Once reserved for large companies, group medical stop loss captives are growing increasingly popular among small to midsize employers (SMBs). Fed up with the expense of fully insured employee benefits plans, SMBs are attracted to group captives’ promise of large group purchasing power, lower pricing volatility, and greater transparency into claims data.
However, not all group captives live up to this promise. In fact, most mainstream group captive offerings are plagued by Adverse Risk Retention (ARR) — a cycle in which the captive retains high-cost employers, or ‘bad risk’, by subsidizing their uncontrolled costs onto low-cost employers, or ‘good risk’.
When we, at ClearPoint, identify a gap in the employee benefits market, we create a proprietary solution. A perfect example? Our evolved group captive, which embodies all that a group captive could — and should — be. Read on to learn how we accomplish this.
ClearPoint’s Evolved Captive: Quality Over Quantity and the 3 Keys of Accountability
Unlike competitors, ClearPoint Health is unwilling to sacrifice the long-term health of the risk pool just to keep employer members in our captive. That’s why we designed our group captive for SMBs prepared to take accountability for cost management. We encourage benefit advisors to carefully vet employer clients before introducing them to our captive solution — quality over quantity is our motto.
When they join our captive, employer members are primed for success. We present them with a custom playbook that outlines specific actions they can take to manage addressable and avoidable risk and achieve a high score on our Member Engagement Index (MEI). We connect them with our Client Success Team, which helps them engage employees in cost management efforts. Finally, employer members of our group captive are supported by infrastructure specially designed to promote accountable member behavior. It stands on 3 keys:
- Configurability: ClearPoint’s evolved captive model enables customization, allowing employer members to choose their preferred third-party administrator (TPA), pharmacy benefit manager (PBM), network, and point solution configurations. This level of flexibility empowers them to craft a health benefits plan that fits the unique needs of their employee population for cost savings and better health outcomes. Click here to watch a webinar on our captive’s configurability.
- Measurement & Support: Our captive normalizes data from all stakeholders in the captive marketplace to provide insights and analytics on each employer member’s behavior. Insight into trends not only influences how our MEI ranks member behavior (more on this later!) but helps ClearPoint’s Client Success Team tailor its approach to support. ClearPoint understands that difficult conversations are sometimes necessary to drive lasting behavioral change among an employee population. Members of our Client Success Team are available to help facilitate them. Watch a webinar on our captive’s measurement & support feature here.
- Incentives: Our captive insurance model solves for ARR through our MEI. To recap, the MEI ranks employer members’ efforts to manage avoidable and addressable employee healthcare claims costs. Employer members that contribute to the sustainability of the captive are rewarded with incentives including no new laser provisions, the distribution of underwriting surplus, favorable rate caps, and renewals. Learn more by watching our webinar on the role of incentives in ClearPoint’s captive.
Built upon a foundation of configurability, measurement & support, and incentives, ClearPoint’s is the rare group captive that fulfills captives’ potential to be accountable environments where SMBs can come together and reap the benefits larger entities enjoy. Contact us to learn more about our evolved group captive.
