Captive Health Insurance · Indiana

Captive health insurance, how mid-size employers share the risk.

A group medical captive lets like-minded employers pool their risk and share the savings instead of handing them to a carrier. Members self-fund small claims, pool mid-size claims together, and buy stop-loss for the catastrophic layer.

It's a middle path between going fully insured and self-funding alone. Favorable performance may be returned to members under the captive's governing terms, but results vary by program and claims experience.

Free benchmark · No obligation · You keep the findings

How It Works

The three claim layers of a group captive

A captive isn't a product you buy off a shelf. It's a funding structure built in layers. Each layer decides who pays which claims, and that's where the savings live.

The retained layer (your claims)

  • You self-fund small, predictable claims below a set threshold
  • These everyday claims are the bulk of spend and stay under your control
  • Premium dollars that go unused stay with you, not a carrier
  • Program costs and carrier margin should be compared line by line

The shared captive layer (the pool)

  • Mid-size claims are pooled across member employers
  • The group cushions any one member's bad quarter
  • Good years return unused funds to members as dividends
  • You gain peer benchmarking, data tools, and advisory support

The stop-loss layer (catastrophic protection)

  • Claims above the pool's ceiling pass to a stop-loss carrier
  • Caps the group's total exposure. No member faces an unbounded loss
  • This is the reinsurance that makes the structure safe
  • Contract terms matter as much as the premium

Where the savings come from

  • No commercial carrier profit margin baked into premium
  • Dividends return favorable claims performance to you
  • Renewals priced off the captive's own experience, not market trend
  • Renewals reflect the captive's experience, program terms, and the broader market

Before You Join

What to weigh before joining a captive

A captive is powerful, but it's a commitment, not a quick switch. These are the four things every employer should weigh first. All manageable with the right advisor.

Consider 01

Capital and collateral

Members may need to post capital or collateral to secure the group's obligations. Requirements, return terms, and exit conditions vary by program, so the cash commitment needs to be modeled before joining.

Consider 02

A multi-year commitment

Captives are generally designed for a multi-year commitment, not a one-year transaction. Employers should understand renewal, withdrawal, unresolved-claims, and capital-return terms before joining.

Consider 03

Active engagement required

Members manage their claims data, run cost containment, and participate in governance. A set-it-and-forget-it employer won't see the returns a captive can deliver.

Consider 04

Group size and claims fit

Eligibility depends on covered lives, claims history, risk tolerance, and the captive's underwriting rules. Employers with known high-cost exposure may face different terms or find another funding structure is a better fit.

FAQ

Captive health insurance, answered plainly

What is captive health insurance?+

Captive health insurance (also called a group medical captive) is a funding structure where a group of employers band together to form and own an insurance company that funds their mid-size health claims. Instead of paying premiums to a commercial carrier, members self-fund their own small claims, pool medium claims in a shared layer, and buy stop-loss insurance for catastrophic claims. When the group runs healthy, unused funds are returned to members as dividends.

How does a group medical captive save money?+

A group medical captive can improve cost transparency, allow participating employers to share a defined layer of risk, and return favorable performance under the program's governing terms. Potential savings depend on claims, fixed costs, underwriting, stop-loss terms, governance, and the employer's time horizon. A captive should be compared with the employer's best fully insured, level-funded, and standalone self-funded options rather than judged on a headline savings estimate.

What's the difference between a captive and a plain self-funded plan?+

A self-funded employer carries its own risk up to its stop-loss attachment point on its own. A captive spreads that mid-layer risk across many employers, so one bad quarter is cushioned by the pool. Captives also come with peer benchmarking, shared data tools, and advisory councils that standalone self-funding doesn't include. Many employers use a captive as a more stable on-ramp to self-funding.

How big does my company need to be to join a captive?+

Eligibility varies by captive. Programs evaluate covered lives, claims history, industry, risk tolerance, participation requirements, and the employer's willingness to manage costs actively. The right test is whether the program's underwriting, shared-risk structure, governance, and exit terms fit the employer better than available fully insured, level-funded, or standalone self-funded options.

How much capital do I have to put up?+

Capital or collateral requirements vary by captive and may be based on contributions, stop-loss premium, shared risk, or another program formula. Employers should ask how the amount is calculated, when additional funding can be required, what happens after a deficit, and when capital becomes eligible for return after exit and unresolved claims.

Does Burt Advisory help Indiana employers evaluate captives?+

Yes. Burt Advisory is based in Elkhart, Indiana and helps school systems, municipalities, manufacturers, and other Indiana employers weigh captive, self-funded, level-funded, and fully insured options side by side. We model the numbers against your current plan, evaluate captive programs, place stop-loss, and manage cost containment through the United Benefit Advisors network.

Free Benchmark

See how your plan stacks up.

  • Your cost per member vs. employers your size
  • The three biggest leak points we see in your plan type
  • A written summary you keep, whether or not we ever talk again