{"id":53543,"date":"2024-03-14T00:00:32","date_gmt":"2024-03-14T04:00:32","guid":{"rendered":"https:\/\/roundstoneinsurance.com\/?p=53543"},"modified":"2024-07-29T11:50:36","modified_gmt":"2024-07-29T15:50:36","slug":"what-does-the-future-of-self-funded-stop-loss-captives-look-like","status":"publish","type":"post","link":"https:\/\/roundstoneinsurance.com\/excelsior\/blog\/what-does-the-future-of-self-funded-stop-loss-captives-look-like\/","title":{"rendered":"What Does the Future of Self-Funded Stop Loss Captives Look Like?"},"content":{"rendered":"<p><strong>Highlights<\/strong><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Roundstone\u2019s Founder and President Mike Schroeder joined the Voices of Self-Funding podcast with host Ramesh Kumar to discuss why self-funded stop-loss captives have exponentially grown the small to midsize market for self-funded insurance.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Roundstone avoids conflicts of interest by never taking commissions from vendors, PBMs, or TPAs \u2013 our priority is always to ensure the best outcome for the employer and the employees.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Data in a self-funded plan provides invaluable insight into cost containment opportunities to optimize the savings of a self-funded health insurance plan.<\/span><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<hr \/>\n<p>&nbsp;<\/p>\n<p><a href=\"https:\/\/hcaainfo.podbean.com\/e\/episode-28-what-is-up-with-the-growth-in-captives\/\"><span style=\"font-weight: 400;\">In a recent Voices of Self-Funding podcast with host Ramesh Kumar, \u201cWhat\u2019s Up with the Growth of Captives<\/span><\/a><span style=\"font-weight: 400;\">,\u201d Roundstone\u2019s Founder and President Mike Schroeder discussed why the market for <a href=\"https:\/\/roundstoneinsurance.com\/excelsior\/blog\/understanding-stop-loss-insurance\/\">self-funded stop-loss<\/a> captives is rapidly growing. Today, the market for stop-loss is $30 billion \u2013 10 years ago, it was roughly half that, Mike said.\u00a0<\/span><\/p>\n<p>&nbsp;<\/p>\n<blockquote><p><em><strong>\u201cCaptives are a big part of that because they\u2019re fitting into that middle market space \u2013 anywhere from 50 to 500 employees,\u201d Mike said. \u201c&#8230;More often than not, captives are providing a bridge for a fully insured or fixed-cost funding vehicle to move into self-funding. Captives are a catalyst \u2013 a driver of the overall market moving to self-funding.\u201d<\/strong><\/em><\/p><\/blockquote>\n<p>&nbsp;<\/p>\n<p><span style=\"font-weight: 400;\">Of that $30 billion stop-loss market, Mike estimates stop-loss captives are 10% to 15%. How big could the market get?<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"font-weight: 400;\">Mike calculates that there are at least half a million small to midsize employers in the United States. Just 1% of that market is equivalent to $1.5 billion in stop-loss premium. Moving just roughly 10% of the middle market into a self-funded stop loss captive would be billions of dollars \u2013 a long runway.\u00a0\u00a0<\/span><\/p>\n<p>&nbsp;<\/p>\n<blockquote><p><strong><em>\u201cI do believe a self-funded captive is a better alternative than a traditional fixed cost where you have no insight or control and you have costs that are going up double digits,\u201d Mike said. \u201cSo yeah, I think any employer in that space should really <a href=\"https:\/\/roundstoneinsurance.com\/excelsior\/blog\/why-choose-roundstone-for-group-captive-insurance\/\">look very closely at self-funding with the captive<\/a>.\u201d\u00a0<\/em><\/strong><\/p><\/blockquote>\n<p>&nbsp;<br \/>\n&nbsp;<\/p>\n<h2>A Streetcorner Evangelist Founding the World\u2019s First Self-Funded Stop-Loss Captive<\/h2>\n<p>&nbsp;<\/p>\n<p><span style=\"font-weight: 400;\">Mike also discussed the early days of founding Roundstone as the first self-funded stop-loss captive in 2005.<\/span><\/p>\n<p>&nbsp;<\/p>\n<blockquote><p><span style=\"font-weight: 400;\"><strong><em>\u201cI joke I was the streetcorner evangelist right up until healthcare reform passed. It was a good idea, but there wasn\u2019t a lot of traction. There wasn&#8217;t a lot of market demand. But with the rising cost of healthcare, that&#8217;s really changed. And now it&#8217;s become a go-to, a better alternative for employers that want to self-fund their employee benefits.