Significant cost increases. Decreasing benefits. Lack of control. If this is your employee benefits story, then we invite you to consider alternative ways to fund your benefits program.
Captives bring a slew of benefits, including more control, long-term cost savings, and the potential to earn dividends. Most importantly, it puts you in charge of your benefits program's performance.
Shawn Lanter from Berkley Accident and Health digs into what a captive is, why they exist, and how they could work for you.
A partnership is one type of business where two or more partners start an entity to do business. For a partnership to exist, there must always be two or more partners.
A partnership is one type of business where two or more partners start an entity to do business. For a partnership to exist, there must always be two or more partners.
This is a short PPT. It contains the provisions of Unfair Labour Practices and its preventions. It comes under the Industrial Disputes Act. Provisions are complying with relevant case laws. This PPT fulfilling all conditions of a standard PPT.
Net Income is defined as excess of Income or Revenue of a business over all the expenditures of the business for the specified period, say an accounting year. Net Income is also termed as Net Profit or Net Earnings or bottom line profit. Copy the link given below and paste it in new browser window to get more information on Net Income:- www.transtutors.com/homework-help/accounting/net-income.aspx
It is a power point presentation for fire insurance. It is mostly applicable for Iran's insurance industry but it also covers fire insurance for worldwide purposes.
2016 Presentation to the Benefits Committee of the TSA Texas Sign Association on the concept of self-insured group medical stop loss captive for employee health insurance.
Cold leads plague our databases, and there needs to be a way to bing them back to life. Here is the answer. From the author of Marketing Automation for Dummies, Mathew teaches you the 5 key aspects to nurturing your cold leads back to life.
The document is a summary of the Concise Australian Commercial Law, 3rd Edition, Turner, Trone, and Gamble 2015. Material distribution is protected to its author’s Intellectual Rights.
Virtual Financial Group is most powerful virtual business & success system ever seen in the history of financial services. Mike Hinsvark & Chris Delfino are CEO & Founder of Virtual Financial Group (VFG), San Diego, CA. Virtual Financial Group Reviews are excellent in ratings for performance in Virtual Financial Services.
The Institute of Medicine's report, Unequal Treatment: Confronting Racial/Ethnic Disparities in Health Care, cited more than 175 studies documenting diagnostic and treatment disparities of various conditions among racial/ethnic populations, even when confounding factors (e.g., insurance and socioeconomic status, comorbidities, age, healthcare venue, stage of diseases) were controlled for in analyses.Specific examples include higher rates of hypertension, diabetes, breast cancer, cervical cancer, colon cancer, and cardiovascular diseases in African Americans; diabetes in Native Americans, Alaskan Natives, and Latino populations; and heart disease mortality in certain Asian American, Latino or Hispanic, and Native American groups.Lower rates of immunization and higher rates of infant mortality have been reported in African American, Hispanic, and Native American populations.
This is a short PPT. It contains the provisions of Unfair Labour Practices and its preventions. It comes under the Industrial Disputes Act. Provisions are complying with relevant case laws. This PPT fulfilling all conditions of a standard PPT.
Net Income is defined as excess of Income or Revenue of a business over all the expenditures of the business for the specified period, say an accounting year. Net Income is also termed as Net Profit or Net Earnings or bottom line profit. Copy the link given below and paste it in new browser window to get more information on Net Income:- www.transtutors.com/homework-help/accounting/net-income.aspx
It is a power point presentation for fire insurance. It is mostly applicable for Iran's insurance industry but it also covers fire insurance for worldwide purposes.
2016 Presentation to the Benefits Committee of the TSA Texas Sign Association on the concept of self-insured group medical stop loss captive for employee health insurance.
Cold leads plague our databases, and there needs to be a way to bing them back to life. Here is the answer. From the author of Marketing Automation for Dummies, Mathew teaches you the 5 key aspects to nurturing your cold leads back to life.
The document is a summary of the Concise Australian Commercial Law, 3rd Edition, Turner, Trone, and Gamble 2015. Material distribution is protected to its author’s Intellectual Rights.
