Medical captive insurance is helping level the playing field for mid-market employers who, along with their brokers and advisers, pledge a more aggressive stance on cost containment, observes Mike Schroeder, president of Roundstone Management, Ltd.

His firm uses a pooling approach to self-fund employers with as few as 25 employees — a strategy that as many as 98% of larger employers have used for years. The cost savings of its stop-loss group captive is 20% on average, which he says is a double-digit advantage over traditional fixed cost health insurance. Under the medical captive model, which helps mitigate self-funding’s volatility challenge, like-minded employers band together to leverage their purchasing power and secure direct contracts with providers.

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