Products / Level-Funded & Alternative Funding Programs

Aetna Funding Advantage

Public facts

Carrier level-funded medical

Aetna (CVS Health) self-funded / level-funded medical plan with a preset monthly maximum, Aetna stop-loss, 50% surplus on renewal, and Springboard Marketplace enrollment.

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Overview

Aetna Funding Advantage is a self-funded health plan option from Aetna, part of CVS Health, for small to mid-sized employers. The employer pays a personalized maximum that covers claims, terminal reserve, stop-loss, and administration. Stop-loss covers claims above that maximum. On renewal, Aetna states it returns 50% of any surplus. Plans are self-insured by the employer and administered by Aetna Life Insurance Company; stop-loss is offered by Aetna Life Insurance Company. A mid-market brochure lists the product for 101–1,000 eligible employees; small-business pages do not publish a single national size band.

Why it matters Aetna publishes the 50% surplus rule, 2024 book surplus averages, and Springboard/PayFlex tooling—concrete comparison points versus other carrier level-funded products.

Target buyer: Small and mid-sized employers and brokers comparing Aetna level-funded medical to ACA fully insured small-group.
Pricing model: Quoted monthly maximum (claims + terminal reserve + stop-loss + administration); No list PEPM. Aetna markets savings of up to 25% versus an ACA community-rated plan (actual savings vary). Book-of-business surplus stats for January–December 2024: 44% of eligible groups earned a surplus; $7,152 average surplus paid per group; $753 average per subscriber. A per-enrolled-employee credit is advertised for some effective dates through October 1, 2026; terms apply.
Availability: National
Research: Last researched 2026-08-23; Public facts category

Key features

Single monthly payment covering claims, terminal reserve, stop-loss, and plan administration
Stop-loss when claims exceed the funded maximum; Aetna says the employer is not asked for unexpected extra expenses
50% of surplus returned on renewal
Springboard Marketplace for digital shopping, enrollment, and reporting
Employee-funded HSA through PayFlex (named on the small-business AFA page)
OTC Health Solution: $35 per enrolled employee per quarter for select CVS Health brand products (unused amounts do not carry over)
Access to Aetna value-based care networks (named on the AFA page)

Integrations

Springboard Marketplace (Aetna enrollment/reporting platform named on the AFA page)
PayFlex HSA
CVS Health / MinuteClinic (named in Aetna funding brochures)
Aetna Health Connections disease management and a wellness bundle (named on the mid-market funding brochure)
Employee assistance program (named on the mid-market brochure)

Overview

Aetna Funding Advantage (AFA) is Aetna’s level-funded / self-funding product for small to mid-sized employer groups. Aetna and MinuteClinic are part of the CVS Health family. Legal language on Aetna flyers: AFA plans are self-insured by the employer and administered by Aetna Life Insurance Company; stop-loss is offered by Aetna Life Insurance Company.

The employer funds a personalized maximum claims amount rather than a fully insured community-rated premium. One monthly payment covers claims, terminal reserve, stop-loss, and administration. If claims exceed the maximum, stop-loss applies. If the group renews and there is a surplus, Aetna says it returns 50%.

Size guidance is not unified on one public page. A 2024 mid-market funding brochure lists AFA for organizations with 101 to 1,000 eligible employees. Small-business AFA pages describe “small to mid-sized” employers without repeating that band.

Key Capabilities

Predictable monthly maximum; Aetna states the employer is never asked to cover unexpected expenses above that structure.
50% surplus share on renewal.
Stop-loss for employee claims above the monthly/maximum amount (specific and aggregate protection is described in customer flyers).
Springboard Marketplace for shopping, enrollment, and reporting.
PayFlex HSA for employees on compatible designs.
OTC Health Solution: $35 quarterly allowance per enrolled employee for select CVS Health brand products; no carryover.
Mid-market brochure also names MinuteClinic visits, Aetna Health Connections disease management, a wellness bundle, an EAP, pharmacy included, and “no plan sponsor liability in case of a deficit.”
Marketing contrast with ACA fully insured: savings of up to 25% on monthly payments versus community-rated plans (location and experience dependent).

2024 book figures Aetna publishes for AFA: 44% of eligible groups earned a surplus; $7,152 average surplus paid per group; $753 average per subscriber (January–December 2024 book).

Integrations & Ecosystem

Named on public AFA materials: Springboard Marketplace, PayFlex, CVS Health / MinuteClinic, Aetna Health Connections, EAP. A full 834 / payroll partner list is not on the small-business AFA page.

Pricing

Custom quote. Components of the monthly bill are claims funding, terminal reserve, stop-loss, and administration. Surplus is 50% on renewal, not a guaranteed refund. Promotional per-employee credits have dated terms (Aetna cited effective dates through October 1, 2026). Confirm current promotions on the live AFA page.

Notes & Limitations

No complete public state-availability list; recorded as National.
Published group-size bands conflict across Aetna PDFs (small business vs 101–1,000). Use the proposal, not this directory, for eligibility.
Savings and surplus statistics are vendor book-of-business figures.
AFA is not Aetna large-group ASO; do not treat them as the same product.

Sources

Tags: level-funded · Aetna · CVS Health · stop-loss · self-funded · group medical