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Report

Analyzing the impact of shifts to level-funded plans

19 March 2025

Small employers that offer health benefits to employees can choose from ACA-compliant fully insured small group health plans, self-funded health plans, and level-funded health plans, with each presenting unique costs, product features, and risks. Understanding these differences is essential for anticipating how shifts in plan adoption might influence the overall health insurance market. Blue Cross Blue Shield of Louisiana recently commissioned Milliman to study this topic. In this report, we discuss:

  • Level-funded health plans and the impact of their increased adoption
  • Overview of small employer health plan funding options
  • Impact of pricing and underwriting on level-funded take-up

This report was commissioned by Blue Cross Blue Shield of Louisiana.


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