In a recent article featured in Captive International’s US Focus 2025 edition, Mike Van Ham, SVP, Health Risk Management (HRM) at Captive Resources, examines how member-owned group captives are redefining cost control to drive employer results by implementing first-dollar strategies, integrated point solutions, and shared innovation.
Below is an excerpt from the article:
At Captive Resources, our philosophy is simple: strategic control begins at the first dollar. Through our HRM framework, captive members gain direct access to granular claims data, integrated dashboards, and clear decision-making benchmarks.
Our open architecture allows members to select or swap their choice of third-party administrators (TPAs), pharmacy benefit managers (PBMs), and point solutions with minimal disruption. This flexibility is a core advantage — it empowers employers to use real-time insights to refine their benefit design to meet their unique needs.
Importantly, our focus isn't just on catastrophic claims — it’s on managing “the other 80%” [the portion of healthcare spending that falls below the stop-loss premium] through innovative plan design and solution strategies. With embedded analytics and predictive modeling, we help members uncover utilization drivers, identify at-risk populations early, and implement targeted interventions that reduce spending and improve health outcomes.
Performance measurement is embedded at every level of our HRM strategy. From developing new partnerships to underwriting discussions, we ensure decisions are informed by near-real-time data, transforming oversight into insight.
One of the quiet engines behind every well-functioning group captive is its member community. Unlike traditional insurance arrangements, our model is member-owned and directed, so the strategy isn’t dictated from the top down. It’s built collaboratively and shared across like-minded peers.
Through interactive workshops, ad-hoc pilot groups, clinical steering committees, and real-time data benchmarking, employers don’t just share ideas — they build on them. It’s not unusual to see one [member-company] bring a solution, another refine it, and a third [that] deploys it at scale within a single plan year.
These peer-to-peer engagements generate something powerful: momentum. Momentum turns pilots into programs and conversations into coordinated action. Whether it’s a shared formulary design for GLP-1s or a multi-employer approach to digital medical clinics with embedded navigation, we’re seeing strategy move faster because it’s built by the people closest to the need.
Click here to read the full article in Captive International.
