How Group Stop-Loss Captives Reduce Insurance Cost Volatility

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  • Stop-loss captive health insurance offers small to mid-sized businesses a safe and cost-effective self-funded alternative to fully funded insurance.
  • Businesses can enter a group captive to minimize risk through cost sharing, cost predictability, and claims control.
  • Roundstone offers the lowest collateral in the industry, at 7%. While other captives charge 11% or more and require stacked collateral, i.e. you pay two years in a row, Roundstone is a one-time payment.
  • Roundstone group captive insurance can help you take control of your health insurance costs.


Healthcare costs have soared by as much as 43% in the past ten years, posing a real challenge for small to midsize businesses trying to offer sufficient coverage without hurting their finances. With about 23% of employees citing health benefits as a key factor in deciding to leave a job, it’s clear that providing good healthcare attracts and keeps talent in your business. How can smaller companies afford to offer quality benefits to attract top-tiered employees?


Stop-loss captive health insurance offers an affordable, sustainable alternative to traditional, fully funded insurance that gives you more control over your healthcare costs by reducing risk and limiting collateral use.




What Is Group Captive Health Insurance?

In group captive insurance, multiple businesses collectively self-fund their health insurance. Each company maintains a claim fund used to pay insurance claims. They also purchase stop-loss insurance, which provides a safety net for unforeseen high-cost or catastrophic claims.


This insurance model spreads the risk across all member companies, reducing the impact of individual claims. It effectively makes self-funding a safe, predictable, and affordable solution for small to midsize businesses. By combining resources, the group can negotiate better terms and coverage, often at a lower cost than traditional insurance.


ROUNDSTONE is an innovative employee health benefits company. We help small and midsize organizations offer competitive benefits at a lower cost by self-funding health insurance through our group medical captive. The Roundstone Captive enables companies to self-insure safely by pooling hundreds of employers together to share risk and save money.


With easy onboarding and personalized support every step of the way, the stop-loss Captive offers control, flexibility, transparency, and returns all savings back to employers where they belong. We believe in always aligning with the employers’ best interests and remain committed to our mission — quality, affordable healthcare and a better life for all.


What Is Collateral?

Collateral is essentially the price of admission into a stop-loss captive — a percentage of stop-loss premium that provides a safety net. Collateral is paid to protect yourself in case healthcare costs exceed stop-loss premium expectations. It covers unforeseen expenses that may surpass the premiums received by the Captive.


However, when affiliating with a reputable and established captive like Roundstone, the need to tap into the collateral is exceedingly rare.


When choosing a self-funded stop-loss captive, minimizing collateral is paramount. Roundstone boasts the industry’s lowest collateral at 7%, payable once upon enrollment. In contrast, other stop-loss captive’s collateral rates range from 11% to 15%, occasionally soaring as high as 25%. Some captives even necessitate consecutive years of collateral payments, termed “stacked collateral,” effectively doubling the financial commitment.


Some captive programs retain your collateral. At Roundstone, we view collateral as your funds. Not only do we refund your collateral payment if the surplus is unused for covering claims, but we also reimburse the accrued investment interest. We reject the notion of collateral forfeiture upon an employer’s exit from the captive.


colleagues-discussing-group-stop-loss-captives_Roundstone Insurance


Reducing Risk with Group Captive Stop-Loss Insurance

Group captive stop-loss insurance offers an innovative and cost-effective way for your business to manage its insurance costs. By joining forces with other companies, you combine your resources and distribute the risk. A stop-loss captive provides the risk-leveling advantage of large numbers. You essentially gain the risk predictability of a Fortune 500 company, even if you only have 25 employees.


Let’s break down how this works.


Resource Pooling

The group captive insurance model allows businesses to collaborate, merging their financial resources into a single, larger fund. This approach contrasts with traditional insurance, where individual companies typically require significant collateral to protect against risks.


The collective contribution to a shared fund spreads the risk among all members, effectively minimizing risk through the pool of large numbers. This collective effort not only eases the financial burden on each business but also fosters a sense of shared responsibility and support among the participants.


