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Syam Adusumilli
The Architecture of Level Funded · LFP-01.TD1

Executive Summary: Glossary of Level Funded Terms

By Syam Adusumilli · 1 min read
Executive Summary Read the full article.

LFP-01.TD1 — The Architecture of Level Funded
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This reference document defines 30 terms used throughout the Level Funded Playbook, covering core level funded plan architecture, stop loss mechanisms that limit employer exposure, the regulatory framework governing self-funded plans, and ancillary benefit structures that appear in plan design. Definitions cover level funded, self-funded, and fully insured as architectural categories; specific and aggregate stop loss, attachment points, lasers, and the aggregate corridor as risk transfer concepts; ERISA, ERISA preemption, and fiduciary as the legal foundation; and operational terms including TPA, ASO, PMPM, SPD, SBC, COB, subrogation, and run-out period. Regulatory and benefit program acronyms covered include MEWA, ICHRA, PCORI, COBRA, RBP, DPC, PBM, CAA, MHPAEA, and NQTL.

Consult when encountering unfamiliar terminology in any Series 01 through Series 16 article. Statutory grounding is ERISA, the ACA, the CAA, and MHPAEA.