Virtual Financial Group is most powerful virtual business & success system ever seen in the history of financial services. Mike Hinsvark & Chris Delfino are CEO & Founder of Virtual Financial Group (VFG), San Diego, CA. Virtual Financial Group Reviews are excellent in ratings for performance in Virtual Financial Services.
The Institute of Medicine's report, Unequal Treatment: Confronting Racial/Ethnic Disparities in Health Care, cited more than 175 studies documenting diagnostic and treatment disparities of various conditions among racial/ethnic populations, even when confounding factors (e.g., insurance and socioeconomic status, comorbidities, age, healthcare venue, stage of diseases) were controlled for in analyses.Specific examples include higher rates of hypertension, diabetes, breast cancer, cervical cancer, colon cancer, and cardiovascular diseases in African Americans; diabetes in Native Americans, Alaskan Natives, and Latino populations; and heart disease mortality in certain Asian American, Latino or Hispanic, and Native American groups.Lower rates of immunization and higher rates of infant mortality have been reported in African American, Hispanic, and Native American populations.
Navigating Health Insurance in the Health Care Reform Era lkennon
A presentation for large employers, small employers and individuals without employer-based insurance. The slides present the current state of health insurance for each group and the impending changes of Health Care Reform and their potential effects.
This presentation is designed to provide the information needed to understand self-funding, assist you in explaining the solution to clients and then determine whether it is right for their company by comparing and contrasting it to a fully insured solution.
Every American is entitled and bound to avail Minimum Essential Coverage (MEC) under the Affordable Care Act (ACA) - also known as Obamacare. While some opt for individual health insurance plans offered by private institutions, more than 60% opt for Employer-Sponsored Health Insurance. Employer-Sponsored Health Insurance makes your work easy because you don't have to go through multiple insurance plans available online. Employers, on an average pay 82% of your premium for a single insurance policy. For employers also this is a win-win situation because it results in employee retention, better health of employees thus more productivity. Employers use good health benefits as a great tool to recruit sought-after talent in the industry.
The slide deck talks about Employer-Sponsored Health Insurance, its comparison to individual health insurance and the win-win situation for employee and employer.
Employers can experience substantial cost savings and avoid liability when employee leaves are effectively managed through well-drafted policies and procedures. Laws such as Worker's Compensation, the Americans with Disabilities Act, and the Family and Medical Leave Act make compliance in this area a challenge for even the most experienced HR professional.
Join our risk advisors in a practical discussion on how to avoid the pitfalls employers encounter when managing employee absences. Attendees will learn how to apply best practices for leave management to actively control costs and minimize liability.
The Food Safety Modernization Act (FSMA) is enforceable starting April 6th, 2017. If you're still unsure about what that means for your operation, join us for a review of the regulations and an action plan to remain compliant.
Do you have an ELD strategy? With the upcoming Electronic Logging Device Mandate just over a year away, many companies have questions about what this means for their fleet, and what is the best way to remain compliant.
This is the first event in HNI's Trucking Technology Series.
TOPICS COVERED
Detailed FMCSA (DOT) regulations that apply to trucking entities
Interstate regulations
Intrastate regulations as applicable to the group
Regulations, processes, procedures and forms that are required to ensure you are in compliance requirements and notices such as ELD's, driver coercion, and safety fitness determinations
Legislative update on pending rules and studies
Learn about how your business can improve its bottom line by taking more control of your insurance program.
Mid-sized organizations can utilize alternative risk solutions, better known as captive insurance companies, to lower their total cost of risk for Workers Compensation, General Liability, and Auto Liability. Through ownership, businesses can reap the benefits of their strong safety performance.
Do you need a DOT compliance refresher or have new staff that requires training? This HNI-U seminar will cover DOT compliance for trucking entities.
Presenters Jeff Swan and Don Jerrell will provide insight from both the inspector's point of view as well as hands-on experience implementing programs and procedures that ensure compliance.
Proper forklift training is important for avoiding property damage, injury, or even death. But - are your trainers passing along the right knowledge when it comes to safety? Trainers who will be training your forklift operators are essentially the last line of defense in stopping untrained or unskilled operators from operating a forklift. This course trains the trainer, making sure safety remains a cornerstone of your operations.
