HOW IT WORKS
How the Roundstone Captive Solution Works
The Roundstone Captive enables companies to self-insure safely. With our three-tiered model, you pay for healthcare costs up to a specific deductible, you share some costs above that deductible across a pool of hundreds of other employers in the Captive, and finally, you shift costs to a stop-loss carrier to cover catastrophic claims. The Captive, with its thousands of lives, acts as an additional protective layer that absorbs risk, reduces stop-loss fixed costs, and gives smaller companies the advantages of self-insuring like the Fortune 500s.
Your new self-funded plan will have 3 cost “layers”:
CARRIER
CAPTIVE
EMPLOYER
Does this mean I have to use the same plan as the hundreds of other companies? Solution
Absolutely not. Your plan is your own. It’s customized to the individual care needs of your employees. Roundstone’s solution gives you complete flexibility in plan design. You end up with great healthcare at a lower cost. And the best part is that you can evolve and optimize your plan as you learn more from your claims data for a highly effective long-term healthcare strategy.
Who's Who in a Self-Funded Health Plan?
Self-funding is an employer-centric solution. Everyone involved is aligned around the best interests of the employer: Benefits Advisor, Roundstone, Third Party Administrator (TPA), and Pharmacy Benefit Manager (PBM). They work together as one integrated team to manage and administer the health plan, process claims, and make sure everything is running optimally. It’s a seamless experience.
How You Save Money with a Self-Funded Plan in the Captive
Self-funding is an employer-centric solution. Everyone involved is aligned around the best interests of the employer: Benefits Advisor, Roundstone, Third Party Administrator (TPA), and Pharmacy Benefit Manager (PBM). They work together as one integrated team to manage and administer the health plan, process claims, and make sure everything is running optimally. It’s a seamless experience.
First, you only pay for the healthcare you use — what you deserve to pay and nothing more. Any savings from the claims account stays with you.
Second, we return any unused premium from the Captive annually to employers on a pro rata basis — $10M in 2023 alone, for example. Annual distributions are based on Captive performance — not one individual company. You can still receive a distribution even if you had a bad claims year.
Third, we prefer transparent and pass-through Pharmacy Benefits Managers who send 100% of pharmacy rebates and savings back to you.
You gain complete transparency
- Data and analytics to make informed decisions to further lower cost and improve care quality.
- Our Cost Savings Investigators work one on one with you to identify savings opportunities and provide recommendations to further drive down cost. Clinicians, advisors, data analysts, claims managers - all work together to proactively optimize plan utilization and spend.
- We provide the most effective and fully vetted cost containment solutions on the market.
Transitioning to Self-Funded Insurance is Easy and Seamless
We provide hassle free onboarding, claims management, customer service, and plan design strategy.
There’s no disruption. Your employees will still have:
They’ll get a great experience and great benefits at a lower cost. You get affordable healthcare without having to sacrifice quality.
How the Roundstone Captive Works
Want a deeper dive into how self-funding health benefits in the Roundstone Captive works? Watch this video to learn the fundamentals.
Our Guarantee to You
Roundstone is so confident that your company will save money that we offer the Roundstone Guarantee: We promise you will save money in the first five years — or we’ll make up the difference.
What’s the First Step?
Contact us for a collaborative, no obligation health plan assessment. We’ll craft a custom proposal to save you money on healthcare.
STEP 1:
Schedule an Intro
– Learn about Self-Funding –
– Engage your Advisor –
– Request a Proposal –
STEP 2:
Make a Choice
– Review Your Options –
– Customize Your Plan –
STEP 3:
Start Saving
– Enroll –
– Implement –