Building a culture of wellness in small businesses through level funding

Small businesses recognize the impact that a healthier workforce may have on their companies’ productivity and overall well-being. More recently, though, businesses understand that healthier employees may also lower their overall health care costs when enrolled in a level-funded plan.

“Since employers who opt for level-funded plans have more ownership over their costs, they’re more engaged in wellness than those who have fully insured plans,” says James Guemple, Regional Vice President, Key Accounts, for UnitedHealthcare’s West region.

Level-funded programs — such as All Savers® Alternate Funding — not only provide  cash flow stability with a fixed monthly payment for health plan costs upfront. They also provide potential opportunities for savings at the end of the plan year through a surplus if medical claims come in lower than expected. One way businesses may improve their chances of receiving a surplus is to help equip employees with the tools they need to engage in their own health care, helping build a culture of wellness in the organization.

3 Key Takeaways

  1. Level-funded plans may provide the type of cost-saving incentives for both employers and employees that may result in a workforce that’s not only engaged, but achieving better health outcomes.
  2. Success in building a culture of wellness starts with the employees and their commitment to engagement, but employers play a key role in encouraging healthier behavior by promoting their wellness programs.
  3. Employers play a key role in encouraging healthier behavior by promoting the programs and providing employees with the flexibility to seek out those engagement opportunities.

Level funding provides incentives for employee engagement

Building a culture of wellness can be an elusive goal for many business owners, as getting employees to engage with a complex health system can be a challenge. That said, level-funded plans may provide the type of cost-saving incentives for both employers and employees that may result in a workforce that’s not only engaged, but achieving better health outcomes as part of their health care experience.

Wellness programs are designed to increase employee productivity, reduce rates of absenteeism and presenteeism (coming to work when sick), and encourage individuals to take ownership of their health. Consider these wellness statistics for small businesses:

  • The number of small business employers offering some kind of wellness program has jumped 65%.1
  • Nearly 9 in 10 of employees who work in a company focused on health report being happier.2
  • Wellness programs can help address health care costs that stem from chronic or preventable disease.3
  • Employees engaged in their health may have lower rates of absenteeism and get more done at work, which is important to consider when productivity losses linked to absenteeism have cost employers $225.8 billion annually in the United States, or $1,685 per employee.4

Simply put, the success of level funding is closely related the commitment of employers and employees to living and working healthier.

“Businesses benefit from the flexibility and freedom of these plans, along with stability in premiums and the potential to get money back each year,” says Susan Steele, Director of All Savers. “The overall price difference can be 25—35% less than a fully loaded, fully insured, traditional plan.” 5

Impactful wellness programs for employees

Success in building a culture of wellness starts with the employees and their commitment to engagement. But employers play a key role in encouraging healthier behavior by promoting their wellness programs and providing employees with the flexibility to seek out those engagement opportunities before, during or after the workday. Tracking progress with the use of advanced digital tools can further encourage and incentivize participation in programs such as these offered through All Savers:

  • HealthiestYou: This no-additional cost telemedicine app lets subscribers talk to a licensed doctor by phone or video from anywhere, compare prices, save money on prescriptions and get information on their coverage.
  • UnitedHealthcare Motion®: Lisa Brenton, Motion’s Director of Product, says this program is popular with employees because they get immediate feedback on goal achievement—and they get paid to walk. "Motion is unique in that it offers financial rewards for meeting daily step goals," she says. “You're already walking each day, so why not get paid to do so? The program also sets a strong foundation for building healthy habits long term, starting simple by walking and advancing further from there.”
  • Real Appeal®: This weight-loss program is designed to help employees improve their health and may reduce the risk of developing chronic conditions like cardiovascular disease or diabetes.
  • Rally Health and Wellness: This is a digital experience that connects employees with personalized recommendations, health content and other resources to help them proactively manage their health.

Level funding puts employers in control

Financial benefits that business may realize through establishing a culture of wellness is just one way employers can have stronger control over their health care costs through level funding.

With a level-funding plan, employers assume the financial risk of providing health care services to their employees. The company establishes a self-funded medical benefits plan that pays for employees’ medical claims directly. These costs may vary from month to month throughout the year. But the plan’s level-funded structure means the administrative fees, stop-loss premium and monthly maximum claims liability are included in one monthly invoice — the amount which is level — throughout the plan year.