Attendees who complete this training will receive certification and will be able to train and certify other operators to OSHA standard.
Your Compliance Manual to OSHA's 300 and 300A FormsHNI Risk Services
Most businesses will need to post their OSHA Form 300A from Feb. 1 through April 30. This document communicates with your people your OSHA recordable incidents for the previous year — that's work-related injuries and illnesses. Failure to meet this requirement could result in big fines for your organization. Also, unprecedented upcoming OSHA regulations may require you to submit your company's OSHA 300 log information directly to OSHA- how might this impact you?
With OSHA's final ruling on requiring employers submit injury and illness data electronically, significant changes will need to be implemented by the effective date of December 1, 2016 to ensure compliance in this changing area.
This webinar will touch on when you must submit your electronic records to OSHA, the implications of OSHA posting your injury records, and how the new ruling impacts your reporting procedures and employee accountability.
Do you have an ELD strategy? With the upcoming Electronic Logging Device Mandate just over a year away, many companies have questions about what this means for their fleet, and what is the best way to remain compliant.
This is the first event in HNI's Trucking Technology Series.
Wondering what is new with regards to the Federal Motor Carriers and the State Patrol? Want to know the latest in enforcement and direction of these agencies? What are the “hot buttons” for the roadside inspectors? Are officers being trained on electronic log devices?
Join us for an informative event featuring representatives from these two organizations and learn about the newest FMCSA and DOT issues affecting the transportation industry.
Presentations will include detailed insights on FMCSA regulations, ELDs, and roadside inspections to name a few. As an owner or top manager for your company it is essential that you are knowledgeable in this area.
If you are a large employer under the ACA (50 or more FT or FTE employees) or your plan is self-funded, join us for an informative webinar on Internal Revenue Code Sections 6055 and 6056.
With our partners at HR Workplace Services, we’ve prepared this briefing to spell-out important employer responsibilities for the filings as well as all the information you should be collecting to adequately prepare these reports.
An Employer Guide: DOL's New Overtime Exemption RulesHNI Risk Services
In May 2016, the Department of Labor announced revised regulations which affect the Fair Labor Standards Act’s “white collar” overtime exemptions. The new regulations increase the salary threshold needed to qualify for overtime exemption from $455/week ($23,600 per year) to $913/week ($47,476/year).
The DOL has made its first major revision to the long-awaited ruling on overtime exemption rules since 2004. This major change will result in many employees gaining eligibility for overtime pay and force employers to make difficult decisions regarding their employees who have now become overtime eligible.
This presentation will provide an overview of the Department of Labor’s new overtime exemption rules including the new salary requirements for exempt employees, options for compliance, and re-classifying employees who are no longer exempt. Are you ready for the December 1, 2016 deadline?
A HIPAA violation could cost your company up to $50,000 per offense.
HR Workplace and HNI have teamed up to bring you an overview of HIPAA (the Health Insurance Portability and Accountability Act), outlining the main components, and identifying who is covered by the Act to make sure you aren't hit with a noncompliance fee.
We will examine the privacy provisions under HIPAA as they relate to protected health information (PHI) and also give your employees and business associates the tools to recognize the key provisions of HIPAA, how their organizations are affected by HIPAA, and how the privacy rules impact them.
HNI U - Brace Yourself: Fall Protection and Safety Strategies to Prevent Work...HNI Risk Services
Did you know that fatalities caused by falls from elevation continue to be the leading cause of death for construction workers? Prevent these avoidable accidents and increase your safety with our upcoming HNI U event that will discuss the behavioral side of safety standards, current OSHA initiatives, and provide an in depth demonstration of different types of fall protection and safety strategies.
Join our experienced advisors in a workshop targeted to preventing falls in the workplace while also equipping you with the tools you need to make safety a top priority in your organization.