\u201d<\/em><\/strong><\/span><\/p><\/blockquote>\n<p>&nbsp;<\/p>\n<p><span style=\"font-weight: 400;\">He talked about <\/span><a href=\"https:\/\/roundstoneinsurance.com\/excelsior\/blog\/self-funded-insurance\/\"><span style=\"font-weight: 400;\">the value and structure of self-funded stop-loss captives<\/span><\/a><span style=\"font-weight: 400;\">. They provide immense value to employers by <\/span><a href=\"https:\/\/roundstoneinsurance.com\/excelsior\/roundstone-csi-dashboard\/\"><span style=\"font-weight: 400;\">offering insights into cost drivers<\/span><\/a><span style=\"font-weight: 400;\"> and enabling better management of employee benefit plans. <\/span><a href=\"https:\/\/youtu.be\/GdspLRLOxAA?si=NtCfMcyBPqEt-KO2\"><span style=\"font-weight: 400;\">Alignment within a captive is essential<\/span><\/a><span style=\"font-weight: 400;\"> to ensure the employers\u2019 objectives are always the priority with a focus on <\/span><a href=\"https:\/\/roundstoneinsurance.com\/excelsior\/blog\/keep-premiums-affordable\/\"><span style=\"font-weight: 400;\">quality healthcare at reasonable costs<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><br \/>\n&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<h2>How to Lower Costs and Ensure Sizable Distributions in a Self-Funded Stop-Loss Captive<\/h2>\n<p>&nbsp;<\/p>\n<p><span style=\"font-weight: 400;\">Mike also <\/span><a href=\"https:\/\/roundstoneinsurance.com\/excelsior\/blog\/how-to-budget-for-a-self-funded-health-plan\/\"><span style=\"font-weight: 400;\">discussed the operational and financial aspects of captives<\/span><\/a><span style=\"font-weight: 400;\"> \u2013 why <\/span><a href=\"https:\/\/roundstoneinsurance.com\/excelsior\/blog\/how-to-find-the-best-stop-loss-captive-for-your-employee-health-plan\/\"><span style=\"font-weight: 400;\">reducing expense loads and maintaining sizable return funds<\/span><\/a><span style=\"font-weight: 400;\"> is so critical to ensuring a high return of unused stop-loss premium to captive members at the end of the year. Roundstone always <\/span><a href=\"https:\/\/www.prnewswire.com\/news-releases\/roundstone-reports-8-million-distributed-back-to-its-group-captive-participants-301872973.html\"><span style=\"font-weight: 400;\">pays its distributions in cash and returns 100% of all unused claims dollars<\/span><\/a><span style=\"font-weight: 400;\"> back to the employers on a pro-rata basis. Most captives don\u2019t \u2013 if they return any dollars at all.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"font-weight: 400;\">Mike also stressed the importance of avoiding conflicts of interest and ensuring decisions within a captive are aligned with the best interests of employers. He pointed out that Roundstone never takes commissions from vendors, TPAs, or PBMs. Roundstone\u2019s priority is always providing the best outcomes to the employer and the employees.<\/span><\/p>\n<p>&nbsp;<br \/>\n&nbsp;<\/p>\n<h2>The Benefits of Data to Reducing Healthcare Costs and Improving Quality of Care<\/h2>\n<p>&nbsp;<\/p>\n<p><span style=\"font-weight: 400;\">Mike also talked about the <\/span><a href=\"https:\/\/roundstoneinsurance.com\/excelsior\/blog\/captives-do-it-better-data-transparency\/\"><span style=\"font-weight: 400;\">value of data analytics for better health plan management<\/span><\/a><span style=\"font-weight: 400;\"> and to further optimize the savings of a self-funded health insurance plan.<\/span><\/p>\n<p>&nbsp;<\/p>\n<blockquote><p><em><strong>\u201cLike anything in business, if you don&#8217;t have information and you don&#8217;t have data to help you figure out what is driving costs, you&#8217;re most likely going to be in an environment in which those costs are going up pretty dramatically,\u201d Mike said.\u00a0 \u201cThat is the fate of employers who are in a fixed cost, fully insured product. They do not get the data necessary to take control over their employee benefit plan.