{"id":47012,"date":"2023-04-28T00:00:02","date_gmt":"2023-04-28T04:00:02","guid":{"rendered":"https:\/\/roundstoneinsurance.com\/?p=47012"},"modified":"2024-07-29T11:48:29","modified_gmt":"2024-07-29T15:48:29","slug":"whats-in-the-box-pain-except-with-self-funded-insurance-plans","status":"publish","type":"post","link":"https:\/\/roundstoneinsurance.com\/excelsior\/blog\/whats-in-the-box-pain-except-with-self-funded-insurance-plans\/","title":{"rendered":"What\u2019s in the Box? Pain. Except with Self-Funded Insurance Plans."},"content":{"rendered":"

In an amazing scene of Dune<\/span><\/a>, Timoth\u00e9e Chalamet’s Paul Atreides is asked to place his hand in the box by the ominously black-veiled Reverend Mother.<\/p>\n

\u201cThe test is simple,\u201d she says. \u201cRemove your hand from the box, and you die. What\u2019s in the box? Pain.\u201d<\/p>\n

 <\/p>\n

The whole scene is kinda like what HR managers annually experience when they learn how high new health insurance premiums will be next year.<\/p>\n

 <\/p>\n

Sticking your hand into a searing box of pain with a poison dagger at your neck? Okay, perhaps that\u2019s a bit of an exaggeration \u2013\u00a0 but when health insurance rates spiked 28.2% last year<\/a><\/span>, it\u2019s understandable if your blood pressure also rose proportionally.<\/p>\n

 <\/p>\n

What\u2019s in the box? Pain. Rates are going to skyrocket, yet again. And there\u2019s nothing you can do about it.<\/p>\n

 <\/p>\n

At least that\u2019s what the insurance companies would want you to think.<\/p>\n

 <\/p>\n

Except for one way you can. By switching to self-funded insurance on Roundstone\u2019s Group Medical Captive model<\/a><\/span>, you avoid spiking premiums and intense, searing pain.<\/p>\n

 <\/p>\n

And you won\u2019t feel that familiar guilt of passing rising insurance costs onto your employees<\/a><\/span> \u2013 who are almost certain to resent you for it.<\/p>\n

 <\/p>\n

How nice. Actually, you\u2019ll probably get a savings next year. With self-funded insurance, the average client saves 20% on their insurance costs over 5 years. In fact, two-thirds of Roundstone customers save enough in their first 4 years to pay the claims for their entire 5th year. And 100% are guaranteed to save money on a self-funded insurance plan<\/span><\/a>.<\/p>\n

 <\/p>\n

Wouldn\u2019t saving on health insurance be an awesome thing<\/a><\/span> to tell your boss next year? Let me explain.<\/p>\n

 <\/p>\n

 <\/p>\n

How Small Companies Can Now Afford the Option of Self-Funded Health Insurance<\/strong><\/h2>\n

 <\/p>\n

Founded in 2005, Roundstone\u2019s Group Medical Captive was the first of its kind. It revolutionized the healthcare space by making self-funded insurance a viable option for small to midsize businesses.<\/p>\n

 <\/p>\n

There\u2019s a reason 82% of workers in large firms are covered by self-funded health insurance plans<\/a><\/span>. It\u2019s cheaper because you only pay for what you need \u2013 the health insurance you deserve. Any spend your employees don\u2019t use isn\u2019t eaten up in profits like it is under a fully insured plan<\/a><\/span>.<\/p>\n

 <\/p>\n

But until Roundstone, small to midsize companies couldn\u2019t afford to offset the risk of self-funded insurance. If something catastrophic would happen to one or more members, they couldn\u2019t afford the hit.<\/p>\n

 <\/p>\n

Roundstone\u2019s Group Medical Captive solves this by pooling the resources of other small businesses like yours. You don\u2019t have to have the same insurance, but together you do dilute the risk.<\/p>\n

 <\/p>\n

With over 700 companies and more than 120,000 lives in its two Group Medical Captives, Roundstone\u2019s clients enjoy the risk leverage corporations have had for generations<\/a><\/span>. It allows them to self insure with the same predictability as a company like General Motors \u2013 even if they only have 25 employees.<\/p>\n

 <\/p>\n

 <\/p>\n

How the Group Medical Captive Works in Self-Funded Insurance<\/strong><\/h2>\n

 <\/p>\n

Under the group medical captive model, companies self-fund their health insurance up to a specified deductible<\/a><\/span>, typically $10,000 to $25,000 per employee, with a specified maximum cap across the whole company. This is 65% of the total costs of your self-insurance plan.<\/p>\n

