Heffernan Medical Solutions Employee Benefits Group Captive

Published on Tue, 06/18/2013 - 16:34

With group health insurance costs rising, many employers are looking to take a more innovative approach to their employee benefits program. Mid-sized employers, (those with 50 to 1,000 employees) are often unaware of an alternative to the fully-insured environment.

The Heffernan Solution

Heffernan Benefits Advisory Services has partnered with a third party administrator to bring you an innovative solution. Our employee benefits group captive allows you to take control of your costs, increase the wellness of your employees and generate real savings.

How Does It Work?

Previously, mid-sized employers have not been able to self-insure claims because their claims are too volatile and the risk exposure has been too great. Not now! The group captive gives employers a way to gain control by self-insuring claims for a portion of the risk. In a captive there are three layers of risk:

  • Small and predictable claims are covered by the employer
  • Each employer contributes premium to the group captive to cover the larger claims, collectively. If funds paid into the captive exceed claims, the employer groups share in the profit.
  • Catastrophic claims are covered by Excess Insurance and are paid by the insurance carrier.

Benefits to Employers Joining the Captive:

The captive is run by knowledgeable consultants and an experienced TPA. They would make the transition seamless to employees. Groups can choose either the Cigna or Blue Shield networks, both well-known global network providers. Benefit plans would mirror a traditional PPO or HDHP plan.

Employers gain increased transparency on claims, (ie. they know what kinds of claims their employees have), and greater predictability of claims risk. Employers also know what wellness areas to focus on that directly relate to their claims and employee health risks.

Employers retain profit from savings that would have gone to insurance companies and state taxes.

Groups create even more savings from employees’ positive behavioral changes that better their health now and in the future.

The benefits captive has seen cost savings up to 30%

Extra Benefits Not Offered by Insurance Carriers:

  • Access to our exclusive wellness program
  • Organ transplant carve-out
  • Front End Case Management
  • Medical Travel to a Center of Excellence, domestically and internationally, through WorldMed Assist