<\/strong><\/em><\/p><\/blockquote>\n<p>&nbsp;<\/p>\n<blockquote><p><strong><em>\u201cThe ability to get information and get control opens the door to savings. Today, particularly with things like the <a href=\"https:\/\/roundstoneinsurance.com\/excelsior\/blog\/3-macrotrends-that-drive-more-employers-to-self-funded-stop-loss-captives\/\">escalating cost of drugs and pharmacy<\/a>, if you don&#8217;t have a good line of sight into how drugs are being delivered to your population and to your employees, your costs are going to run out of control. That&#8217;s what the captive does. It opens the door for these employers to self-fund, gain insight into what is driving costs, and then give them the control to manage those costs. And when you do that, <a href=\"https:\/\/roundstoneinsurance.com\/excelsior\/blog\/desk-mike-schroeder-february-edition\/\">the self-funding captive environment keeps the savings with the employer<\/a> and with the community. The outcomes are better than what they were doing before.\u201d<\/em><\/strong><\/p><\/blockquote>\n<p>&nbsp;<br \/>\n&nbsp;<\/p>\n<h2>The Vision for a Value-Driven Healthcare Industry<\/h2>\n<p>&nbsp;<\/p>\n<p><span style=\"font-weight: 400;\">Both Mike and Ramesh expressed enthusiasm about the potential for self-funded stop-loss captives to contribute to a more transparent, value-driven healthcare industry.\u00a0<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"font-weight: 400;\">Mike also encouraged advisors to participate in <\/span><a href=\"https:\/\/roundstoneuniversity.org\/\"><span style=\"font-weight: 400;\">educational initiatives like Roundstone University<\/span><\/a><span style=\"font-weight: 400;\">. He highlighted the rewarding aspects of working toward improving healthcare affordability and quality, and discussed why captives provide a pivotal tool to allow small to midsize employers to finally turn the tables on escalating healthcare costs and be able to provide affordable, quality care for their employees.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"font-weight: 400;\">Listen up and enjoy!<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"font-weight: 400;\">Have a question for Mike? <\/span><a href=\"mailto:marketing@roundstoneinsurance.com\"><span style=\"font-weight: 400;\">Let us know.<\/span><\/a><\/p>\n<p>&nbsp;<\/p>\n<p><a href=\"https:\/\/hcaainfo.podbean.com\/e\/episode-28-what-is-up-with-the-growth-in-captives\/\" target=\"_blank\" rel=\"noopener\"><img fetchpriority=\"high\" decoding=\"async\" class=\"alignnone wp-image-53554\" src=\"https:\/\/roundstoneinsurance.com\/excelsior\/wp-content\/uploads\/2024\/03\/Voices-of-Self-Funding-Podcast-Listen-Now-CTA-300x86.webp\" alt=\"Voices-of-Self-Funding-Podcast-Listen-Now-CTA\" width=\"1388\" height=\"398\" srcset=\"https:\/\/roundstoneinsurance.com\/excelsior\/wp-content\/uploads\/2024\/03\/Voices-of-Self-Funding-Podcast-Listen-Now-CTA-300x86.webp 300w, https:\/\/roundstoneinsurance.com\/excelsior\/wp-content\/uploads\/2024\/03\/Voices-of-Self-Funding-Podcast-Listen-Now-CTA-768x219.webp 768w, https:\/\/roundstoneinsurance.com\/excelsior\/wp-content\/uploads\/2024\/03\/Voices-of-Self-Funding-Podcast-Listen-Now-CTA.webp 778w\" sizes=\"(max-width: 1388px) 100vw, 1388px\" \/><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p class=\"excerpt\">Highlights Roundstone\u2019s Founder and President Mike Schroeder joined the Voices of Self-Funding podcast with host Ramesh Kumar to discuss why self-funded stop-loss captives have exponentially grown the small to midsize market for self-funded insurance. Roundstone avoids conflicts of interest by never taking commissions from vendors, PBMs, or TPAs \u2013 our priority is always to ensure [&hellip;]<\/p>\n","protected":false},"author":16,"featured_media":53589,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3334,1827],"tags":[],"class_list":["post-53543","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-advisors","category-employers"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v22.8 (Yoast SEO v25.6) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>What\u2019s the Future of Self-Funding and the Role of the Stop-Loss Captive?<\/title>\n<meta name=\"description\" content=\"On a recent Voices of Self Funding podcast, Roundstone\u2019s President Mike Schroeder speaks about why captives have exponentially grown the market for self-funding.\" \/>\n<meta name=\"robots\" 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