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Self-Funded Stop-Loss Captives: A Better School of Thought

Jul 12, 2024

Imagine an employee benefits plan that is flexible, transparent, and allows your school to retain 100% of the unused claims dollars. The Independent School Benefits Consortium™ (ISBC) embodies that vision.

Instead of buying insurance for health-related expenses such as office visits, office procedures and maintenance medication, self-funded plans pay these expected claims as an expense and buy stop-loss insurance for the unpredictable claims. Aggregate stop-loss protects self-funded plans from overall high frequency of claims in any one plan year, while specific stop-loss provides protection from high individual or catastrophic claims.

The aggregate attachment point, or maximum claim liability, is determined based on a corridor (usually 120%) over total expected claims. The specific deductible is determined based on the size of the group and level of risk an employer is willing to accept.

Currently, the ISBC includes 80+ schools, 14,000 plan members and is located in 20 states. This program enables schools to have flexibility of plan design, full transparency of claim utilization data and incorporates cost savings opportunities through wellness incentives.

ISBC offers financial leverage and stability through a proven track record of performing significantly better than industry standards. In an environment where inflation for medical and prescription cost has been double digits, over the past five years, the overall average annual cost for all schools has increased only 2.2%.

In 2014, the ISBC transitioned to a funding arrangement that allows schools to keep 100% of unused premiums. Since inception of this program almost $7.9 million has been returned to the schools as underwriting dividends.

The ISBC not only enables schools to control their health insurance spend, but the program also provides a full range of services including plan member concierge and advocacy resources, telemedicine, mobile app, care coordination and chronic condition management.

Times may be turbulent for health insurance, but by joining the ISBC, you gain a partner and a program with proven results and a plan of protection for the challenging road ahead.