Risk Spreading

The risk of high-cost claims in group health insurance captives is shared among all the participating businesses. If one company experiences a year with costly claims, the financial impact is distributed across the entire group. This reduces the likelihood of any single company needing to provide additional premium to cover these unexpected costs.


Because costs and risks are spread among the stop-loss captive, you can receive a sizable return of unused claim spend at the end of the year, even if you had a bad claims year.


Most group captives also address risk management in health insurance with a stop-loss policy, which provides another layer of protection against catastrophic claims. Stop-loss coverage kicks in to cover costs exceeding a predetermined threshold, safeguarding each company within the captive from the financial strain of large claims.


can captive insurance help your company save money


Cost Predictability

Group captive insurance has more predictable costs than conventional insurance plans. This consistency is achieved by being less susceptible to market fluctuations and avoiding the annual premium hikes often seen in traditional insurance. As a result, it allows for more precise budget planning.


For example, premiums in healthcare have risen about 7% in 2023. Under a group stop-loss captive, you won’t see the same price spikes and can offset any increase with cost containment measures during the year. Group captive insurance is a more controlled and predictable way to handle insurance expenses. It’s a way that small to midsize companies can afford to offer quality health insurance to their employees and get off the escalator of high-rise insurance premiums.


Claims Control

With group captive insurance, your business has more control over the claims process. This allows you to use strategies like employee wellness education to manage and minimize claims, ultimately reducing overall costs.


For example, by using data transparency tools, you can track claims trends and identify areas for cost savings. Taking proactive steps in claim management helps cut expenses and further improves the savings of a self-funded stop-loss captive. This active involvement allows you to impact and manage your insurance costs.


Return of Unused Funds

Unlike many stop-loss captives, Roundstone returns unused claims funds back to captive members in the form of cash.


It’s worth mentioning that certain captives retain a portion of the distribution or allocate it to a capital account inaccessible to members until they depart the captive, if at all. The carrier retains the remainder.


At Roundstone, we promptly distribute 100% of the captive’s savings to employers. We firmly believe that this money belongs to you, empowering you to reinvest it into your employees at your discretion.

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The Roundstone Self-Funding Guarantee

Our dedication to helping your business save on health benefits is unwavering, which is why we present the Roundstone Guarantee: We promise that your company will experience savings within the first five years — or we’ll make up the difference. This guarantee reflects our confidence in delivering efficient and affordable solutions for your company’s healthcare requirements.


In fact, two-thirds of Roundstone clients save enough in their first four years in the Captive to entirely pay for their fifth year of claims. On average, a member of the Captive will save 20% over a traditional, fully funded insurance plan. As these savings accrue, they can become substantial over time.


We’ve proven our commitment over the last 20 years, with over $72 million in premium refunds to our customers. In July 2023 alone, we announced an $8 million pro rata cash distribution for companies in our group medical captive.


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Roundstone: A Case Study in Group Captive Insurance

As an early adopter of group captive insurance, our own success story is an example of the cost-saving potential of this approach. Confronted with a steep 30% rise in healthcare expenses, Roundstone transitioned from conventional insurance to a self-funded group captive model as the company expanded to 35 employees.


With this strategy, we effectively managed rising premiums, resulting in a total savings of $1,132,950 over a span of five years. By using the benefits of a captive insurance company, such as a flexible plan design, a Third-Party Administrator (TPA), and a transparent Pharmacy Benefits Manager (PBM), we successfully avoided premium hikes for eight years.


Our success showcases group captive insurance as a sustainable model for providing cost-effective healthcare in any economic environment.


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Take Advantage of Captive Health Insurance With Roundstone

Group captive insurance provides an efficient method for small to midsize businesses to handle employee health insurance costs. By pooling resources with other similar-sized companies, you can access customized benefits and exert greater control over your expenses.


Join a group captive plan with Roundstone today and see how you can save thousands on health insurance costs with self-funded insurance for your small business. Contact a Roundstone Advisor today to learn how to make the switch.


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