How To Choose A Pharmacy Benefit Manager
Pharmacy costs are rising faster than any line item in your health plan. Here’s how to choose a PBM that actually controls them.
Pharmacy costs are rising faster than any line item in your health plan. Here’s how to choose a PBM that actually controls them.
Stop-loss insurance protects self-funded employers from catastrophic claims by pooling risk with similarly sized businesses through a group captive plan.
Strategic incentives, education, and communication can increase wellness program engagement by 40-60%. Here’s how self-funded employers design programs that actually work.
Self-funded health insurance lets employers pay claims directly, capture savings when employees stay healthy, and see exactly where every dollar of spend goes.
Per-employee-per-year (PEPY) cost is the truest benchmark for whether your health plan is competitive. Here’s how to use it to drive decisions.
Specialty drugs are the fastest-growing line item in employee benefits. A self-funded plan gives you the visibility and levers to manage the spend.
A medical group captive is a self-funded health insurance model where employers share risk to gain stability, transparency, and buying power.
Employers using fully-insured pay a fixed premium for the carrier to take 100% of the risk and keep any profits. Captives allow employers to band together to control costs and receive refunds for better-than-expected claims.
Employers using level-funded pay a fixed monthly fee to cover administrative, claims, and stop-loss insurance expenses. Any surplus may be partially refunded at the carrier’s direction. With captives, you gain control—full data ownership, plan flexibility, and the ability to keep any savings.
Roundstone works with employers ranging in size from 25 to 1,000+ eligible employees.
Yes, with the right partners, transitioning to self-funding is easy. Roundstone assigns a dedicated Customer Outcomes Manager to guide clients through the process. Your third party administrator (TPA) then handles day-to-day administration and claims.
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