Two Forms of Volatility Self-Funded Employers Face Today
High-Cost Claims Management: High-cost claims remain a central concern for self-insured employers. Whereas medical stop loss captives are also subject to high-cost claims, employers can pool risk with other members of the captive to stabilize volatility more effectively. From current approval rates, the FDA speculates it will approve approximately 10 to 20 new CGT products per year beginning in 2025. Employers' need to pool risk is greater than ever before.
Regulatory Compliance: Captives assist advisors and employers as they navigate the evolving regulatory landscape, including compliance with laws that govern self-insurance, captives, and healthcare. Captives can ensure employer members are always maximizing what is legally allowed under ERISA and other evolving guidelines and laws. Volatility can include reporting requirements, program requirements, and benefit additions for employers of all sizes.
Managing Volatility in Medical Stop Loss Captives
Data Analytics: Employers within a medical stop loss captive can leverage deeper data analytics to gain insights into claims trends, patterns, and even rising risks. This data-driven approach helps them anticipate potential volatility and make informed decisions about risk management that benefit all employer members.
Risk Pool Diversification: Captive members can benefit from diversification by including a mix of employers from different industries and geographies. This can help spread risk and reduce the impact of high-cost claims on individual employer participants.
Strategic Risk Management: Employers in a medical stop loss captive can collaborate on strategic risk management initiatives by leveraging their collective buying power for wellness programs, clinical point solutions, and even provider network negotiations, and more, which helps them control healthcare costs and mitigate volatility.
Compliance Expertise: Staying up to date with regulatory changes is crucial. Employers may benefit from working with captive management experts who specialize in compliance and can help navigate the regulatory landscape.
Medical stop loss captives offer a unique approach to managing the volatility of healthcare coverage for self-insured employers. By pooling resources and sharing risks, employers within a captive can better address the full spectrum of health benefits cost management, including high-cost claims, premium fluctuations, regulatory compliance, and risk pool dynamics. Through data analytics, diversification, strategic risk management, and compliance expertise, medical stop loss captives empower employers to effectively navigate the challenges of healthcare volatility. Medical stop loss captives help companies maintain financial stability and provide not only essential, but competitive, healthcare benefits to their employees.
Contact us to find out more about medical stop loss captives and the wide range of employee benefits funding solutions.