OSHA Initiatives Emphasis Programs and Fall HazardsHNI Risk Services
Did you know that fatalities caused by falls from elevation continue to be the leading cause of death for construction workers? Prevent these avoidable accidents and increase your safety with our upcoming HNI U event that will discuss the behavioral side of safety standards, current OSHA initiatives, and provide an in depth demonstration of different types of fall protection and safety strategies.
Join our experienced advisors in a workshop targeted to preventing falls in the workplace while also equipping you with the tools you need to make safety a top priority in your organization.
Did you know that fatalities caused by falls from elevation continue to be the leading cause of death for construction workers? Prevent these avoidable accidents and increase your safety with our upcoming HNI U event that will discuss the behavioral side of safety standards, current OSHA initiatives, and provide an in depth demonstration of different types of fall protection and safety strategies.
Join our experienced advisors in a workshop targeted to preventing falls in the workplace while also equipping you with the tools you need to make safety a top priority in your organization.
Compliance Alert: Get Ready for New Food Safety Act Regulations HNI Risk Services
Changes are on the horizon for food safety regulations. Are you ready for the Sanitary Transportation of Human and Animal Food rule that will be finalized March 31, 2016? This webinar will make sure your company is in compliance with the Food Safety Modernization Act provisions and address any looming questions and concerns.
Presenter Jonathan Stringer will provide guidance and insight on managing the effects on carriers and other impacted parties. He wil also briefly discuss cargo claims, ways to limit liability and defenses, along with bad contract provisions to watch out for.
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It is a sample of an interview for a business english class for pre-intermediate and intermediate english students with emphasis on the speking ability.
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This article provides a comprehensive guide on how to
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What is the TDS Return Filing Due Date for FY 2024-25.pdfseoforlegalpillers
It is crucial for the taxpayers to understand about the TDS Return Filing Due Date, so that they can fulfill your TDS obligations efficiently. Taxpayers can avoid penalties by sticking to the deadlines and by accurate filing of TDS. Timely filing of TDS will make sure about the availability of tax credits. You can also seek the professional guidance of experts like Legal Pillers for timely filing of the TDS Return.
RMD24 | Retail media: hoe zet je dit in als je geen AH of Unilever bent? Heid...BBPMedia1
Grote partijen zijn al een tijdje onderweg met retail media. Ondertussen worden in dit domein ook de kansen zichtbaar voor andere spelers in de markt. Maar met die kansen ontstaan ook vragen: Zelf retail media worden of erop adverteren? In welke fase van de funnel past het en hoe integreer je het in een mediaplan? Wat is nu precies het verschil met marketplaces en Programmatic ads? In dit half uur beslechten we de dilemma's en krijg je antwoorden op wanneer het voor jou tijd is om de volgende stap te zetten.
Memorandum Of Association Constitution of Company.pptseri bangash
www.seribangash.com
A Memorandum of Association (MOA) is a legal document that outlines the fundamental principles and objectives upon which a company operates. It serves as the company's charter or constitution and defines the scope of its activities. Here's a detailed note on the MOA:
Contents of Memorandum of Association:
Name Clause: This clause states the name of the company, which should end with words like "Limited" or "Ltd." for a public limited company and "Private Limited" or "Pvt. Ltd." for a private limited company.
https://seribangash.com/article-of-association-is-legal-doc-of-company/
Registered Office Clause: It specifies the location where the company's registered office is situated. This office is where all official communications and notices are sent.
Objective Clause: This clause delineates the main objectives for which the company is formed. It's important to define these objectives clearly, as the company cannot undertake activities beyond those mentioned in this clause.
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Liability Clause: It outlines the extent of liability of the company's members. In the case of companies limited by shares, the liability of members is limited to the amount unpaid on their shares. For companies limited by guarantee, members' liability is limited to the amount they undertake to contribute if the company is wound up.
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Capital Clause: This clause specifies the authorized capital of the company, i.e., the maximum amount of share capital the company is authorized to issue. It also mentions the division of this capital into shares and their respective nominal value.
Association Clause: It simply states that the subscribers wish to form a company and agree to become members of it, in accordance with the terms of the MOA.
