Form

Healthcare captives are not for everybody, but for the right businesses, they can be a tremendous asset as an alternative to traditional health insurance options in the marketplace.

This quick questionnaire will help determine your company's level of readiness for participation in a captive. If we determine you aren't quite ready, it can serve as a guide to help you get started putting strategies in place so that you can be ready in the future.

Please complete this form and one of our experts on healthcare captives will be in touch to discuss your answers.

First name*

Last name*

Email*

Company name*

Phone number*

1. Full-time Employees*

How many full time workers does your company employ?

less than 50

50-100

100 or more

2. Claims History*

What is your company's history of claims?

History of high claims

History of moderate/average claims

History of low claims

3. Risk exposure*

How would you rate your company's exposure to risk?

Significant exposure to loss

Moderate exposure to loss

Low exposure to loss

4. Company Premiums*

In which range does your company's premiums fall?

$250K or more in annual premium

$100-$250K in annual premium

Less than $100K in annual premium

5. Progressive leadership*

Is your management/leadership team capable of handling an "out of the box" health insurance solution?

Not only capable, but ready & willing to do so.

Capable, but would need support and guidance

Not ready at this time.

6. Willingness to maintain employee programs*

Are you willing to implement robust programs to reduce cost and improve the health and satisfaction of employees?

We already have some wellness programs in place and are willing to do what it takes

We have considered wellness programs and are willing to explore options

We're not ready to implement new programs at this time.

7. Financial stability*

How would you describe your company's current financial stability?

We are financially stable and willing to accept a portion of the health program's risk.

We are working toward financial stability and will be ready to accept this risk in the near future

We are not ready yet to take on added financial risk

8. Plan Management*

How prepared is your company to take on the role of plan administration?

We are prepared to commit additional time and resources to captive administration

We would need assistance in preparing our team to take on added administration

We are not able to take on the added role of plan administration