2. WelcometoAffordableHealthcare
Our objective is to Make American Health Care Affordable. Our health plans spread claims risk over a large group by
using a self-funded, level pay, platform that includes reinsurance protection, network discounts and differentiated claims
management.
By joining together with other groups, to become one large group, we spread the risk among thousands of members as
opposed to individual groups. This helps create competitive rates and assumed positive renewals.
To be eligible for participation, you must complete the underwriting process and be accepted. All eligible employees are
required to complete an individual online health questionnaire. Large groups may submit 3 years of claims & rate history,
in lieu of the individual health questionnaires.
Once the information is obtained and underwriting has assessed your groups risks, rates will be furnished for your
consideration.
Build the Plan That's
Best for You
Our Captive provides you with the opportunity to choose from pre-
selected plan options. Based on employer size, we can offer a
unique, self-funded group health benefit program that maximizes benefits
to employees while implementing cost saving opportunities for employers
to stabilize benefit costs without reducing benefits. Advantages of our
approach include:
• Flexibility in carrier partners based on group size
• Ability to offer multiple plan designs including base plan
and additional options
• A group health benefits platform that remains consistent regardless
of the selected carrier
• Deductible credits for wellness program participation
• Seamless claims payment and reporting
A Better Alternative for Group Benefits
Level Funded Health Plans offer a great alternative to traditional, fully insured group health plans. With our level-funded
Captive plan, monthly premiums are locked in for your plan year and savings are deposited back into your plan to help
keep renewal rates lower than comparable fully insured plans.
3. Advantages of Level Funded
Group Benefits
Captive health plans are governed primarily by federal ERISA laws. ERISA plans differ from state benefit mandates,
which result in lower costs and expenses for sponsoring employers. For employees, the features of anERISA plan,
as described in the Summary Plan Description (SPD), will be similar to the benefits they are familiar with in a fully
insured plan with co-pay, deductible and pharmacy benefit options. Each employee will have access to their plans
SPD detailing these benefits as they enroll in the Captive health plan. In all cases, the plans are full major medical
coverage, ACA compliant with lifetime unlimited maximums.
How it Works
The monthly group health premium paid to the Captive for your group is made up of three separate components:
• Administration Costs
• Custom Stop Loss (CSL) Coverage
• Claims Fund
Your maximum annual claims, including claims run-off liability, are predetermined and you pay 1/12 of this cost each
month for the 12 months of your plan year. After you have paid this amount, there are no other charges for the claims
fund. Once all claims have been paid for the plan year, any unused dollars will be used to reduce future premium rate
increases.
4. Questions and Answers
What is a Captive?
A captive is an insurance company created and wholly owned by
one or more other companies to insure the risks of its owner(s).
Why join a captive?
A captive offers the key benefits of pricing stability, insurance
coverage stability and improved services. Given the law of large
numbers, overall claims experience can be predicted with more
confidence for a captive insurer than if a single organization's
exposures were being covered. IInsures Tax-Deductible
Captives also can obtain services and reinsurance more
cost-effectively than if each member attempted to obtain by
themselves.
Risk Premiums
IOPERATING COMPANY
Does the captive require collateral for participation?
No, there is no fee to join our Captive.
What is required of me to participate?
• Provide Employee Census in Excel format
• Complete underwriting requirements
• Meet a 75% participation requirement (excluding those with valid waivers with proof of other coverage)
• Minimum employer contribution of 75% of the lowest employee rate
• Partnering with captive administrators to insure deadlines are met
What happens if Ichoose to leave?
• You will not be allowed to rejoin for 12 months and will be subject to individual underwriting approval
• Claims experience will be provided
• You will not be responsible for any terminal liability
*May not be available in all states.
Mickey Christian
760.889.2306
bnmpartners@thinkabx.com