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September 6, 2023

The Captive Vernacular:

Defining the Common Parties Involved in Medical Stop-Loss Captives

Captive Managers, Program Managers, and Captive Advisers: Understanding Their Distinct Roles
Captive health plans have gained significant traction as an innovative risk management strategy from groups of all sizes. However, different roles within this landscape often lead to confusion. We are going to look at three terms: Captive Managers, Program Managers, and Captive Advisers and discuss how these functions contribute to a unique experience.
Captive Managers: Captive Managers traditionally oversee the day-to-day operations of a captive insurance company. You will often find them handling administrative tasks, ensuring regulatory compliance is met, providing necessary financial reporting, and even the physical claims management of a plan. So, when considering a captive manager, you can expect them to make sure the captive operates smoothly and efficiently and provides alignment with the captives’ goals and regulatory obligations. It’s also not uncommon to see the state regulatory agency require a Captive Manager to be involved in any new captive concept.

Program Managers: Program Managers often focus their efforts on designing, implementing, and managing insurance programs tailored to specific risks within an organization. This means that Program Managers are much more involved in the details, particularly for those high-cost members that can greatly impact the groups and captive’s expenses. A valuable program manager relationship means that you have someone in your corner to assess the risk profile of the group, manage stop-loss policies, pre-configure and integrate health plan operations, monitor for value-add opportunities, and ultimately create the highest performing insurance structures. When partnering with a Program Manager, you have a partner who will collaborate with Captive Managers, or sometimes act as both, on your behalf and integrate captive solutions into your organization’s complete insurance strategy.
Captive Advisers: Captive Advisers often function as the strategic guide for an organization who may be considering a captive. These individuals are often industry experts who share their insights on the feasibility, benefits, and risks associated with captives. A true captive adviser can help an organization, or benefit advisor, determine if a captive plan is the right idea, help them navigate any legal requirements, assist with regulatory information, and even optimize captive performance. Captive advisers often have preferred relationships with Program Managers and Captive Managers, largely due to experience and existing business relationships.

As you are determining the specific parties that you need at the table while considering a captive, make sure you have the right players administering the right duties. In summary, Captive Managers handle operational and regulatory intricacies, Program Managers develop tailored insurance solutions, and Captive Advisers offer strategic insights. These roles can traditionally be found working together to maximize the potential of captives, enhancing risk management and financial strategies for organizations. Understanding their respective roles empowers businesses to make informed decisions in the ever-evolving landscape of captive insurance.

ClearPoint Health is proud to be one of the most knowledgeable and creative Captive Program Managers in the business. Through our industry leading ClearPoint Health Platform, we bring options to our partners designed to drive significant benefit savings for those companies that need it the most, small to mid-sized employers.

Contact us today at to find out more information and to learn how we can devise a benefit strategy with your advisor for maximized savings.