Level Funding & Claims Fund Credits

Sana plans are self-funded, which is one of the ways we save employers so much money.

Unlike fully-insured plans that charge high monthly premiums, self-funded plans allow employers to only pay for what they use to cover the claims of their employees.

Our self-funded plans are paid for through level funding to give employers predictable premium costs and limit their risk. 

Level Funding

For small and medium businesses on a budget, consistent cash flow is important. Level funding allows employers to pay fixed monthly contributions whether claims are high or low, preventing big claims from throwing off monthly budgets.

Level-funded plan premiums are allocated to several different buckets once they’re paid to Sana — your claims fund, stop loss insurance, and administrative fees. Smaller day to day claims are paid from your claims fund. Larger claims, either for an individual member, or the group as a whole, will be covered by the stop-loss policy once the claims fund is depleted. However, you as the employer are only responsible for the monthly premiums, based upon enrollment. 

If claims are high, stop-loss insurance steps in so you can feel confident you won't owe anything more than what you pay in monthly contributions. 

If claims are low, you may receive a credit if there are leftover contributions to your claims fund after the 180-day run-out period ends. As a reminder, the runout period is the time after your policy ends when claims from during the policy year can still be submitted for reimbursement. 

  • Credits for surplus claims fund contributions are processed 3 months after your run-out period ends, which is typically nine months after the end of your plan year.
  • Sana may retain a percentage of any excess claims funds and requires renewal for eligibility. Please refer to your Administrative Services Agreement (ASA) in your document center for additional information.
  • A credit is only due if there are excess funds in your company claims fund. Remember, your premium is split up into three main buckets, as mentioned above. We don't credit the portions of your premium that go towards purchasing stop-loss insurance or paying admin fees (which include fees for our network, Care Partners, TPA services, broker services, and more). 
  • Your credit will be processed as an invoice credit.
  • If the credit exceeds the amount of your invoice, we'll spread it across several invoices.
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