For years, larger employers have turned to self-insured plans as a solution due to better pricing terms and lower taxes, less margin lost to insurance carriers, and more employer control over the plan design.

Increasingly, small- to mid-size groups are joining with like-minded employers to form group medical captives. At their core, the goal of medical captives is to address the stop loss market access/dysfunctionality at the smaller end of the employer market, which is accomplished by providing a lower specific stop loss attachment point for employers with approximately 100-300 employees. These captives are sold with a promise to keep medical costs steady and more predictable from year-to-year by spreading the risk among multiple small- to mid-size employer groups.