# Why Gravie is not worth it

Source: https://www.getprescience.com/guides/gravie-review
Author: Aditya Jain, MD, Cofounder and COO, Prescience
Published: 2026-11-09
Updated: 2026-11-09
Cite as: Aditya Jain, MD. "Why Gravie is not worth it." Prescience, November 9, 2026. https://www.getprescience.com/guides/gravie-review

Gravie is not worth it for most small teams: its BBB reviews average 1 star for wrong network listings, botched enrollments and terminated coverage, and Prescience Diamond has an effective $0 deductible. Gravie sells level-funded health plans to small and mid-sized employers and says they saved new 2026 clients an average of 13% against their renewal, with more than 3,300 groups across its products and 97% employer satisfaction. Those numbers are better than almost anyone else in the market publishes, which is exactly why they deserve scrutiny. Level funding is a real mechanism and Gravie is a real operator. The savings, when they come, usually come from plan design choices your employees feel, and from a good year nobody promised you.

- **Worth it?:** No: 1-star BBB review average; pick Prescience Diamond
- **Plan type:** Level-funded, with possible refunds
- **Published pricing:** None. Quoted on census
- **Prescience Diamond:** A fixed monthly cost, not a funded account

## What Gravie customers report

Gravie has no Trustpilot reviews, so I went to the Better Business Bureau, where its 14 customer reviews average 1 star. They come from employees, employers and brokers.

- **Coverage terminated by Gravie's error.** A January 2025 reviewer wrote that Gravie botched her family's enrollment two years running: "Their error resulted in termination of our coverage," and her daughter couldn't get needed medication.
- **Moved into a pricier plan without notice.** In September 2026 an employee wrote that Gravie "enrolled me in a different plan that was $200 more but failed to tell me," then paid premiums late, and she once received a notice that her coverage was being terminated.
- **The app's network was wrong.** In October 2026 a member picked an urgent care because Gravie's app showed it "in network" and no-cost, then was billed over $150 when Gravie said it was out of network.
- **A prescription bounced between companies.** A June 2025 reviewer, a Type 1 diabetic, wrote that after two and a half years her prescription was denied, and "Gravie says they have no control over a PA denial that is up to CVS Caremark," while CVS said the reverse.
- **Billing employers can't reconcile.** A February 2026 reviewer cited funds held too long and "difficulty reconciling invoices," and a March 2025 employer reported over $10,000 in billing issues for one employee and constant account-manager turnover.
- **Half the refund.** Gravie markets refunds when claims run low, but the share returned depends on the contract: one 2026 chamber of commerce offer for its level-funded plans lists a "50% refund on surplus of premiums at renewal," and the employer's money pays claims first.

Gravie reports 97% employer satisfaction, and some members are happy. But these are failures in the basics of getting covered. Read the [BBB reviews](https://www.bbb.org/us/mn/minneapolis/profile/insurance-services-office/gravie-0704-96536609/customer-reviews) yourself.

## What level funding actually is

Level funding means your company pays a fixed monthly amount that covers expected claims, administration and stop-loss insurance. If claims come in below expectations, you may get some money back. If they come in above, the stop-loss policy takes over at a threshold. It is a way for a small employer to keep some of the upside of a healthy year, which a fully insured plan never offers.

Gravie sells this structure with its own plan designs and its own administration. The company reports more than 3,300 employer groups across all its products and 97% employer satisfaction. For its level-funded plans specifically, it reports 81% retention, a 75% customer satisfaction score and 13% average savings against renewal for new 2026 clients. Its better-known 30% savings and 92% retention figures are for Gravie CHOICE, its ICHRA product.

The mechanism worth understanding is where the savings come from. A level-funded plan can be cheaper than fully insured coverage because the employer takes on part of the risk and because the plan design is more controlled, often with narrower networks and higher cost sharing. Both are legitimate. Neither is free.

> **The question that matters:** Ask what the refund looked like for groups your size in each of the last three years. Not whether refunds exist. How often they actually arrived, and how large they were. That converts a marketing phrase into a number.

## No published price, and an unusual plan menu

Gravie does not publish a rate card. You submit a census and get a quote. That is standard for the category, and it means the company's savings figure is the only number most employers will ever see before a sales call. Company-published averages are a useful anchor and a poor substitute for a rate table on your own people.

The plan menu is where Gravie differs. Comfort, its flagship plan, covers common in-network care such as primary care, specialist visits, urgent care and generic drugs at no cost to the member. Higher-cost care such as hospital stays and ER visits has cost sharing that varies by plan. That is genuinely appealing to employees who find deductibles confusing, and it makes cost comparison harder because you cannot line it up row by row against a conventional plan.