Importance of Memorandum of Association:
Legal Requirement: The MOA is a legal requirement for the formation of a company. It must be filed with the Registrar of Companies during the incorporation process.
Constitutional Document: It serves as the company's constitutional document, defining its scope, powers, and limitations.
Protection of Members: It protects the interests of the company's members by clearly defining the objectives and limiting their liability.
External Communication: It provides clarity to external parties, such as investors, creditors, and regulatory authorities, regarding the company's objectives and powers.
https://seribangash.com/difference-public-and-private-company-law/
Binding Authority: The company and its members are bound by the provisions of the MOA. Any action taken beyond its scope may be considered ultra vires (beyond the powers) of the company and therefore void.
Amendment of MOA:
While the MOA lays down the company's fundamental principles, it is not entirely immutable. It can be amended, but only under specific circumstances and in compliance with legal procedures. Amendments typically require shareholder
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A personal brand exploration presentation summarizes an individual's unique qualities and goals, covering strengths, values, passions, and target audience. It helps individuals understand what makes them stand out, their desired image, and how they aim to achieve it.
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𝐓𝐉 𝐂𝐨𝐦𝐬 (𝐓𝐉 𝐂𝐨𝐦𝐦𝐮𝐧𝐢𝐜𝐚𝐭𝐢𝐨𝐧𝐬) is a professional event agency that includes experts in the event-organizing market in Vietnam, Korea, and ASEAN countries. We provide unlimited types of events from Music concerts, Fan meetings, and Culture festivals to Corporate events, Internal company events, Golf tournaments, MICE events, and Exhibitions.
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⭐ 𝐅𝐞𝐚𝐭𝐮𝐫𝐞𝐝 𝐩𝐫𝐨𝐣𝐞𝐜𝐭𝐬:
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HR recruiter services offer top talents to companies according to their specific needs. They handle all recruitment tasks from job posting to onboarding and help companies concentrate on their business growth. With their expertise and years of experience, they streamline the hiring process and save time and resources for the company.
2. 48YEARS
in operation
Berkley Accident and Health is a member of W. R. Berkley Corporation:
5where WRBC operates
worldwide
7.1in revenues in 2014
$
BILLION
Source: W. R. Berkley Corporation year-end 2014 results. Fortune 500 property/ casualty ranking
and #409 overall ranking, www.Money.CNN.com, June 2014. Best Managed Companies,
ww.Forbes.com, 2007. Market capitalization as of May 20, 2015.
6.2Market capitalization
$ BILLION
14 LARGEST
property/casualty
insurance group
th
Best Managed
Companies in America
CONTINENTS
BERKLEY ACCIDENT AND HEALTH IS A MEMBER
OF W.R. BERKLEY CORPORATION:
3. W. R. BERKLEY INSURANCE GROUP
49 OPERATING UNITS WORLDWIDE
4. Insurance is underwritten by Berkley Life and
Health Insurance Company, known for its
financial stability:
BERKLEY ACCIDENT AND HEALTH
Source: www.ambest.com and www.wardinc.com, 2014.
Rated A+ (Superior) by A. M. Best (second-
highest rating out of fifteen)A+
Named a Ward’s 50 top-performing insurer for
safety and consistency
5. CAPTIVATE ONLOOKERS
AGENDA
1. Group Captives – What, Why, How, Who
2. The Market Climate
3. Berkley’s Group Captive Program
4. Financial Scenarios
5. Other Considerations
6. WHAT IS A CAPTIVE?
A Captive is a medium for taking risk.
