Capstone Benefits
The services of Capstone are designed to fill the gaps we so often see in employee benefit administration. That is why we extend far beyond what you might see from a typical consultant or broker and give you the information, tools and insight you need to provide competitive and effective benefits to your employees. Rather than contracting and coordinating with multiple vendors and service firms, you can rely on one trusted advisor to be your advocate in the complex world of healthcare.

Special Funding Arrangements A new answer for a challenging question

One of the most basic, yet important, decisions that an employer or group will make is whether to operate under a self-funded or fully-insured arrangement. Many consultants will tell you that this decision is dictated by group size alone; however, we believe there are many factors that should influence this choice. Both options offer clear advantages and have their own compliance and financial consequences. Yet, at some point, many groups wish there was a middle ground between the two.

Now, there is.

Capstone has engineered a product that bridges the gap between self and fully insured – the Capstone Minimum Premium Plan. This provides the claims savings potential of a self-funded product, yet eliminates the additional regulatory and compliance burden. For multiple employers, it gives them the peace-of-mind of a fully insured product and the flexibility of treating each employer as an individual company – with its own ratings and plan options.

The Capstone Minimum Product Plan offers many advantages over a self-funded plan:

  • It is a fully insured arrangement, thereby avoiding or mitigating most state and federal MEWA requirements.
  • It provides cash flow similar to a self-funded arrangement without the additional claims risk.
  • Surpluses [Premiums – (Claims + Plan Costs)] are retained by the policyholder allowing for greater premium stabilization.
  • It offers maximum risk protection for individual (specific) claims.
  • The maximum claim liability (aggregate) is capped at 100% of expected claims.
  • It offers as much flexibility in choices of plan design, plan administration and claims administration.

The Capstone Minimum Premium Plan’s advantages over a fully insured plan include:

  • Claims are not subject to taxation, significantly reducing premium taxes.
  • It provides an improved cash flow – similar to self-funding
  • Surpluses [Premiums – (Claims + Plan Costs)] are retained by the policyholder – not the insurance company.
  • Increased flexibility in choices of plan design and plan administration.

The Capstone Minimum Premium Plan is not right for every group, yet it completes the spectrum of funding arrangements and gives you a viable third option to make the best choice for your members.