Providing creative and innovative health insurance solutions that employers need.

Major Medical

Helping one employer at a time secure a better health insurance solution

Major Medical Health Insurance Plans - Innovative Health Insurance Advisors

Innovative Health Insurance Advisors has partnered with the most creative and innovative industry leaders in the market to bring employers a better solution that will allow them to regain control of their healthcare spend.

Problems with the current health insurance model:

  • Healthcare costs continue to rise at an unsustainable rate – rising at nearly three times the rate of inflation. At this pace, healthcare costs will double every eight years and outpace inflation by 58%.
  • Fully insured plans are non-flexible with their plan designs and typically have a delayed reporting process.
  • Employers are forced to make reactive decisions that are centered around a twelve-month renewal/reporting cycle.
  • Spreadsheets, inquiries and technologies that look backward results in missed savings opportunities, heightened risk and inaccurate reporting.
  • Traditional health insurance proposals do not include adequate information on what’s behind the premium cost, offers little to no control over the products and provides no estimate of where costs are going.
  • Medical “TREND” – is the combination of the change in cost (generally an increase) of a medical service or product times the rate of utilization or consumption of the service or product.

Our programs combine the advantages of self-funding medical cost with the protection of stop-loss insurance, the stability of a group captive, and successful risk management strategies. The combined strength can help mid-size employers (50-1000) reduce health care cost, streamline health care delivery, improve employee wellness, and achieve long-term financial stability.

Medical stop-loss captives are considered the most efficient form of alternative risk transfer in terms of increasing control and reducing the cost of employee benefits.

“Unsuccessful businesses make decisions based on their current predicament. Successful businesses, however, make decisions based on where they want to be long term.”

Major Medical Health Insurance Plan - Innovative Health Insurance Advisors

Benefits of a creative and innovative health insurance solution:

  • Reduces the impact of industry TREND
  • Greater control and flexibility of their benefits design plan
  • Improve cash flow, as claims are paid as they arise
  • Lower premium taxes and operational expenses lower insurance premiums
  • Share a portion of risk with other like-minded employers in a controlled environment and mitigating volatility
  • Collective purchasing buying power of stop loss
  • Turnkey solutions that provide participants with stability, risk diversification and risk sharing with minimal administrative cost
  • Ability to analyze your population’s health data in real time, allowing insights that a traditional carrier’s reports cannot match
  • Our program provides the needed support to identify gaps in care and address areas of improvement, which allow a savings to clients
  • Mobile app that makes healthcare and employee benefits simple, quick and painless, which uses modern technology to deliver a seamless experience
  • Average savings of 18% – 26% versus traditional fully insured plan
  • Average rate increases 0% – 4%

As with any major purchase, employers should be looking to finding out the real cost, the suitability or adaptability of the product and an estimate of ongoing expenses related to the product.  Is this currently happening for business owners who are buying health insurance year to year?

Unfortunately, most business owners are not following these basic purchasing rules when it comes to buying health insurance.

We want to help you stop being a BUYER of health insurance and start becoming a CONSUMER of health insurance. By being a consumer of health insurance, you regain the control, have the knowledge, and get the support needed to meet your need. (Stop being handcuffed by the larger insurance companies that force you to just be a buyer of healthcare insurance.)

Major Medical Health Insurance Plan - Innovative Health Insurance Advisors


What is a captive insurance company

It is an insurance company that provides insurance to its owners

What is a Group Captive

It is an insurance facility for unrelated participants who join together to share risk. Each participant has a desire to control its own risk.

What is the difference between a “standard” market insurance program and a captive insurance program

All risk is assumed by and all profits are retained by the insurance carrier. A captive program allows the captive participants to share in the risk for a potential reward of lower cost, underwriting profits, and investment income.

What entity issues the Medical Stop-Loss insurance policy

The programs use a domestic A.M. Best A+ rated, class XV carrier that is an admitted carrier regulated by the Department of Insurance for the state where the policy is issued.

Why take the risk

The opportunity to capture the profits your fully-insured carrier has been enjoying.

Is there more risk in a self-insurance captive vs fully insured programs

Comparing both programs side by side over a one-year period the captive might appear to have more risk. Structure and protection is key to your solutions. Employers handle all incurred small claims up to a limit, the captive handles all medium claims up to a limit, and the reinsurance policy protects for all large claims.

Our solution is not a one-year solution. It looks at your risk long term and controls it. Simply put, if you’re unhappy with your current health insurance situation and have been putting your company’s well-being in the hands of the large insurance companies, whose interest do you think they are looking out for?

How does the captive protect from catastrophic losses

Each captive program includes the protection of reinsurance/stop-loss agreement that limits any catastrophic or aggregation of risk. The program’s reinsurance structure limits the participant’s maximum loss and means the participant will never be required to fund more than its premium and collateral. The carrier assumes the program risk is about the aggregate and specific occurrence attachment points.

Why is collateral required

To fund the captive assumed risk above the premium, net of expenses. This ensures all potential losses are funded up front and participants are not required to contribute more money.

Can I keep my current benefits

You can have any plan design that meets your needs and the federal requirements. Most members keep their existing plan intact for the first year and slowly make changes as they progress.

What will my employees think

In most cases your employees have no idea that you have moved to a self-funded captive structure whatsoever. The main differences they will notice are an increased wellness, personalized guidance, and technology advancement that bridge the gap between healthcare and benefits. Network availability can stay the same, or now we can partner with another network that meets your employees’ needs better (Aetna, Cigna, United Healthcare).

Speak with a Representative

5 days a week 8 a.m. – 5 p.m.