It can be formed by
a single company Or multiple companies
Single Parent Captive Group Captive
7. WHAT IS A GROUP CAPTIVE?
A Group Captive can be made up of companies
in the same industry or different:
Same industry Different industries, sizes,
or regions
Closed membership Open membership
(Homogeneous) (Heterogeneous)
8. WHY DO GROUP CAPTIVES EXIST?
Group Captives exist to give employers:
Control
Lower overhead/inefficiency from insurance carriers
Long-term stability
Capacity
Data transparency
Collaboration/best practices
9. WHAT IS BERKLEY’S GROUP CAPTIVE?
Group stop-loss captives combine three strategies:
EmCap
Self-funded
health plan
Group
captive
structure
Collaborative
health risk
management
10. CAPTIVE MISCONCEPTIONS
• “Employee benefits captives are only for jumbo‐sized employers”
• “All captive employee benefit programs must be approved by the
Department of Labor (DOL)”
• “There’s just no way that Risk/Finance and HR will ever see
eye‐to‐eye regarding the advantages of a captive employee benefit
program”
• “The whole process is just too complex for us to deal with”
• “We could get permanently locked into a program we’re just not
happy with”
12. STAY THE COURSE – FULLY
INSURED
Affordable Care Act (ACA) hits fully insured plans the hardest
ACA’s Ten-Year Total Tax Impact = $164 billion
Small Employers +$2,760 single +$6,830 family
Large Employers +$2,610 single +$7,130 family
ACA’s Tax Sources (in billions)
$102
$34
$29
Health Insurance
Plans (does not impact
self-funded plans)
Medical Devices
Prescription
Drugs
Source: Effects of the PPACA Premium Tax on Small Businesses and Their Employees: An Update, http://www.nfib.com; Estimated Premium
Impacts of Annual Fees Assessed on Health Insurance Plans, http://www.ahip.org; based on the ten-year period from 2014-2023; AHIP 2013.
Stay the
Traditional
Course
14. Today, nearly all large companies self-fund their health plans
13% 15% 17%
13%
10% 10%
13% 13% 12% 12%
15% 16%
13% 15% 16%
60%
67%* 66% 66%
72% 73% 75%
78% 77% 77% 77%
83%* 82% 81% 83%
0%
20%
40%
60%
80%
100%
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
Large Firms (200+ workers)
Small Firms (1-199 workers)
Notes: For 2000, the large firm estimate is statistically different from the estimate for the previous year shown (p<.05). In 2006, funding status was not asked of firms with
conventional plans, due to a change in the survey questionnaire. Therefore, conventional plan funding status is not included in the averages in this exhibit for 2006.
Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2013, www.kff.org.
WHO SELF-FUNDS?
15. PROS OF SELF-FUNDING
Traditional Advantages
• Risk is limited with stop-loss reinsurance
• Cash flow advantages;
no pre-funding of claims with advantage
to employer in favorable claims years
• Data transparency (detailed utilization
data) allows employers to identify issues
and promote healthier cultures
• Multi-state plan design; benefit flexibility;
ease of administration
• Lower fixed costs
• No premium tax
• No insurance company profits
• Lower long-term cost
Additional Advantages Under ACA
• Not required to provide coverage with minimum
essential benefits
• Not required to participate in
a risk-adjustment system
• Not subject to provisions,
such as Medical Loss Ratio requirements and
premium increases
16. WHY DO EMPLOYERS SELF-FUND?
Significant advantages to self-funding
• They have the financial leverage to assume risk
• They have the size to provide predictability (lower risk premium)
• They purchase medical stop loss at a higher retention level (mitigation/stability)
= less dependency on insurance
• They can implement best-practice health risk
management strategies (high-performing companies) to bend the cost curve
17. BENDING THE COST-CURVE
Using self-funding as part of a performance driven
strategy to proactively manage your health risk
• Impact is huge
• Employer health premiums
have increased at a
compounded rate of 9%
for the last 10 years1
• “High-performing” risk
companies have trend
at or below 3%2
1Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2013, www.kff.org.
2Towers Perrin, annual study of health insurance costs
$900,000
$1,069,000
$1,270,000
$900,000
$955,000
$1,013,000
$0
$250,000
$500,000
$750,000
$1,000,000
$1,250,000
$1,500,000
2013 2014 2015 2016 2017
Average
9% trend
High-performing
over 5 years
3% trend
18. STOP-LOSS REINSURANCE
How does Medical Stop Loss insurance work?
