Tag Archive for: Healthcare

A medical captive is a type of insurance arrangement that allows businesses and employers to self-insure their health care costs. This means the company will assume financial responsibility for any medical expenses, rather than purchase coverage from a traditional insurer. It also means they can take advantage of potential cost savings by controlling how their healthcare dollars are spent.

While a medical captive can be a great option for businesses that want more control over their healthcare costs, there are some drawbacks as well. In this blog post, we will explore the pros and cons of medical captives and help you decide if this type of health insurance is right for your business.

What is a Medical Captive?

A medical captive is a type of insurance company that provides coverage exclusively to its parent or affiliated healthcare organizations. The purpose of setting up a medical captive is to insure the risks inherent in providing healthcare, such as rising malpractice costs, increased patient care costs and unpredictable losses from litigation. Medical captives are usually established by large hospitals, health systems, universities and physician groups, who use them to protect themselves against specific risks associated with the delivery of healthcare services.

How Captives Operate

Medical captives are typically funded by reinsurance companies or other insurance carriers and structured as either a single-parent captive or a group captive. Single-parent captives are owned by one parent organization and provide coverage for just that entity’s risks. Group captives provide coverage for a group of organizations, allowing them to pool their risks and receive more favorable terms.

How Captives Are Regulated

Medical captives are regulated by state insurance commissioners. They must file annual financial statements with the appropriate state authority, comply with all applicable laws and regulations, maintain adequate capital and surplus levels and secure an independent audit each year.

Additionally. . . 

In addition to providing coverage for medical malpractice and other healthcare risks, medical captives can also provide self-insurance for operational and administrative expenses such as marketing costs, employee benefits and worker’s compensation. Captives can also offer additional services such as risk management consulting, claims administration and loss control services.

Medical captives are an increasingly popular option for healthcare organizations looking to manage their risk and save on insurance costs. They offer the potential to reduce overall costs while providing greater control over how they are managed and protected.  However, it is important to understand that medical captives are not a substitute for traditional health insurance – rather, they provide an additional layer of protection that can help mitigate certain risks.  As such, it is important to consult with an experienced insurance broker or captive manager to ensure a medical captive is the right choice for your organization.

Is a Medical Captive Bad? 

Medical captives are not inherently bad, as long as they are used responsibly. In some cases, a medical captive can be an efficient and cost-effective way to manage health care costs. However, it’s important for businesses to do their research and understand the risks associated with this type of arrangement before committing to it. There is a potential for loss if a medical captive is not managed properly. 

Additionally, it’s important to consider the pros and cons of this type of arrangement in comparison to traditional insurance coverage. Ultimately, the decision about whether or not a medical captive is right for your business should come down to careful consideration of all potential outcomes.

The Pros of a Medical Captive:

  • More control over medical costs – By creating their own plan, businesses can have more control over the medical costs they incur.
  • Reduced administrative costs – Since medical captives are self-funded, administration costs are typically much lower than with other types of health insurance plans.
  • Flexible coverage – Businesses can tailor medical captives to the specific needs of their employees. This gives businesses more flexibility when it comes to deciding what medical services and treatments are covered.

The Cons of a Medical Captive:

  • Riskier proposition – Since medical captives are self-funded, businesses may be taking on more risk than they would with a traditional health insurance plan.
  • Higher medical costs – While medical captives can help to control medical costs, they may still be higher than those of other health insurance plans.
  • Difficult to set up – Medical captives can be complex and difficult to set up, as businesses need to comply with regulations and laws in order to create a medical captive.

 

As you can see, medical captives have both advantages and disadvantages to consider. It’s important to do your research and understand the risks and benefits associated with medical captives before deciding if this type of health insurance plan is right for your business. With the right information, medical captives can be a great way to provide healthcare coverage to your employees while minimizing medical costs. 

Things to Consider

If you decide to pursue a medical captive, it’s important to understand all the details involved. You should:

  • Select a structure that is appropriate for your business
  • Consider the financial implications of entering into a captive arrangement
  • Fully research potential service providers before committing
  • Set up an internal team responsible for managing the captive and handling any claims that may arise 

Doing your research and understanding the risks involved can help ensure that a medical captive is the right choice for your business and will allow you to take advantage of its potential benefits.

