Level Funded Health Plans: The Smartest Financial Move Small Businesses Can Make

The New Playbook for Small Business Health Benefits

Every small business owner knows the pain of opening that renewal letter. Premiums are up again — 8%, 12%, sometimes 20%. It doesn’t matter if claims were low or if the team stayed healthy; the carrier still raises rates.

That cycle has crushed small businesses for decades. You pay more, get less, and watch big corporations access custom health plans you could never touch.

But the game has changed.

With level funded health plans and PCFG Insurance’s VitalEdge Program, small businesses finally have leverage. You can offer benefits that look and feel Fortune 500-level — without the Fortune 500 price tag.

Let’s break down why.

What Is a Level Funded Plan (and Why You’ve Never Been Offered One)?

A level funded plan is a hybrid between traditional health insurance and self-funding. It’s designed to give small and mid-sized companies the same flexibility and financial advantages that large employers have enjoyed for years.

Here’s the structure:

1. Fixed Monthly Cost: You pay a consistent, predictable monthly amount — the “level” part.

2. Claims Reserve: A portion of your payment funds your team’s actual medical claims.

3. Stop-Loss Insurance: Protection that kicks in if claims exceed projections, so you’re never exposed.

4. Admin Fees: Covers plan management, compliance, and member support.

At the end of the year, if your claims come in lower than expected, you may receive a refund or credit toward renewal.

That’s right — you can actually get money back from your health plan.

Compare that to traditional fully insured plans, where you pay premium after premium and the insurance company pockets every bit of surplus.

Level funding flips the model. You get ownership, transparency, and control.

Why Most Brokers Never Bring It Up

Let’s be real — many brokers avoid level funded plans for one simple reason: it takes work.

Traditional fully insured plans are easy to renew. They take five minutes, a spreadsheet, and a carrier quote. Level funded plans, on the other hand, require strategic analysis, claims forecasting, and hands-on plan design.

But at PCFG Insurance, we specialize in smarter plan architecture. We don’t push products; we build outcomes.

The VitalEdge Program is our way of bringing a big-business strategy to small employers in a way that’s simple, scalable, and cost-effective.

The Power of Predictability

For business owners, unpredictability kills momentum.

You can manage payroll, taxes, and marketing. But healthcare? That’s a black box.

Level funding gives you predictable monthly costs with end-of-year performance potential.

Let’s say you’re spending $30,000 per month on a traditional plan for your 50-person team. You switch to a level funded plan under VitalEdge and your monthly contribution remains the same. But by managing health engagement and preventive care, your claims come in under projections.

At renewal, you could see:

• $50,000–$100,000 in surplus credits,

• Single-digit renewal increases, or

• Even premium reductions.

You gain data. You gain leverage. You start playing offense, not defense.

How the VitalEdge Program Enhances the Model

The VitalEdge Program amplifies the level funded structure with data, technology, and behavioral engagement.

Most health plans are reactive. They pay claims after employees get sick. VitalEdge is proactive. It uses data-driven monitoring and wellness tools to prevent big claims before they happen.

Here’s what makes it different:

• Smart Device Integration: Employees sync wearable devices that track key vitals — steps, blood pressure, heart rate, sleep quality.

• Care Navigation: A dedicated care team monitors at-risk members and intervenes before a minor issue becomes a major claim.

• Telehealth Access 24/7: No waiting rooms, no lost work hours — just instant, high-quality care.

• Preventive Care Reimbursements: Employees earn cash rewards for completing health screenings or participating in wellness challenges.

• Advanced Reporting for Employers: You finally see what drives costs and where to focus improvement.

With VitalEdge, you’re not just funding care. You’re engineering better outcomes.

The Business Advantage of Level Funding

1. Predictable Costs with Upside Potential

Unlike traditional insurance, where you pay whatever the carrier demands, level funded plans give you a cap on expenses. You’ll never pay more than your monthly premium — but you can absolutely pay less.

2. Transparent Data and Control

You finally gain access to de-identified claims data. You can see where your dollars go — which conditions, which services, which trends. That visibility lets you act strategically.

3. Cash-Back Opportunities

When your team stays healthy and claims stay low, surplus funds come back to you instead of disappearing into an insurance company’s profit margin.

4. Customization

Level funded plans can be tailored by industry, workforce demographics, and company goals. Whether your business is construction, manufacturing, tech, or hospitality, PCFG builds a plan that fits.

5. Employee Attraction and Retention

Offering a benefits package that feels premium — with real health engagement — attracts top talent and keeps them. Employees appreciate when their employer invests in their long-term wellbeing.

Why Level Funded + VitalEdge Beats “Traditional” Health Plans

Traditional insurance is built for the carrier’s profit, not your success.

It’s like leasing a car forever — you pay monthly, but you never own anything.

Level funding with VitalEdge changes that. It’s ownership over your healthcare spend. It’s a model that says, if we manage health better, we win financially.

That’s exactly how big corporations operate. They invest in wellness, data analytics, and engagement because they know the ROI is real.

Now, small businesses can do the same — without needing a million-dollar HR department.

Case Study Example: Small Business, Big Win

Let’s use a simple scenario.