 <\/p>\n

Claims above the deductible are then paid by the stop loss insurer that is reinsured by the group medical captive up to $500,0000. Stop loss premium payments by the employer make up 25% of your total costs. The remaining 10% of your total costs covers your admin fees from your consultant, TPA and any other unbundled plan services like telehealth or care navigation tools.<\/p>\n

 <\/p>\n

By self-funding your health insurance, 85% of your costs are variable \u2013 which means you have control over them and can save money as a result. If it doesn\u2019t get spent, those funds are refunded.<\/p>\n

 <\/p>\n

Anything not spent in Roundstone\u2019s Group Medical Captive is paid back to you pro rata in the form of a check. In 2022, Roundstone distributed $24.4M unspent captive premium pro rata<\/a><\/span>. The refund is based on how well the reinsurance pool of employers does, not necessarily your company specifically. You may be entitled to a refund even if you had a high stop loss claims year.<\/p>\n

 <\/p>\n

Every year, we send checks in the tens of thousands of dollars back to clients as annual refunds on their medical group captive. They can choose to spend it, bank it, or save it for next year\u2019s self-funded insurance plan. One of Roundstone\u2019s clients invested their refund into a company gym, which not only made their employees healthier but drove down claims in the following years.<\/p>\n

 <\/p>\n

And you get those funds back whether or not you choose to renew the following year. Fortunately for us, 95% of Roundstone\u2019s clients <\/a><\/span>renew. They tend to stick around because of the savings, the valuable data insight, and care quality. The fraction who do leave tend to be the results of buy-outs into bigger companies where the group medical captive model is no longer necessary.<\/p>\n

 <\/p>\n

And that\u2019s fine. Unlike level-funded plans where you\u2019ll be lucky to receive 50% of your funds back and only if you renew, our plans don\u2019t have any handcuffs. You receive a refund regardless if you decide to continue with the plan the following year.<\/p>\n

 <\/p>\n

 <\/p>\n

The Value of Data-Driven Insights in a Self-Funded Insurance Plan<\/strong><\/h2>\n

 <\/p>\n

Unlike a fully insured plan, self-insurance delivers meaningful and actionable data that can be used to drive down your plan\u2019s costs<\/a><\/span> and increase savings.<\/p>\n

 <\/p>\n

For example, you can see if one employee\u2019s premium drug is driving up prescription costs and then get that employee into a pharmacy rebate program, saving you potentially tens of thousands of dollars. Or you can switch to an independent pharmacy benefits manager that has 100% pass-through savings<\/a><\/span> to the group, a strategy that lowered one client\u2019s prescription claims by 47%, resulting in a total cost savings of $28,000 from one employee.<\/p>\n

 <\/p>\n

Roundstone\u2019s team continually analyzes your data on the hunt for savings. We then make cost-containment recommendations<\/a><\/span>. Our experienced cost containment staff makes it easy for you to optimize your plan with simple action items that can result in thousands of dollars in annual savings. The choice is up to you<\/a><\/span>.<\/p>\n

 <\/p>\n

 <\/p>\n

Self Insurance Empowerment 101: Yes, It\u2019s Good for Your Employees<\/strong><\/h2>\n

 <\/p>\n

The truth is the traditional insurance industry doesn\u2019t care about you. They\u2019re focused on their bottom line, not yours. That\u2019s why renewal time often feels like a box of pain every year. It\u2019s a frustrating experience where you don\u2019t feel like you have much choice.<\/p>\n

 <\/p>\n

If you\u2019re sick and tired of staggering price increases every year, why not do something about it?<\/p>\n

 <\/p>\n

The first step is to take back control. Download<\/a><\/span> your copy of \u201cWhat Your Fully Insured Carrier Doesn\u2019t Want You to Know\u201d today.<\/p>\n

 <\/p>\n

 <\/p>\n

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In an amazing scene of Dune, Timoth\u00e9e Chalamet’s Paul Atreides is asked to place his hand in the box by the ominously black-veiled Reverend Mother. \u201cThe test is simple,\u201d she says. \u201cRemove your hand from the box, and you die. What\u2019s in the box? Pain.\u201d   The whole scene is kinda like what HR managers […]<\/p>\n","protected":false},"author":16,"featured_media":47043,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1827],"tags":[],"class_list":["post-47012","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-employers"],"yoast_head":"\nWhat\u2019s in the Box? Pain. Except with Self-Funded Insurance Plans. | Roundstone Insurance<\/title>\n<meta name=\"description\" content=\"Self-funding insurance under a Group Medical Captive delivers substantial savings over fully insured plans. 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