{"id":46674,"date":"2023-04-06T08:46:30","date_gmt":"2023-04-06T12:46:30","guid":{"rendered":"https:\/\/roundstoneinsurance.com\/?p=46674"},"modified":"2024-07-29T11:54:01","modified_gmt":"2024-07-29T15:54:01","slug":"red-pill-or-blue-pill-what-the-insurance-industry-doesnt-want-you-to-know","status":"publish","type":"post","link":"https:\/\/roundstoneinsurance.com\/excelsior\/blog\/red-pill-or-blue-pill-what-the-insurance-industry-doesnt-want-you-to-know\/","title":{"rendered":"What the Insurance Industry Doesn\u2019t Want You to Know About Self-Funding"},"content":{"rendered":"

In that iconic scene in the Matrix<\/span><\/span><\/a>, Morpheus offers Keanu Reeves the Red pill or Blue pill. The Red pill reveals things as they actually are; the Blue lets you drift back to the sleep of unawareness.<\/span><\/p>\n

 <\/p>\n

\u201cThe Matrix. It is the world that has been pulled over your eyes to blind you from the truth,\u201d Morpheus tells Keanu.<\/strong><\/em><\/p><\/blockquote>\n

 <\/p>\n

Writing these self-funded insurance blogs kind of makes us feel like Morpheus sometimes.\u00a0<\/span><\/p>\n

 <\/p>\n

But instead of offering readers a Red pill unveiling a hideous armageddon nightmare, we get to teach readers<\/span> how to save money on health benefits<\/span><\/a><\/span> and provide employees better care quality through self-funded health insurance.\u00a0<\/span><\/p>\n

 <\/p>\n

That\u2019s a reality the insurance companies don\u2019t want you to know. They\u2019d rather you take the Blue pill and drift back to the sleep of unawareness, totally oblivious to the fact that you have a choice that actually costs less yet delivers higher quality care.\u00a0<\/span><\/p>\n

 <\/p>\n

We\u2019ll tell you the truth: the traditional health insurance industry is a bit of a racket. They make outrageous profits through misaligned incentives \u2013 and you pay through the nose as a result.<\/span><\/p>\n

Fortunately, there\u2019s a solution that\u2019s more affordable and actually provides better care \u2013 self-funded insurance under the group medical captive model.<\/span><\/p>\n

 <\/p>\n

Let\u2019s <\/span>explain the value of self-funded insuranc<\/span><\/a><\/span>e<\/span> and how self-insurance can help small businesses save big on insurance costs when compared to fully insured.<\/span><\/p>\n

\"The-guide-that-could-save-you-thousands\"<\/a><\/p>\n

<\/h2>\n

Why Most Employees in Large Firms are Self-Insured<\/strong><\/h2>\n

Take a ride on the subway. Believe it or not, many of the people on your commute are insured under self-funded health plans, but they probably don\u2019t know it. (Because when you have self-insurance, your employees often aren\u2019t even aware. They still have similar medical cards, similar processes, similar portals as their old plans. They still get the same level of integrated support. But self-insured plans cost less and provide better care quality.)<\/span><\/p>\n

 <\/p>\n

Among large firms, <\/span>82% of workers are covered by self-insurance<\/span><\/a><\/span>. That makes sense because it\u2019s cheaper. You only pay for the insurance you need \u2013 the insurance you deserve.<\/span><\/p>\n

 <\/p>\n

But what about small to mid-size companies? Until recently, they couldn\u2019t afford the risk of self-funding their health plans. If something catastrophic would happen to one or more of their members, they couldn\u2019t afford the hit.\u00a0<\/span><\/p>\n

 <\/p>\n

Roundstone\u2019s <\/span>Group Medical Captive model changes all that<\/span><\/a><\/span>. Launched in 2005 and the first of its kind, our Group Medical Captive allows smaller companies to pool their resources to dilute their risk. Today our Group Medical Captives protect over 120,000 lives, or belly buttons as we like to call them.<\/span><\/p>\n

 <\/p>\n

Companies with only 25 employees can now enjoy the same risk predictability as Fortune 500 brands. And that\u2019s great news because they can now self-fund like Fortune 500s.<\/span><\/p>\n

 <\/p>\n

And no, Roundstone clients don\u2019t have to have the same insurance plans as other companies in the captive. The beauty of self-funding health benefits under the group captive model is each plan can be tailored to your employees\u2019 unique needs. You can <\/span>choose your own TPA<\/span><\/a><\/span> as well as your own advisor. You\u2019re not forced into the one-size-fits-all approach of fully insured. The end result is a plan that better meets your needs and provides higher quality care.<\/span><\/p>\n

 <\/p>\n

And that\u2019s something the insurance companies don\u2019t want you to know. They\u2019re banking on the possibility you\u2019ll go back to sleep. To them, misalignment is a cash machine.<\/span><\/p>\n