At the end of the plan year, if the total health care claims are lower than anticipated, the employer may receive surplus money back, where allowed by state law. While the experience for each employer varies, more than 1 in 3 small businesses with All Savers® Alternate Funding plans receive a surplus at the end of the year.[1] Of employers that receive a surplus, the amount on average is about 7% of the total annual cost of the plan — fixed and variable costs.7

“Level-funding health plans make it possible for an employer to take greater control of their health spending,” says Janet Mashl, Vice President, Operations, UnitedHealthcare. “They provide tools typically available only to larger employers, and the marketplace is responding.”

For more information, reach out to your broker or UnitedHealthcare representative.

Level funding’s impact on small business cash flow

Considering the level of investment required each year for health care benefits, cash flow and predicting costs are always top of mind for business owners. That predictability is especially helpful in an environment of increasing costs, as 69% of business owners say their health plan costs have increased in the last 4 years. Find out how level funding may help.

Level-funding plans may provide opportunities for health care savings

Our latest white paper focused on All Savers® Alternate Funding outlines how level funding may provide small businesses with new ways to pay for health services, manage costs and help employees get more value from their benefits.


  1. Small Business Trends, Workplace Wellness Programs are on the Rise – And Employers See Results, January 2019.
  2. Hyperbiotics: The Key Benefits of Wellness Programs, January 2019 From Better Health to Bottom Line.
  3. WellSteps —Effective Employee Wellness Solutions: This is the Impact of Your Employee Wellness on Health Care Costs., Sept. 2018.
  4. CDC Foundation, “Worker Illness And Injury Costs U.S. Employers $225.8 Billion Annually,” Jan. 2015.
  5. 2020 All Savers data.
  6. Based on 2019 UnitedHealthcare All Savers national surplus data.
  7. Data from more than 1,500 groups that received a surplus from March 2019 —February 2020.

HealthiestYou is not health insurance. HealthiestYou is designed to complement, and not replace, the care you receive from your primary care physician. HealthiestYou physicians are an independent network of doctors who advise, diagnose, and prescribe at their own discretion. HealthiestYou physicians provide cross coverage and operate subject to state regulations. Physicians in the independent network do not prescribe DEA controlled substances, non- therapeutic drugs and certain other drugs which may be harmful because of their potential for abuse. HealthiestYou does not guarantee that a prescription will be written. Services may vary by state. HealthiestYou by Teladoc® and UnitedHealthcare are not affiliated and each entity is responsible for its own contractual and financial obligations.

UnitedHealthcare Motion is a voluntary program. The information provided is for general informational purposes only and is not intended to be nor should be construed as medical advice. You should consult an appropriate health care professional before beginning any exercise program and/or to determine what may be right for you. Receiving an activity tracker and/or certain credits and/or purchasing an activity tracker with earnings may have tax implications. You should consult an appropriate tax professional to determine if you have any tax obligations under this program, as applicable. If any fraudulent activity is detected (e.g., misrepresented physical activity), you may be suspended and/or terminated from the program. If you are unable to meet a standard related to health factor to receive a reward under this program, you might qualify for an opportunity to receive the reward by different means. You may call us toll-free at 1-855-256-8669 or at the number on your health plan ID card, and we will work with you (and, if necessary, your doctor) to find another way for you to earn the same reward. Rewards may be limited due to incentive limits under applicable law. Subject to HSA eligibility, as applicable.

Real Appeal is a voluntary weight loss program that is offered to eligible participants as part of their benefit plan. The information provided under this program is for general informational purposes only and is not intended to be nor should be construed as medical and/or nutritional advice. Participants should consult an appropriate health care professional to determine what may be right for them. Any items/tools that are provided may be taxable and participants should consult an appropriate tax professional to determine any tax obligations they may have from receiving items/tools under the program.

Rally Health® provides health and well-being information and support as part of your health plan. It does not provide medical advice or other health services, and is not a substitute for your doctor's care. If you have specific health care needs, consult an appropriate health care professional. Participation in the health survey is voluntary. Your responses will be kept confidential in accordance with the law and will only be used to provide health and wellness recommendations or conduct other plan activities.

Administrative services provided by United HealthCare Services, Inc. or their affiliates. Stop-loss insurance is underwritten by All Savers Insurance Company (except MA, MN, and NJ), UnitedHealthcare Insurance Company in MA and MN, and UnitedHealthcare Life Insurance Company in NJ. 3100 AMS Blvd., Green Bay, WI 54313 (800) 291-2634.