Captive Health Insurance
Captive Health Insurance Solutions for Employers
A captive is a formal self-insurance structure where an employer — or a group of employers — funds their own health claims through an insurance company they own or partially own. Many small to medium-size businesses face the challenge of providing robust employee benefits while managing costs effectively. At Gilbert’s, we offer captives as a tailored solution: a distinctive employee benefits health plan designed to optimize coverage and control expenses.
Captives offer an effective way for employers to self-fund benefits, minimizing the costs, volatility, and uncertainty associated with traditional self-funding.
While we’re proud to call Pennsylvania our home, we’ve helped businesses all across the country manage their risk and we look forward to helping you, too – no matter where it is that you call home.
Benefits of a Captive Health Plan
- Cost Savings: Avoid the profit margins built into traditional fully insured carrier plans
- Investment Income: Potential to earn investment income on reserves held by the captive
- Transparency: Direct visibility into claims data most employers never see under a fully insured plan
- Long-Term Cost Control: More predictable, stable costs over time compared to the volatility of the traditional market
Our RISK SHIELD® Process
Our manufacturing clients find great value in our risk management approach that identifies your exposures and puts a loss control plan in place to mitigate them. Often the solution is an insurance product, but frequently it’s a recommendation for a business process or measure that reduces an exposure.
CONSULT
DESIGN
BUILDING
MAINTAIN
Our Benefits Management Services Approach
We offer a full complement of benefits from the nation’s premier insurance partners, and our experienced employee benefits consultants can help you develop a package that’s right for your workers and your budget nationwide. Our approach is consultative and solutions-based.
Your Outsourced Partner
Setting up a captive is a significant financial decision, not something to navigate alone. Our experienced benefits consultants help you evaluate whether a captive fits your claims history and risk tolerance, then guide you through implementation.
360 Degree Approach
We take a 360-degree view of your business to ensure all aspects are secure. Our team of experts in Loss Control, Employee Benefits, HR, and training are all available to our commercial clients, ensuring multi-pronged risk mitigation.
Value Added + Tailored Solutions
In addition to access to our highly experienced benefits and HR consultants, we think you need another layer of protection. A 2015 study found U.S. employers face about a 12% chance of an employee claim that could result in a lawsuit — compliance, documentation, and HR best practices are your main defense. Many employers don't recognize the potential risks they carry, lacking adequate policies or procedures to mitigate them. We're dedicated to offering tailored solutions for each unique scenario, helping you implement captive insurance as a risk management measure and select the optimal coverage to protect your business and employees.
Captive Health Insurance FAQs
Traditional group health insurance transfers all risk to a carrier for a fixed premium. A captive lets employers self-fund claims through an insurance entity they own or partially own, offering more control, transparency, and potential cost savings.
Captives tend to work best for small to mid-size businesses with relatively stable claims experience, often joining a group captive to share risk with similar-sized employers.
Employers take on more direct exposure to claims volatility than with a fully insured plan, though stop-loss coverage is typically used to cap that risk.
Both are self-funded structures, but a captive involves shared ownership of an insurance entity with other employers, while a level-funded plan is typically a standalone arrangement with a single carrier offering more predictable monthly costs.
Stop-loss insurance caps an employer's financial exposure by covering claims that exceed a predetermined threshold, protecting the captive from catastrophic, unpredictable losses.