 <\/p>\n

How Self-Insurance Works on a Group Medical Captive Model<\/strong><\/h2>\n

 <\/p>\n

Unlike fully-funded insurance plans, 85% of self-insurance costs are variable \u2013 you have control over them and can save money as a result.<\/span><\/p>\n

\"How<\/p>\n

The first pool of money \u2013 in blue \u2013 is your claims fund. This is the fund you use to directly cover costs up to a specified deductible, typically $10,000 to $25,000 per employee, and a specified amount of aggregate costs. This fund will be 65% of the total costs of the self-funded insurance plan.<\/span><\/p>\n

 <\/p>\n

Any costs beyond that deductible are paid from the Group Medical Captive \u2013 in green \u2013 up to $500,000. This is the fund you pay into collectively along with other members of the captive. By sharing this pool, you collectively offset the risk \u2013 essentially gaining the risk predictability of a company with a hundred thousand employees, even if you only have 25 employees on your payroll. Suddenly you\u2019re a mom-and-pop shop with the risk predictability muscle of General Motors.<\/span><\/p>\n

 <\/p>\n

Roundstones\u2019 Group Medical Captive is 25% of the total costs of the self-funded insurance plan.<\/span><\/p>\n

 <\/p>\n

Whatever isn\u2019t spent in the Group Medical Captive gets refunded back to you, pro rata, in the form of a check. <\/span>The refund is based on how well the group does, not necessarily your company specifically.<\/span>\u00a0<\/span><\/p>\n

 <\/p>\n

In 2022, Roundstone <\/span>distributed $24.4M unspent captive premium pro rata<\/span><\/a><\/span>. <\/span>Every year, we write checks in the 10s of thousands of dollars back to clients as refunds on the captive. They <\/span>can spend it<\/span>, bank it<\/span>, or save it<\/span><\/span><\/a> for next year\u2019s insurance costs \u2013 the choice is theirs.\u00a0<\/span><\/p>\n

 <\/p>\n

That\u2019s why insurance companies want you to take that Blue pill \u2013 they don\u2019t want you to know you can actually get back the money you don\u2019t spend on your insurance premiums. They\u2019d rather bank that money as profit. That\u2019s how the nation’s largest insurers are able to <\/span>rake in billions of dollars in record profits<\/span><\/a><\/span> as the country stands on the brink of a recession.\u00a0\u00a0<\/span><\/p>\n

 <\/p>\n

Come to MCF 2023 and Explore the Benefits and Savings of Self-Funded Insurance<\/strong><\/h2>\n

 <\/p>\n

There is a solution to expensive, out-of-control insurance premiums. By self-insuring under Roundstone\u2019s Group Medical Captive model, <\/span>you\u2019re guaranteed to save money<\/span><\/span><\/a>. Two-thirds of our customers save enough in their first four years with us to pay the claims for their entire fifth year. And 100% save money, full stop.<\/span><\/p>\n

 <\/p>\n

If you\u2019re ready to <\/span>wake up to the realities of self-funded insurance<\/span><\/a><\/span>, you need to <\/span>attend Roundstone\u2019s Medical Captive Forum (MCF)<\/span><\/a><\/span>.\u00a0<\/span><\/p>\n

 <\/p>\n

Held this May 18 to 19 in Chicago, MCF brings employers and benefits advisors together to learn more about self-funding best practices and trends. It\u2019s designed to be educational. We\u2019ll explore a variety of issues in the current health benefits landscape. Learn how to best save money through self-funded insurance using the Group Medical Captive model and improve care quality for your employees.<\/span><\/p>\n

 <\/p>\n

If the system isn\u2019t working for you, why aren\u2019t you doing anything about it? Attend MCF, and learn more about the benefits of self-funded insurance using Roundstone\u2019s Group Captive Model.<\/span><\/p>\n

 <\/p>\n

Secure your spot at Roundstone\u2019s MCF<\/span><\/span><\/a>.<\/span><\/p>\n

 <\/p>\n

\"2023<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

In that iconic scene in the Matrix, Morpheus offers Keanu Reeves the Red pill or Blue pill. The Red pill reveals things as they actually are; the Blue lets you drift back to the sleep of unawareness.   \u201cThe Matrix. It is the world that has been pulled over your eyes to blind you from […]<\/p>\n","protected":false},"author":16,"featured_media":46679,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1827],"tags":[],"class_list":["post-46674","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-employers"],"yoast_head":"\nWhat the Insurance Industry Doesn\u2019t Want You to Know About Self-Funding | Roundstone Insurance<\/title>\n<meta name=\"description\" content=\"Learn what the insurance industry doesn\u2019t want you to know about the benefits and savings of self-funding your company's healthcare plan.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"What 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