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