Vālenz CaptiV: Medical Stop Loss Group Captive Solutions

Reduce risks and gain control of your health plan spend with data-driven collaboration

As health care costs continue to rise, self-insured employers are facing greater risks of high-dollar claims. Roughly two out of every three self-insured health plans incurred a claim in excess of $500,000 last year, and more than 30% had a truly catastrophic claim of more than $1 million.*

Recognizing the significant advantages and cost effectiveness of combining employer plans in a medical stop loss (MSL) group captive program, Vālenz® CaptiV offers self-insured employers the opportunity to participate in the next generation of MSL group captives.

Vālenz CaptiV goes beyond risk sharing to provide a fully integrated, data-driven cost and risk reduction model. Success is built upon group members engaging early and often in managing their medical costs while improving health outcomes — and that’s precisely what Valenz CaptiV does.

How it works:

Vālenz operates at the forefront of risk and cost management by offering a complete and integrated ecosystem of data and service solutions to energize employers through data-driven control over their risk costs. Concurrently, Valenz CaptiV optimizes the health plan and benefits to reduce costs for both the employer and employee.

For self-insured employers with less than 1,000 employees, Valenz CaptiV leverages a larger and more diverse population to reduce plan level and catastrophic risk, while delivering exceptional cost reduction strategies, increased underwriting credibility and long-term rate stability for employees.

Valenz partners with the industry’s top captive manager and advisors, insurance carriers and claims administrators to deliver market-leading results for Valenz CaptiV members.

Why it works: The Power of the Valenz Ecosystem

Valenz operates at the center of the MLS group captive, actively engaging the group of employers and their employees in the Valenz proprietary ecosystem of data and service solutions.

From the inception of work with captive members, Valenz reduces the potential of incurring high-cost claims, creating the best opportunity to transform health plan costs.

Valenz engages data and enables better decisions across the life of a claim, pinpointing employees at highest risk, exposing gaps in network designs and aligning care solutions to employee and employer needs. That’s the Power of the Valenz Ecosystem.

With Valenz, employers visualize – and realize – every opportunity under the Claim Cost Arc. From pre-claim loss to post-claim resolution, our suite of fully interactive solutions build on one another, uncovering actionable information at each step in the life cycle of a claim.

Before a claim is realized, Valenz data identify opportunities to improve network design, analyzes employee health risks and aligns solutions to drive down the cost of care while improving health outcomes.

As the patient journey into healthcare begins, the ecosystem delivers and facilitates services and solutions that expertly navigate member health, ensuring in-network care for improved outcomes at appropriate costs. Valenz drives the right care in the right setting at the right time – and moves from reactive care to proactive population health management. By engaging employees early and often in the ecosystem, Valenz delivers a 20-40 percent improvement in savings to employers. As the central hub for care coordination, Valenz  empowers employees to make better health decisions and enhances the patient experience.

The Valenz model analyzes millions of data points within the ecosystem and weaves analytics into claim workflow for efficiency in cost and process – identifying additional negotiation opportunities with the provider.

Even after a claim is complete, we continue harnessing the power of real-time data and predictive modeling to protect the plan and manage potential risk. As a result, employers gain insights for  better decisions in plan modeling and provider contracting that bring balance to the cost-quality equation.

Meet financial objectives and risk tolerances

MSL group captives effectively provide employers with enhanced ability to optimize their self-funded healthcare plans. Properly structured group captives have proven to reduce costs and increase plan stability by effectively managing, diversifying and broadly diffusing risk.

Under the MSL group captive model, organizations that effectively manage claim costs are rewarded and those that face unanticipated costs are protected. Valenz CaptiV positions group members to succeed in controlling costs while improving health outcomes.