The Bottom Line

Overall, a medical captive can be a great way to manage healthcare costs if used responsibly. It’s important to understand all the details before committing to this type of arrangement and to make sure it is the right choice for your business. By doing your research, you can make an informed decision about whether or not a medical captive is the right choice for you.

If you still have questions regarding medical captives, reach out to us

Or to learn more, read about the differences between standard market insurance and captive insurance programs.

Healthcare insurance brokers are constantly looking for ways to provide the best for their clients while increasing their margins. If this is the case for you, look no further!

Innovative HIA provides the most competitive rates for Minor Medical coverage plans. Our mission as a benefits administrator is to help you—as a healthcare insurance provider—deliver the best for your clients (and a little extra commission wouldn’t hurt).

Below are a few tips on how to increase margins as a healthcare insurance broker (Hint: we saved the best tip for last!)

How to Increase Your Margins as a Healthcare Insurance Broker

As a healthcare insurance broker, you are always looking for ways to provide the best possible coverage for your clients while also increasing your own margins. 

There are a few key ways that you can do this:

Get Higher Commissions

One way to increase your margins is to simply get higher commissions from the insurance carriers you work with. This can be done by negotiating better terms with the carriers, or by simply switching to carriers that offer higher commissions. (But more on this later!)

Get Better Insurance Rates

Another way to increase your margins is to get better insurance rates for your clients. This can be done by:

  • Hopping around for the best rates
  • Using discounts, or
  • Simply being aware of the different rates that are available

Increase Your Efficiency

Finally, you can also increase your margins by increasing your efficiency as a healthcare insurance broker. This means finding ways to work faster and more efficiently, saving you time and money long-term.

How Brokers Can Earn Higher Commissions with Innovative HIA

We told you we saved the best tip for last! Working with Innovative HIA is the easiest way you can increase your margins as a healthcare insurance broker.

At Innovative HIA, our ACA-compliant policies start at a base price with a set commission built-in. Additionally, we work with our brokers to ensure you feel comfortable with the commission you’re earning – no one knows how much your time is worth except for you and we want you to be satisfied with your rate.

Brokers that work with Innovative HIA can set their insurance rates to reflect the market and effort they put into managing their accounts. 

Increase Your Margins by Working with Innovative HIA!

By following these tips as a healthcare insurance broker, you can easily increase your margins. This will allow you to provide even better coverage for your clients while also making more money yourself. So don’t wait, start increasing your margins today!

Get in touch with Innovative HIA today to learn more or read on to learn how brokers can get their employer groups engaged!

Healthcare providers have been offering remote services for years, which have allowed patients to receive healthcare from the comfort of their own homes.

However, following the COVID-19 pandemic, telemedicine services became a necessity and are now a common tool utilized by many patients and healthcare professionals.

Why? These phone and video calls help patients protect themselves and others as well as provide a host of other benefits (but more on this later!) 

In this article, we’ll discuss what telemedicine is, the types of telemedicine, and when patients should be using these services. Let’s dive in.

What is Telemedicine?

Telemedicine allows healthcare providers to connect with patients without an in-person visit. Telemedicine services are provided primarily online or via smartphone through video chats or phone calls.

What is the Difference Between Telehealth and Telemedicine?

The terms “telemedicine” and “telehealth” are often used interchangeably, though the two have a few key differences: telemedicine refers specifically to remote clinical services and telehealth can refer to remote non-clinical services. 

Telemedicine, as stated by the World Health Organization, is “healing from a distance.” You receive treatment without an appointment or visiting the office.

Telehealth uses electronic information to support long-distance clinical healthcare, education, and administrative activities. It improves patient care and physician education rather than providing a service. Telehealth involves scheduling appointments, medical education continuation, and training for physicians.

In short, all telemedicine is telehealth, but not all telehealth is telemedicine. 

Types of Telemedicine

Using telemedicine, you can discuss symptoms and medical issues, receive a diagnosis, learn treatment options, and get prescriptions. There are a few common types of telemedicine which include:

Real-Time or Interactive Medicine

Interactive telemedicine, also commonly referred to as real-time or live telemedicine,  involves a physician and patient communicating in real-time.  

Real-time telemedicine involves any two-way communications –such as video conferencing and phone calls – that let providers and patients talk and allows healthcare providers to offer medical care. 

