of your plan. Healthier employees are happier, more productive and less expensive employees.
How does this work with the Affordable Care Act (ACA)?
Level-funded plans provide savings over fully insured plans because they are exempt from the Health Insurance Tax (HIT) and from some ACA and state-mandated benefits requirements.
When can I start?
You can make the switch to Level Up any time of the year. Call us or get started by requesting a quote.