Series

Geography and Market Variation

A level funded plan performs differently depending on where it operates. Five geographic variables produce the conditions: state regulatory treatment, provider network density, stop loss carrier appetite, ACA marketplace quality, and local broker and TPA infrastructure. New York prohibits stop loss for small groups. Texas and the Sunbelt have the deepest markets. Rural America has the worst network access. The geography shapes everything.

LFP-07.01

Why Geography Determines Whether Level Funded Works: The Variables That Matter

A level funded plan that works in Dallas does not work in rural Montana even with identical plan documents and identical stop loss terms. Five geographic variables determine …

LFP-07.02

The States Where Level Funded Thrives and the States That Regulate It Out of Existence

State regulatory treatment determines whether level funded can exist before any network or pricing question is asked. New York Insurance Law prohibits stop loss for employers with …

LFP-07.03

Network Deserts: Where Leased Networks Fail, Rural Access Collapses, and What the Alternatives Are

Leased networks provide adequate access in metro markets. In rural and exurban areas, the directory lists providers who are not accepting patients or have left the network without …

LFP-07.04

Multi-State Employers: Compliance and Operational Complexity Across Jurisdictions

Remote work permanently expanded small employer geographic footprints. BLS data shows 22.9 percent of employed persons teleworked in Q1 2024, reaching 41.5 percent in professional …