Each Captive participant creates its own health benefit plan that meets their unique corporate culture and risk management needs. The plan includes a provider network and administrator and benefit structure.
Each participant is linked through a common stop loss carrier: Berkley Accident & Health (BAH).
They pay a single monthly premium to BAH.
There are three layers of coverage in each plan
The first layer is constituted of the claims that the employer pays from its own funds and covers normally incurred medical claims costs. Each employer determines the level of risk it is willing to take. That determination dictates the premium costs to the employer and its employees.
The second layer of the plan is funded from 60 percent (on average) of each Captive participant’s premium and pays for claims up to a prearranged annual cap for each individual and for the employer as a whole.
The third layer of the plan is covered by the 40 percent (on average) premium paid to BAH that covers all costs where an individual’s claims are greater than an annual cap or the sum of all claims of the individual employer exceed an annual cap.