Benefits Captive Program
Self-Insured Benefits Programs
Self-insurance gives you the freedom to create your own health benefits program. ParetoHealth makes it easy.
Choose from a curated selection of medical and pharmacy plans and third-party administrators (TPA) and fine-tune them to meet your needs.
Medical Benefits
ParetoHealth combines all the coverage and services you’ll need in a range of turnkey benefits program packages.
Plans
Choose a plan that strikes the cost-and-coverage balance that’s right for you and your employees—or keep the coverage you currently offer.
TPAs
ParetoHealth partners with best-in-class third-party administrators to get your plan up and running including enrollment, claims payment processing, reporting and more.
Health Networks
ParetoHealth’s TPA partners work with both national PPOs and local networks, so your employees have access to quality healthcare services at the lowest possible prices.
Pharmacy Benefits
ParetoHealth gives you a range of pharmacy benefits program options.
Formularies
Your formulary is the list of drugs covered by your pharmacy benefits program. Create your own or choose one of the three options developed by ParetoHealth.
PBMs
ParetoHealth negotiates exclusive pharmacy benefits management (PBM) contracts to ensure that your PBM is helping you achieve your drug cost reduction goals.
See how much you can save with ParetoHealth
Enter your current fully-insured premium to see at a glance, the savings you'llmake.
Calculate your savings with ParetoHealth
See how savings add up over time
Enter your current fully-insured premium *
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Projected costs over time
Your savings add up over time
Fully Insured Premium
ParetoHealth
ParetoHealth with ICM
Year 1
$2,000,000
$1,850,000
$1,765,280
12%
Savings
Year 2
$2,000,000
$1,850,000
$1,765,280
Year 3
$2,000,000
$1,850,000
$1,765,280
Additional
17%
Savings
Year 4
$2,000,000
$1,850,000
$1,765,280
Additional
19%
Savings
Year 5
$2,000,000
$1,850,000
$1,765,280
Additional
22%
Savings
Year 10
$2,000,000
$1,850,000
$1,765,280
Additional
29%
Savings
* Savings projected here are estimates. Actual results may vary according to claims experience.
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Captive Membership
There’s strength—and protection—in membership.
When you join ParetoHealth, you join more than 2,200 employers representing more than 810,000 lives and more than $3B in healthcare spending. ParetoHealth captives are formed by groups of employers with the same business goal: To reduce the cost—but not the quality—of their employee health programs, without taking on unnecessary risk.
When you join the captive, you pay your employees’ claims yourself, just like in a self-insured plan.
To mitigate the amount of risk you’re taking on, captive membership includes two types of medical stop-loss insurance.
Specific Stop-Loss
Specific stop loss covers large claims from individuals. When claims for any one person on your plan exceed your specific deductible, you get reimbursed for the difference.
Aggregate Stop-Loss
Aggregate stop loss puts a limit on how much you’ll pay during the entire plan year. So, if you end up with more claims than expected, you’re covered.
Both specific and aggregate coverage are included with your captive membership, and every Member contributes to a fund that creates a long-term buffer against stop-loss premium increases.
That’s how captive membership reduces claims risk and makes self-insurance possible for employers like you.
Want to run your numbers?
We’ll connect you with a ParetoHealth expert that can do that.
With ParetoHealth, the self-insurance risk is under control and we've saved almost $2M in less than 3 years.
Cori Ekman
SVP, Human Resources
Nagra, USA
