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Cons of a Captive Insurance Plan Increased risk With a captive, the owner-insureds put their own capital at risk. If a company experiences a high number of claims, that capital could be lost. This is why its important to have robust risk management policies.
Within a group captive, each employer establishes a separate self-funded plan for their own employees, and purchases medical stop-loss coverage ing to their own risk appetite. The stop-loss is purchased from the common insurer or reinsurer that will provide coverage to each member of the captive.
Essentially, the captive provides an additional layer between the employers selected retention and an excess reinsurance layer. This middle layer, the captive retention, is shared with other employers.
Stop Loss insurance is typically purchased by the employer through a TPA or directly from a carrier underwriter. Working with these experts, an employer can determine their threshold of claim payment risk and thereby set the desired level of protection needed.
A captive insurer is generally defined as an insurance company that is wholly owned and controlled by its insureds; its primary purpose is to insure the risks of its owners, and its insureds benefit from the captive insurers underwriting profits.
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Captive Membership ParetoHealth captives are formed by groups of employers with the same business goal: To reduce the costbut not the qualityof their employee health programs, without taking on unnecessary risk. When you join the captive, you pay your employees claims yourself, just like in a self-insured plan.

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