Some common services provided via interactive telemedicine include assessments of medical history, basic visual examinations, psychiatric evaluations, and even ophthalmic tests.

Remote Patient Monitoring

Remote patient monitoring gives caregivers the ability to monitor patients who have medical equipment that collects information like blood pressure, blood sugar levels, and more.

Through technology, information is sent to healthcare professionals and allows them to provide care and keep an eye on patients without the patients needing to visit in person. 

Remote patient monitoring can result in benefits such as reducing the time a patient needs to be in the hospital, reducing a patient’s exposure to other illnesses present in a healthcare building, as well as giving the patient time to recover at home. 

Remote patient monitoring is especially effective for chronic conditions such as heart disease, asthma, and diabetes.

Store and Forward Practices

In telemedicine, store and forward practices allow providers to share their patient’s information with other healthcare specialists and professionals.

The most significant advantage of these practices is that it doesn’t require the simultaneous attention of the delivering and receiving parties.

Many healthcare professionals—such as field technicians, caregivers, or specialists, for example—can collect the necessary data and upload it for use by other healthcare professionals.  

When Should You Use Telemedicine?

Telemedicine is for straightforward questions and issues, and any follow-up consults. It also can be helpful with psychotherapy and teledermatology. Some examples of straightforward issues include cold and flu symptoms, insect bites, diarrhea, pink eye, and sore throats.

Telemedicine has advanced our current health care options by offering several new benefits. It is making healthcare accessible for more patients, whether they live in a remote location, have a packed schedule, or any number of other reasons.

When Should You NOT Use Telemedicine?

Telemedicine is not for emergencies. For anything that requires urgent, primary care, you should go to a doctor in person. 

Benefits of Telemedicine

Telemedicine Saves Time

These services also help people avoid unnecessary hospital visits, which helps healthcare professionals give advice at a distance, save time, and reduce costs for both patients and doctors. Not only will it help avoid hospital visits when they aren’t necessary, but it will also give patients in the hospital the ability to discharge sooner by monitoring their vitals with telemedicine.

Telemedicine is Affordable

A recent study found that the average telemedicine visit is around $79, whereas an average doctor’s appointment is $149, and a trip to the emergency room costs, on average, $1,734. As telemedicine continues to grow, health insurance providers are offering coverage for telemedicine visits. Some states even require that health insurance plans reimburse patients for telemedicine visits.

Telemedicine is Accessible

Telemedicine offers a more accessible opportunity for healthcare and changes the way we visit the doctor. At Innovative HIA, we offer the most competitive limited benefit plans in the industry, including virtual health options! Check out our services for more information!

Read on for the pros and cons of telemedicine.

At Innovative HIA, we pride ourselves on offering:

  • Affordable Benefits
  • ACA Compliance, and
  • Exceptional Service


Today, we’d like to chat a bit more about the third element—the exceptional service we provide—and why Innovative HIA is, therefore, the gold standard of customer service for Minor Medical insurance providers.

(Hint: Our one-stop-shop benefits portal plays a large role in our successful customer service efforts!)

Let’s dive in.

How Innovative HIA Supports the Onboarding and Offboarding Processes

At Innovative HIA, we support businesses beyond providing Minor Medical coverage. We are proud to support the employee onboarding process so your human resources (HR) teams have more time to focus on the daily tasks that keep your business running.

This is why we offer a complete insurance solution that covers:

  • Implementation
  • Enrollment
  • Administration, and
  • Reporting

Our benefits professionals are fully equipped to support onboarding and offboarding procedures to eliminate the hassle for businesses.

How? Using our benefits portal.

Our Benefits Portal

Employee benefits administration can be a pain for any HR department. At Innovative HIA, we aim to simplify the process by giving you access to everything you need in one place.

Our one-stop-shop portal is proprietary and unlike any other. Our portal grants you access to all of the tools necessary to support a new hire (from beginning to end).

We eliminate the headache of unnecessary paperwork with benefits management portal access. You can:

  • Make plan changes
  • Order ID cards
  • Check claim status online
  • Track onboarding and offboarding
  • And more

Resources are only a click away.

Besides creating a seamless onboarding process with our all-in-one portal, we also provide video tutorials for our partners. These resources provide instructions that assist navigation through the portal.

Read on to view our enrollment portal walkthrough.