• Covers catastrophic or unpredictable losses
• Protects the self-funded employer’s assets
• Individual/Specific Stop Loss
o Protects against high claims from any one individual
o Protects against the severity of a single catastrophic claim
• Aggregate Stop Loss
o Provides a ceiling for overall claims liability
o Protects against higher-than-expected usage or frequency of claims from
the entire group
19. CONS OF SELF-FUNDING
• Not good fit for companies with consistently bad claims ongoing
(unfavorable loss ratios)
• Requires strong balance sheet
• Typically 100+ employees
• Annual risk 10% - 25% of Expected Claims costs
• Cash flow fluctuations
• Reserves needed to switch back to fully insured
• Requires more senior leadership involvement
• Longer term commitment
20. Challenge: How do you create the large employer advantage for small
and midsize companies?
• Self-funding provides benefits typically enjoyed only by large
companies:
o Control
o Transparency
• Group Captives can provide stability by spreading risk across its
members
• Health risk management can lower short- and long-term cost
trends:
o Opportunity to control costs
WHY DON’T MORE EMPLOYERS SELF-
FUND?
22. GROUP CAPTIVES MITIGATE VOLATILITY
ANNUAL CLAIMS
Low
High
PROBABILITY
LowHigh
Shift expected due to law of large numbers
Self-Funded Health Plan moving into a Group Captive
25. GROUP STOP-LOSS CAPTIVE
Group Captives bring it all together by allowing small
employers to act like large employers:
1. Traditional advantages of self-funding
2. Additional advantages with ACA
3. Best practices for health risk management
4. Collaborative financial strength
5. Greater scale for predictability
6. Buy less Stop Loss insurance (higher deductible)
26. CAPTIVE OPTIONS
1. Start one from scratch (single or multi-employer)
• Considerations / Barriers:
• Time
• Resources/Capital
• Creation can be a very costly value proposition. Ballpark to start your
own captive from scratch can range from $500K to $750K.
• Regulatory requirements
• Captive components and vendor selection
2. Join a existing captive
28. JOINING EXISTING
CAPTIVE
Segregated Cell Captive Option
• Allows participants to create
something unique for its owner
members
• Industries, geographic location,
demographics, etc.
• Join re-created established
captive model
• Already Capitalized
• Completed regulatory requirements
• Benefits of larger group, and
economies of scale - until critical
mass is reached
Existing
Stop-Loss Captive
Segregated
Stop-loss
Cell
29. Target employers for a Group Stop Loss Captive:
50-1,000 employees eligible for health benefits
Forward-thinking management team
Good communication with employees on health care costs
Willing to implement robust health/wellness programs
Financially stable and willing to take on a portion
of the risk for their health plan
WHO SHOULD CONSIDER A CAPTIVE?
30. RISK LAYERS: CLAIMS EXPOSURE/COSTS
Retain. Share. Transfer.
Group Captive Layer
Premium + Non-Premium Funding (collateral)
Employer
1
(SFR)
Employer
2
(SFR)
Employer
3
(SFR)
Employer
4
(SFR)
Employer
5
(SFR)
Berkley Retained Layer
Retained Excess + Captive Aggregate Coverage + Fixed Costs
No risk sharing
Employers pay
for claims up to
Stop Loss
(Individual or
Aggregate
claims)
Employer Layer
Risk shared
among members
in captive
Risk assumed by
Stop Loss insurer
>$250k individual
and captive max
31. RELATIONSHIP OF PARTIES
*Includes plan, broker, TPA, and risk management strategies
RETAIN
Captive
Agreement
Stop Loss
Policy
Reinsurance
Agreement
SHARE
Group
Captive
TRANSFER
Employer
Plan*
Berkley
Stop Loss/
Excess
33. STEP 1 – SELF-FUND
Each employer:
• Chooses to self-fund its employee health benefits
• Creates and manages its own self-funded health plan
• Commits to a focused and consistent strategy of health risk
management
• Pays for claims on behalf of its plan
34. STEP 2 – BUY STOP LOSS POLICY
Each employer:
• Buys a Berkley Stop Loss policy1
with Specific and Aggregate
protection (individually rated; no group rates)
• Determines own retention levels
($25k used for example purposes)
• Pays premiums to Berkley for their Stop Loss policy
• Gets reimbursed by Stop Loss policy for covered claims above
Specific or Aggregate level
1Stop Loss policies are underwritten by Berkley Life and Health Insurance Company
(“Berkley” or “Berkley Life and Health”)
