Highlights

• Consumers are showing growing dissatisfaction with traditional health insurance plans offered by employers.

• A self-funded health insurance plan may be a better alternative for some small and midsize businesses who want to improve their employee benefits plan.

• Self-insurance through a group medical captive offers flexibility, data transparency, and cost savings benefits over fully insured health insurance policies.

• Employers who switch to self-funded insurance with Roundstone can attract and retain top talent by offering reduced employee healthcare costs.

• Data analytics in a self-funded insurance plan can help you optimize plan utilization.

Group Captive Self-Funded Health Insurance Plan vs. Fully Funded Health Insurance

A 2021 Verint survey found that, on average, only 29.3% of consumers covered by the top 25 health insurance companies would recommend their provider to someone else.

The study looked at six primary health insurance concerns for consumers, including value, services, enrollment, provider availability, claims, and digital experience offered by the insurer.

Results showed that only 8% of consumers like the costs associated with their plan, 6% approved of provider options, and 12% like their coverage.

Only 12% of consumers like their healthcare coverage.

Frustrations With Traditional Insurance

One of the questions asked by the Verint survey sought to discover what matters most to people when selecting a health insurance plan.

Top concerns for consumers included:

• Benefits – 100%
• Copayments – 76%
• Number of in-network providers – 68%
• Premiums – 65%
• Cost-transparency – 37%

In light of these concerns, there are many possible reasons customers don’t feel loyal to their health insurance providers.

Some are tired of the lengthy claims process or the lack of communication and understanding they receive when they call their provider for assistance. Some find that their policy does not cover clinicians and services they need, and they end up paying hefty out-of-pocket costs for patient care visits.

The most pressing concern for consumers is the cost of their health plan. Traditional health insurance policies are becoming too expensive for both employers and plan members.

High insurance costs can preclude certain individuals from coverage and medical care. According to a 2021 West Health-Gallup report, an estimated 20% of people say they avoided healthcare services due to cost, and 12.7 million Americans report a time in the past year when a family member or friend died because they could not afford treatment.

Benefits of a Self-Funded Group Captive Health Insurance Plan

The many drawbacks of traditional insurance are leading savvy employers to make the switch to self-funding healthcare benefits. A group captive health insurance plan offers flexibility, data transparency, and cost savings to the rising number of employers dissatisfied with their traditional insurance carriers.

Switching to self-funded health insurance can save you and your employees money, help attract and retain top talent, and improve your health plan utilization.

Roundstone offers a unique self-funded health insurance solution: a group medical captive that provides flexibility, control, and visibility into cost drivers that traditional insurance companies can’t. These advantages set Roundstone and self-funded insurance apart from fully insured plans with mega carriers.

Roundstone’s latest client renewal rate is 95%, which reflects overall satisfaction with Roundstone’s solution and the group medical captive model.

Here’s what you get when you enroll in a self-funded group captive insurance plan with Roundstone.

Freedom to Choose

Typical fully insured health insurance providers lock their clients into a one-size fits all plan. These health plans are often expensive and may come with benefits that don’t suit your employees’ individual needs.

A group captive health insurance plan allows you to customize your coverage so you can ensure that your plan works for your group’s specific needs. With Roundstone, you can use our open platform to build your plan from the ground up.

Choose your own third-party administrator (TPA) and pharmacy benefits manager (PBM) to feel confident that your health plan partners have your back — and your budget — and will work with your best interest in mind, not their own.

Ability To Convert Fixed Costs to Variable Costs

Self-funded health insurance can improve your company’s finances by allowing you to convert fixed costs (paid to the insurance company) to variable costs.

With traditional insurance policies, an employer pays a fixed premium, and the insurance company assumes the risk of paying for any medical claims employees make. That’s 100% fixed cost, which means the employer has no say in how to control or reduce healthcare spend.

Under a group captive health plan, the employer pays for a share of each claim as it is incurred, thereby improving cash flow and ultimately reducing employee health insurance costs. The total fixed cost is 15%, leaving 85% of your healthcare spend variable costs — which you can control — and offering opportunities for savings.

Group captive health insurance plans allow employers to retain funds year-over-year. That means if your claims spend is less than predicted in a given year, those savings stay with you and can be used any way you like.

You Pay Only for What You Use

Roundstone offers you two cashback opportunities, so you only pay for what you use:

• You keep any money left over in your pre-funded claims account at the end of the coverage term.
• Your monthly stop-loss premium payments are kept in a pool you share with other captive participants. Any pooled premium funds not spent by the end of the plan year are returned to the employers as distribution checks on a pro-rata basis.

Two-thirds of customers save enough money in their first four years with Roundstone to pay premiums for their entire fifth year of insurance, and 100% of customers save money over the life of their policy.

Data Insights for Cost Containment

Roundstone’s Cost Savings Investigators (CSI Team) can leverage your company’s data and analytics to recommend ways you can optimize your plan utilization.

For example, this transparency allows Roundstone groups to spend an average 20% less on pharmacy costs per member per month than the national average.

Traditional insurers don’t offer a similar approach to data transparency and cooperation.

Ability To Hire and Retain Top Talent

Potential employees consider healthcare plans and benefits when job searching. Offering self-funded health insurance that reduces employee health plan costs may help your company attract higher-quality candidates.

Companies that offer low-cost, flexible health benefits also have a leg up when it comes to talent retention. 56% of American adults with employer-sponsored health benefits claimed that whether they liked their current health plan was a critical factor in deciding to remain at their job. Keep your high-performing employees happy with better health insurance.

Full Disclosure

You can’t fix a problem if you don’t know the cause. With Roundstone’s group medical captive health insurance plan, employers have direct access to their claims data from dollar one through the CSI Dashboard.

Roundstone’s CSI Dashboard provides a clear and concise outline of all your claim data. Its user-friendly format also anonymizes your Protected Health Information (PHI), so you can safely access sensitive information anywhere. Employers can also find actionable insights for increased cost savings on the CSI Dashboard.

Areas To Impact Reports

Every quarter, Roundstone creates an Area To Impact (ATI) Report for its members that clearly spells out how and where your employees are using their plan benefits. ATI reports cover specific areas such as:

• Prescription costs
• Urgent care use
• Mental health services
• Musculoskeletal care

These reports give you the data you need to make changes that will improve care for your employees and to easily identify opportunities for cost containment.

Personalized Service

When you opt for self-funded health insurance from Roundstone, you gain the personalized services of underwriters, claims advocates, relationship managers, data and analytics pros, and clinicians. Roundstone’s group captive health plans offer you a one-stop shop of experts advocating on your behalf.

Switch to a Group Captive Health Insurance Plan with Roundstone

Roundstone’s group captive health insurance plan makes it possible for companies of all sizes to gain control of their healthcare benefit costs. With improved flexibility and reduced costs for you and your employees, self-funded insurance can help you draw and keep top talent at your company.

Contact us today to learn more about how a self-funded plan from Roundstone can save you money and improve employee satisfaction with your health insurance plan.