Company: 40 employees in Upstate New York
Current Plan: Fully insured, $28,000/month premium
Annual Cost: $336,000

Switch to VitalEdge Level Funded Plan:

• Monthly cost remains $28,000 (budget neutral).

• Claims come in 20% lower than expected due to proactive care and telehealth usage.

• Employer receives $50,000 in year-end surplus credits.

• Renewal rate drops by 6% instead of increasing 12%.

That’s a $90,000 financial swing in one year — with zero change to employee coverage levels.

Multiply that by three years, and you’ve built a quarter-million-dollar advantage without adding a single employee or selling a single extra product.

That’s leverage.

How VitalEdge Drives Healthier Behavior

Traditional insurance doesn’t reward healthy employees. Whether your people take care of themselves or not, everyone pays the same — and you lose.

VitalEdge flips the incentives:

• Healthy habits = cash rewards.

• Preventive screenings = reimbursements.

• Active app usage = lower long-term costs.

The more your team engages, the more you win as an employer.

That’s what Grant Cardone would call “stacking wins.”

You turn your benefits program into a profit center — not a line-item expense.

For Employees: Health Freedom Meets Simplicity

The average employee doesn’t care about funding mechanisms; they care about convenience, cost, and access.

With VitalEdge:

• They get 24/7 care through telehealth.

• Prescriptions are delivered affordably and quickly.

• Labs are nationwide and easily booked through Quest Diagnostics.

• Virtual counseling supports mental health and stress management.

• Wellness challenges create community and engagement across teams.

They don’t have to jump through hoops. Everything’s integrated, mobile, and personal.

For employees, it’s not “insurance.” It’s support — built into their daily lives.

The Compliance Advantage

Small businesses fear compliance issues — ACA reporting, ERISA rules, COBRA, and IRS Section 125 cafeteria plan regulations.

PCFG Insurance’s VitalEdge Level Funded Plans handle compliance automatically. Every plan design is ACA-compliant, HIPAA-secure, and employer-friendly with full documentation support.

You stay compliant. You stay protected. You focus on running your business.

Who Should Consider a Level Funded Plan?

• Businesses with 5 to 200 employees.

• Employers who want to control renewal costs and earn potential refunds.

• Companies offering benefits but seeing low employee satisfaction.

• Owners tired of double-digit premium increases.

• Leaders who want to build a long-term retention tool around health benefits.

If that’s you, it’s time to get in the game.

What Makes PCFG Insurance Different

PCFG isn’t just a broker — it’s a strategic benefits partner.

We don’t just sell plans. We engineer outcomes that lower costs, raise satisfaction, and keep your business competitive.

The VitalEdge Program is a reflection of that mindset. It merges innovation, technology, and benefits management into one cohesive ecosystem:

• Strategic plan design based on your workforce data.

• Hands-on care navigation for your employees.

• Performance reporting so you always know where you stand.

• Continuous optimization as your company grows.

This is how you future-proof your health benefits strategy.

The ROI Mindset: Turning Benefits Into Leverage

Grant Cardone says: “You don’t have a money problem. You have an attention problem.”

In health insurance, most businesses have a visibility problem — they can’t see where their money goes.

VitalEdge fixes that by putting your data to work. You’ll know:

• How many employees used telehealth.

• Which conditions drive your highest claims.

• How wellness engagement correlates with renewal rates.

That level of insight lets you make decisions like a CFO, not a guesser.

And when you stack that data year over year, you gain the same strategic leverage Fortune 500 companies use — at a small-business scale.

The Leadership Advantage

Dan Martell teaches that leverage and systems are the core of scaling any business.

Health benefits are no different.

When you implement a level funded plan through VitalEdge, you create a system that scales with you.

• Add employees easily.

• Integrate with payroll and HR tools.

• Keep costs aligned with growth.

It’s a long-term infrastructure play — one that gives you predictability, control, and retention power as you expand.

That’s what real leadership looks like.

Next Steps: How to Get Started

1. Schedule a Discovery Call with PCFG Insurance
   We’ll review your current benefits, claims data, and renewal history to identify opportunities for savings.

2. Receive Your Custom VitalEdge Plan Proposal
   Get side-by-side comparisons of your current plan vs. a level funded VitalEdge model.

3. Implement and Launch Employee Engagement Tools
   We handle onboarding, education, and compliance — your team gets connected and engaged from day one.

4. Track, Measure, and Optimize
   Monthly reports show performance trends and potential savings, so you always know the impact.

Final Word: The New Era of Health Benefits

Small businesses don’t need to accept rising health costs as “just how it is.”

With level funded plans and the VitalEdge Program, you can finally take control. You can stabilize your expenses, improve your employees’ lives, and reinvest the savings into your growth.

The big guys have played this game for years. Now it’s your turn.

This is your moment to stop being reactive — and start being strategic.

Your benefits should work for you, not against you.

Call to Action

👉 Ready to see how much your business could save?
Book your free Level Funded Plan Assessment today at PCFGInsurance.com/VitalEdge.

Let’s build a smarter, stronger, and more profitable benefits strategy — together.