An Introduction to Self-Funding & Captives

In this episode of Captivating Health Insights, host Maddison Bezdicek sits down with Dave Gillis, Head of Business Development for Health Solutions at Captive Resources, for a crash course in self-funding and group captives. They unpack how shifting from fully insured to stop-loss arrangements can allow employers to reclaim transparency and control over their second-largest P&L cost.

Dave debunks worries about catastrophic risk and administrative complexity, shows how analytics platforms turn raw claims data into action, and shares proven cost-containment plays—from pharmacy-rebate recapture and international drug sourcing to reference-based pricing, direct provider contracts, and expanded virtual care. He explains how captives pool risk, foster community learning, and create a long runway for strategic improvements, enabling employers to own their reinsurance vehicle, benchmark progress with peers, and reinvest the savings in richer benefits.

Chapters

• (00:00:00) - Employers are becoming owners of their health insurance
• (00:00:52) - Captive Resources CEO on the Challenges of the Industry
• (00:02:08) - What is the Difference Between Being Self-Funded and Fully-
• (00:04:28) - Self-Funding vs. Stop Loss
• (00:07:20) - Anticipating Self-Funded Pharmacy Risk?
• (00:09:27) - PBM and TPA: How important is it?
• (00:10:25) - Are We Seeing More Innovation in the Healthcare Market?
• (00:12:25) - International sourcing and cost-effective PBM
• (00:14:07) - Group Captive vs. Network Access
• (00:16:54) - Group Captive and Self-Funded Insurance
• (00:22:09) - What are the cost containment strategies that employers are using?
• (00:25:24) - Group Captivity