Redefining healthcare

As the costs associated with providing healthcare coverage continue to rise, businesses are looking to improve risk management and reduce expenses. Historically, in order to accomplish this, management has increased employee contributions, cut benefits, or worse, a combination of both. However, it is possible to utilize customized risk transfer methods to improve the financial management of an employer-sponsored health plan.

With our strategic partners, we have created a type of self-funding arrangement that coordinates plan design, claim processing, risk protection, and data reporting in a single source turn-key package, providing the advantages of self-funding with the safety of a budgeted maximum cost.

We provide your business with access to an alternative risk management tool typically used by large employers

Interest in self-funding and captive programs is growing significantly as medical costs continue to rise and the uncertainties related to the PPACA health care reform threaten the amount of control employers are able to maintain within more conventional insurance structures. This development has, in turn, spurred interest in self-insurance and captive insurance programs.

Advantages of self-funding

Self-funding can provide an average 25-30% annual savings on health benefit costs

Take control of employee benefits financing

No Affordable Care Act premium taxes

Avoid community rating

Group purchasing strength for services

Stabilization of rates over multiple years

Larger population results in greater predictability

Lower rates for preferred risks

Reduced claims volatility through captive layer

Opportunity to share in underwriting profits

Self-insured plans must only satisfy the PPACA’s affordability and minimum value tests, affording more leeway in deciding the value level of basic plan components such as hospitalization and pharmacy benefits

How does it work?

Medical stop-loss captive insurance

The CapCare program affords employers the opportunity to reduce the volatility and costs associated with providing health benefits to their employees. Employers who participate in the CapCare program join a group captive for medical stop-loss – CapCare Re. The group captive reinsures, or assumes, risk from each stop-loss policy. Since the group captive reinsures the risk of multiple policies, the risk assumed by the group captive is a larger and more diverse risk, and therefore more predictable.

Learn more about our CapCare program

Fair and transparent

Cost Plus reference-based pricing

CapCare provides a unique and revolutionary method to reimburse hospital facilities for their services. Our Cost Plus reference-based pricing is designed differently from conventional plans, and is not a PPO plan. Cost Plus reference-based pricing directly challenges the ambiguity of hospital pricing in a creative and logical effort to pay health providers a reasonable reimbursement without the use of a PPO contract by establishing limits for the payment of medical claims that correlate to the providers’ cost of services.

Learn more about reference-based pricing

By negotiating payments to healthcare providers based on the amount Medicare pays for the same procedures, plan sponsors may be able to cut spending substantially

Redefine your healthcare

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