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Medical Expense Stop Loss Group Captive

Medical Expense Stop Loss Group Captive Program from Roundstone

Roundstone offers a Medical Expense Stop Loss Group Captive program designed for mid-size self-funded employers seeking cost control, transparency, and long-term financial benefits. This fully insured program is ideal for Taft-Hartley plans, single employer groups, school districts, and municipalities. With a required minimum of three years of self-funded claims history, your clients can access a structured, stable solution to better manage rising healthcare costs.

Ideal Accounts and Appetite

This group captive is best suited for entities with a strong commitment to managing healthcare spend and who have demonstrated stable claims performance. Target insureds include:

  • Taft-Hartley multi-employer plans
  • Municipalities and school districts
  • Mid-size to large single employer groups

Clients should have at least three years of self-funded history and an interest in long-term cost containment strategies. An ideal self-insured retention (SIR) falls between $50,000 and $300,000.

Coverage Highlights and Advantages

Roundstone’s Group Captive model empowers participants to take control of their healthcare spending. Key benefits include:

  • Continued payment of claims within a defined self-insured retention
  • Shared risk participation in a group captive layer
  • Stabilized premiums despite market cycles
  • Increased control over TPA services and vendor costs
  • Potential to earn back underwriting profits and investment returns

The program is structured to reward favorable loss experience, making it a strong fit for groups committed to wellness, engagement, and claims management.

Underwriting Notes and Minimum Premiums

Underwriting requires a minimum of three full years of self-funded claim data. The ideal SIR range is $50,000–$300,000. Pricing varies based on group size, claims experience, and program structure. Groups with healthy loss ratios and a proactive benefits strategy are more likely to benefit from this captive model.

Territories and Availability

This program is available in all 50 states plus Washington, DC. Coverage is written on an admitted basis, giving your clients added regulatory confidence and compliance ease.

Why Work with Roundstone?

Roundstone specializes in innovative captive solutions for mid-size employers. Their strong focus on transparency, cost efficiency, and long-term sustainability makes them a trusted partner for agents and brokers seeking alternative stop loss options for their clients. With a proven track record of returning savings to employers and supporting brokers with tailored support, Roundstone helps you deliver real value to your insureds.

Whether your client is a school district looking to stabilize healthcare budgets or a municipality ready to transition from fully insured to self-funded, Roundstone’s Group Captive program offers a compelling path forward.

Frequently Asked Questions

What types of accounts are a good fit for this program?

Ideal accounts include Taft-Hartley plans, municipalities, school districts, and mid-sized single employer groups with stable self-funded history and a focus on wellness and cost control.

What is the required self-insured retention (SIR) range?

The ideal SIR for this program ranges from $50,000 to $300,000, depending on group size and risk tolerance.

Can newly self-funded groups participate?

No. Groups must have at least three years of self-funded claims experience to be eligible for this program.

How does the group captive layer work?

Each participant retains responsibility for claims within their SIR. Claims above that threshold enter a shared captive layer where risk is pooled, allowing members to benefit from collective performance.

What are the benefits for brokers placing business with Roundstone?

Brokers gain access to a proven captive model, competitive pricing, underwriting transparency, and the opportunity to help clients control costs while potentially earning back unused premium dollars.

Need help placing an account? Connect with a market specialist.

U.S. States Available

  • U.S. States Available:
  • Provider Type:
    Captive
  • Admitted:
    All Available States
  • Carriers:
  • Carrier Ratings:
    A.M Best A rated
  • Commission:
    10%
  • Min Premium:
    -

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Roundstone has other insurance programs like American Business Captive.