GHA Medical Stop Loss Program Lunch and Learn Webinar-GHA Medical Stop Loss Program Lunch and Learn Webinar Presentation

GHA Medical Stop Loss Program Lunch and Learn Webinar Presentation

Pdf Summary

The 2025 Arthur J. Gallagher & Co. presentation outlines a medical stop loss captive insurance program developed for members of the Georgia Hospital Association (GHA). The captive is structured as a Segregated Portfolio Company (SPC) domiciled in the Cayman Islands, providing risk-sharing benefits for rural and independent hospitals seeking cost containment on stop loss insurance premiums.<br /><br />Captives are licensed insurance companies owned by members to self-insure risks, offering governance, regulatory compliance, and capital requirements tailored to healthcare risk. GHA’s SPC format provides individual "cells" for each member hospital, isolating assets and liabilities within cells to protect from cross-risk exposure, while sharing administrative overhead.<br /><br />The captive initially offers a fixed coverage layer of $250,000 above self-funded claims, with excess claims covered by group stop loss, and is designed for flexible future expansion. Participation currently includes six rural hospitals with over 2,400 insured lives, representative of the target population. Preliminary actuarial analysis indicates competitive premiums, an expected 2% profit margin, and improved budget predictability compared to standard market renewal rates, which can exceed 20%.<br /><br />Capitalization requires 25% of net ceded premiums, with options for proportional hospital contribution or partial funding by the GHCIC. Collateral requirements are detailed per hospital, with GHA offering to collateralize 25% of premiums. The program includes specialized services from Gallagher, Strategic Risk Solutions, MSL Captive Solutions as managing underwriter, and US Fire Insurance Company as the fronting insurance carrier.<br /><br />Timelines establish data collection and quoting beginning September 2025, with implementation targeted for early 2026. The program’s goal is to provide hospitals with sustainable healthcare cost control, profit sharing, and renewal stability through a collaborative captive insurance model supported by Gallagher’s analytics platform for data-driven risk and people management decisions.<br /><br />In summary, this captive program offers member hospitals a financially efficient, shared-risk approach to medical stop loss coverage, reducing premium volatility and fostering long-term cost containment in healthcare insurance.

Keywords

medical stop loss insurance

captive insurance program

Georgia Hospital Association

Segregated Portfolio Company

rural hospitals

cost containment

self-insurance

risk-sharing

healthcare insurance premiums

Gallagher analytics platform