**What Gravie publishes about cost, October 2026**

| Question | What you get |
| --- | --- |
| Is there a published rate? | No. Quoted on your census |
| What savings are claimed? | 13% versus renewal, new 2026 level-funded clients |
| Is the plan level-funded? | Yes, with stop-loss and possible refunds |
| Which network does it use? | Aetna or Cigna national networks, including Aetna PPO, or a regional network, depending on the plan |
| What is published about retention? | 81% on level-funded plans |

**What a 13% saving looks like, and what it does not include**

Illustrative. 45 employees, renewal quote of $18,000 per employee per year. Gravie quotes a 13% reduction.

- Renewal annual cost: $810,000
- 13% reduction: $105,300
- Level-funded annual cost: $704,700
- Refund if claims are low: Possible, not guaranteed
- Cost if claims exceed the threshold: Stop-loss applies above the limit

A $105,300 annual saving is a lot for a 45-person company. It is also an average, on someone else's census. The only number that matters is the quote on yours, plus the plan design your employees will actually experience at the pharmacy counter.

## Where the savings come from

I have never seen a double-digit saving that came from administrative efficiency alone. Coverage costs what it costs. The difference has to come from somewhere, and the honest places are plan design, network configuration and risk transfer. All three are legitimate, and all three land on your employees.

Plan design: a plan with no-cost office visits can still be expensive at the point of a hospital stay or an ER visit. Network configuration: narrower networks cost less and cover fewer doctors. Risk transfer: you carry part of the claims risk in exchange for the possibility of a refund, which is a real trade and not a discount.

None of this makes Gravie dishonest. It makes the savings claim incomplete, in the way every savings claim in this market is incomplete. The number is real for someone. Whether it is real for your team with two employees in ongoing treatment is a different question, and the answer is in the plan document.

- **Ask what a family with a chronic condition pays** in a bad year, not in an average year.
- **Ask for the network in each county** where you have employees, by hospital system.
- **Ask what the stop-loss threshold is** and who pays above it.
- **Ask what the refund history looks like** for groups your size.

## The year that decides whether level funding worked

Level-funded plans are usually evaluated over one year, which is the wrong horizon. The structure rewards a healthy year and punishes a bad one, and a single large claim in a 45-person group can move the following year's rate by double digits. That is not unique to Gravie, and it is more acute than in a fully insured pool where the risk is spread wider.

The renewal question is therefore not whether year one was cheap. It is what year three looks like if one employee has a $500,000 claim in year two. Ask the broker to model it, or ask Gravie directly. A vendor that understands its own product should be able to answer in one sentence.

**Three years, with one bad claim**

Illustrative. 45 employees, level-funded at $704,700 a year. Year two includes a $400,000 claim that hits the stop-loss threshold partway through.

- Year 1 cost: $704,700
- Year 2 cost: $704,700, with stop-loss covering the excess
- Year 3 renewal: Repriced on the new experience
- Typical year 3 increase: Well above trend after a large claim

Level funding protects you in the claim year and reprices you afterward. That is the honest shape of the product. It is a good deal if the alternative was unaffordable, and a worse deal than a stable group rate if your claims are volatile.

**Compare the renewal with a census-based alternative**

Use the current employee list, family tiers and benefit requirements. Keep refunds, contract obligations and the full renewal cost visible when comparing the next written proposal.

[Compare my renewal options](https://www.getprescience.com/quote)

[Review the level-funded comparison](https://www.getprescience.com/compare/level-funded-alternative)

## Who Gravie is genuinely good for

Gravie is a good fit for a company that has been quoted brutal fully insured rates, has a young and reasonably healthy team, and wants a plan that employees find easy to use. No-cost common care is a real benefit for people who cannot model a deductible, and the refund possibility is a genuine upside that fully insured coverage never offers.

It is a poor fit for a company that wants cost certainty above all else, or that has several employees in active treatment. In those cases the level-funded structure adds a variable you do not need, and the savings claim may not survive your own census. You will find that out in the quote, and the quote is where the decision should be made.

The one thing I would push back on is the framing that level funding is a superior structure. It is a different structure. It trades certainty for upside. For some companies that is a good trade and for others it is a bet they did not mean to place.

There is also an administrative cost that never appears in the savings figure. A funded arrangement needs a monthly reconciliation, a stop-loss threshold you understand and a renewal negotiation with someone who holds the claims data. In a fully insured plan the carrier does that work and prices it into the rate. In a level-funded plan you have bought the work back, whether or not you have anyone to do it.

For a company with a benefits lead and a finance team that enjoys the exercise, that is a fine use of a Thursday. For a founder doing payroll at eleven at night, it is a project they will do badly in year two and then wonder why the refund did not arrive. Ask who inside your company owns the reconciliation before you sign, and if the answer is nobody, that is information.

## What to ask on a Gravie call

- What is the total annual cost on my census, and how does it compare with a fully insured quote in dollars?
- What is the stop-loss threshold, and what happens above it?
- What refunds did groups my size receive in each of the last three years?
- Which hospitals and physician groups are in network in each county where we have staff?
- What does a family with a chronic condition pay out of pocket in a bad year?
- What did renewal look like for clients after a large claim?
- Can I see the plan document and the rate methodology before signing?