35. STEP 3 – JOIN THE GROUP
CAPTIVE
• Berkley Life and Health reinsures the layer between
$25,000-$250,000 per individual to a captive
• The captive is a reinsurer of Berkley and does not issue policies
• The captive receive premium for the layer from Berkley
• Each employer provides collateral to the captive, in case
premiums are insufficient, and pays a fee to cover the captive’s
expenses
• Berkley limits the captive’s exposure with a program Aggregate
• Unused captive funds are returned to
employers
36. Retain. Share. Transfer.
FREQUENCY OF
CLAIMS
PERINDIVIDUAL
BERKLEY LIFE & HEALTH
Individual
$25,000
per
Individual
MEMBER RETENTION
Aggregate
110%-125%
of expected claims
STOP LOSS POLICY STRUCTURE
37. Risk Layer Funding
Retain. Share. Transfer.
BERKLEY LIFE & HEALTH
Individual
$25,000 per
Individual
MEMBER RETENTION
Aggregate
110%-125%
of expected claims
FREQUENCY OF
CLAIMS
PERINDIVIDUAL
EXPENSES
Individual
$25,000
per
Individual
MEMBER RETENTION
(SFR)
Aggregate
110%-125%
of expected claims
Berkley Life & Health retained excess,
expenses, TPA
Up to $250k
individual
Premium
funding
Non-
premium
funding
(collateral)
GROUP CAPTIVE
38. LARGE CLAIM EXAMPLE
Employer has a $600,000 claim from a premature birth:
BERKLEY LIFE AND HEALTH
Stop Loss policy reimburses
$575,000 to the employer
GROUP CAPTIVE reimburses
Berkley for $225,000
EMPLOYER funds first $25,000
through its self-funded retention
39. Sample EmCap Layers vs. Average
Results
Self-Funded
Retention
70%
Captive Layer
25%
Collateral 5%
Expenses 15%
COSTS, RESULTS, AND FINANCIAL SCENARIOS
41. EmCap Layers
Self-
Funded
Retention
70%
Captive
Layer
25%
Collateral
5%
Expenses
15%
Berkley EmCap
programs are averaging
10-15% BELOW SFR
Berkley EmCap programs
are averaging 7-9% CAPTIVE
LAYER SURPLUS in 2012
Surplus at Captive Layer =
No collateral draw
Past EmCap results are not a predictor of future results. Past performance does not guarantee
future results. Current performance may be lower or higher than the performance data shown.
COSTS, RESULTS, AND FINANCIAL SCENARIOS
42. Sample Results:
200 Lives, Fully Insured, $25K Specific EmCap Proposal
* Past EmCap results are not a predictor of future results. Past performance does not guarantee future
results. Current performance may be lower or higher than the performance data shown.
**All unused funds are returned to the member.
Sample Account EmCap Proposal 2012 Avg Results*
Expenses $375,000 FIXED $375,000
Self-Funded Retention $1,750,000 85% $1,487,500
Group Captive Retention** $625,000 91% $568,750
Collateral $125,000 0% $0
Total Cost $2,431,250
vs. Insured Premium $2,500,000
EmCap Total Savings $68,750
Potential savings opportunity, plus data, stability, and transparency
COSTS, RESULTS, AND FINANCIAL SCENARIOS
44. CAPTIVATE ONLOOKERS
SUMMARY
Member organizations take control of their costs
Cumulative effect of retention = Long-Term Plan
1. Retain positive variability
2. Spread negative variability
Increased risk tolerance with experience/data
Surplus potential = collateral carryover
45. CAPTIVATE ONLOOKERS
SUMMARY
"Pay Yourself" leveraged trend
Harness group purchasing power
1. TPA/Admin Fees
2. Network Contracts
3. Pharmacy Benefit Manager contracts (PBM)
4. Health risk management services