Case Study-
Captive Employer

How a Captive Employer Drove Behavior Change — Not Just Accounting

Persona:
Captive Employer / Finance & Benefits
Structure:
Group captive, self-funded
Employees:
~85
“For the first time, being in a captive actually changed behavior — not just accounting.”
~ Benefits Lead, Captive Member Employer
Challenge
While participating in a captive, the employer lacked tools to influence utilization before claims occurred. Most care still flowed through PPO channels with limited visibility.
Healco’s Approach
HealCo operated as the care navigation and direct contracting layer inside the captive:
• Direct primary care access
• Bundled specialty episodes
• Early identification of high-cost pathways
• Claims feed used only as a validation loop
No changes to captive governance, TPA, or stop-loss.
Results
• 18% reduction in paid claims vs. expected
• Improved loss ratio entering renewal
• Earlier intervention on MSK and GI episodes
• Clear attribution between navigation and outcomes
See how HealCo guides smarter care decisions