## Who Gravie fits, and who should take a fixed price

**My take by situation**

| Your company | Does Gravie make sense? |
| --- | --- |
| Quoted brutal fully insured rates, healthy team | Often yes. This is the intended case |
| Employees who struggle to understand deductibles | Yes. No-cost common care helps them |
| Two or three people in active specialist treatment | Only after you model a bad year |
| A company that needs a fixed cost it can budget | Weaker fit. Level funding moves with claims |
| A team that needs a specific hospital system | Check the network first, carefully |

Gravie is one of the better products in this market and I would not talk a founder out of it lightly. I would only insist that they see a quote, a network list and a refund history before they believe the savings figure.

> **Prescience Diamond: A company health plan with an effective $0 deductible.** Diamond is a company group plan with an effective $0 deductible and a broad national PPO network, for one monthly cost fixed in your quote, with no admin fees and no refund to wait for.
> - **An effective $0 deductible** and simple copays shown before a visit
> - **A broad national PPO network,** plus providers we contract with directly
> - **24/7 physician-led care navigation** that books visits and explains costs
> - **Usually 10–20% below comparable fully insured coverage,** fixed in your quote, with no admin fees
> Best for teams of about 15 or more that want one great group plan. [Get a Diamond quote](https://www.getprescience.com/get-started?p=Employer&product=diamond)

## Frequently asked questions

**Why is Gravie not worth it?**

Its BBB reviews average 1 star, describing coverage terminated by Gravie's own enrollment errors, wrong in-network listings, unannounced plan changes and billing employers can't reconcile. Its level-funded refunds depend on the contract, and one 2026 offer returns half the surplus. Prescience Diamond has one monthly cost fixed in your quote.

**How much does Gravie cost?**

Gravie does not publish a rate card. It quotes on your census. The company states that new level-funded clients saved an average of 13% against their renewal in 2026, but that is an average, so the only number that matters is the quote on your own people.

**What is a level-funded health plan?**

A level-funded plan charges a fixed monthly amount covering expected claims, administration and stop-loss insurance. If claims come in low you may receive a refund, and if they come in high the stop-loss policy applies above a threshold. The employer carries part of the risk.

**Is Gravie a health insurance company?**

Gravie is a licensed third-party administrator. On level-funded plans the coverage is your company's own plan, the network is rented from Aetna or Cigna, and stop-loss comes from Risk Solutions Insurance Company, a Vermont insurer in which Gravie holds voting shares. It is a plan manager rather than the entity holding all the risk, which is why the stop-loss terms matter.

**What is the Gravie Comfort plan?**

It is Gravie's flagship plan. It covers common in-network care such as primary care, specialist visits, urgent care and generic drugs at no cost to the member, with cost sharing for higher-cost care that varies by plan. It is easier for employees to understand, and harder to compare line by line against a traditional PPO.

**Will I actually get a refund?**

Sometimes. Refunds depend on your group's claims coming in below the funded level. Ask for the refund history of groups your size over the last three years rather than relying on the possibility being mentioned in a sales deck.

**What happens after a large claim?**

Stop-loss covers the excess in the claim year, and the following year is repriced on the new experience. Expect a renewal above trend after a large claim, which is the honest cost of the level-funded structure.

**What is a better alternative to Gravie?**

If you want a group plan at a fixed monthly cost with no funding account and no refund to wait for, Prescience provides one with an effective $0 deductible and a broad national PPO network, usually 10–20% below comparable fully insured coverage, with no admin fees.

## Sources

- [Better Business Bureau, Gravie customer reviews (checked November 5, 2026)](https://www.bbb.org/us/mn/minneapolis/profile/insurance-services-office/gravie-0704-96536609/customer-reviews)
- [Envision Greater Fond du Lac, Gravie level-funded health plans flyer (2026)](https://www.envisiongreaterfdl.com/wp-content/uploads/2026/04/gravie-level-funded-health-plans-flyer-M3-Envision.pdf)
- [Gravie, Homepage (3,300+ groups, 97% employer satisfaction; 30% savings and 92% retention are Gravie CHOICE figures; checked November 10, 2026)](https://www.gravie.com/)
- [Gravie, Level-funded plans (13% savings v. renewal for new business in 2026, 81% retention, 75% satisfaction; checked November 10, 2026)](https://www.gravie.com/level-funded/)
- [Gravie, Who is Gravie overview (Comfort plan, networks, RSIC stop-loss; checked November 10, 2026)](https://www.gravie.com/wp-content/uploads/2026/08/Who_is_Gravie_Overview.pdf)
- [KFF, 2025 Employer Health Benefits Survey](https://www.kff.org/health-costs/2025-employer-health-benefits-survey/)
- [U.S. Chamber of Commerce, PEOs vs. insurance brokers](https://www.uschamber.com/co/run/human-resources/peos-vs-insurance-brokers)
- [KFF, Private insurance research and data (background on the small-group and level-funded market)](https://www.kff.org/private-insurance/)