There is no end in sight when it comes to current US health insurance challenges, with SMEs disproportionally being impacted, according to ClearPoint Health CEO, Jeb Dunkelberger.
Earlier this month, the South Carolina-based company launched a medical stop-loss captive and an employer services platform to provide insurance to benefit advisors and small to midsized employers.
“When we look at the rising cost of health insurance, we see it disproportionately affecting small to mid-sized employers more than your larger employers,” Dunkelberger told Captive Intelligence.
“The second piece that exacerbates that issue is we do not see an end in sight, and we have provider shortages, and with labour shortages comes the increase in the costs for labour.”
ClearPoint’s captive platform is designed for employers ranging from 10 to 1,000 employees as well as to partner directly with benefit advisors.
Dunkelberger said there is a large shift in terms of the US population moving towards Medicare and Medicaid, and government funded lines of business, which sometimes reimburse less than commercial insurance lines.
“As we combine all the things happening on the clinical side, we start to realise commercial insurance is the one thing that is going to continue to be negotiated and pushed up to offset those costs,” he said.
“When we look at those small to midsize businesses as the ones that need protection, they need a solution.”
ClearPoint’s captive structure is domiciled in Tennessee, largely due to the State having the required legislation that supports Series LLCs.
“Tennessee also has the ability to be able to rapidly launch cells, which is really important for our business model,” Dunkelberger said.
“All the partners that we’re working with just so happened to be in Tennessee and have strong relationship with the Tennessee Department of Commerce and Insurance.”
Those using the ClearPoint platform can pick their preferred service partners, including third party administrators, pharmacy benefit managers, network’s clinical cost management and clinical quality improvement enhancers.
Dunkelberger said the key to the platform is to provide “optionality’ and allow different vendors and partners to compete to create the most value for the end user.
“It’s not uncommon to show an employer a large menu of options and them then take a step back and be stunned at the variety of choices they must make, which can be negative because it can be too much,” he said.
“The benefit advisor can be the connoisseur of selecting the different partners and can then present them directly to their client.”