Captive Group Plans

A New Kind of Group Plan Where Premiums Stay in Your Employees' Names

A fully-insured group health plan built on the Enough! Health Insurance Member Premium Reserve architecture. Your company sponsors the plan. A defined share of premium goes to individual employee Reserve accounts, held in each employee's name. Balances stay in their name and keep paying for their care.

How Captive Group Plans Work

1

Employer Sponsors the Plan

You choose the premium contribution level and plan design (HDCP or HDHP). Enough! Health handles all administration, compliance, and claims processing.

2

Premiums Flow to the Member Premium Reserve

A defined share of premium goes to each employee's Reserve — a custodial account in their name at a qualified custodian. The rest covers plan administration.

3

Employees Use the Care Approved Card

Healthcare is accessed at self-pay rates through the Care Approved Card. Lower costs mean more stays in each employee's Reserve.

4

Employees Keep What They Don't Spend

Unused balances carry forward and stay in the employee's name. Employees can see their balance and what they've kept over time. Reserve balances are portable based on tenure tier.

Why Captive Group vs. Traditional Group Insurance

FeatureTraditional GroupCaptive Group (Enough! Health)
Monthly employer cost/employee~$650$400–550
Employee premium allocation$0 (premiums are gone)Most goes to the employee's Reserve
Annual cost trend8–12% annual increaseFlat or negotiated
Plan flexibilityOne-size-fits-allHDCP or HDHP
Admin burdenHighMinimal (Enough! Health manages)
Employee financial benefitNoneBalance carries forward in their name

ICHRA vs. Captive Group — Which Is Right for Your Workforce?

ICHRA gives employees choice — each picks their own individual plan. Captive Group gives employees the Member Premium Reserve benefit directly through the employer-sponsored plan. Choose ICHRA if your employees want maximum flexibility. Choose Captive Group if you want to ensure every employee gets the Reserve architecture.

Compare all three solutions →

Three Layers of Financial Protection

1

Layer 1Member Premium Reserve

After the deductible, the employee's Reserve pays claims. Most employees pay claims from their named balance.

2

Layer 2Plan Coverage

The plan's pooled coverage steps in when an employee's Reserve balance is insufficient. Self-funded by the plan structure.

3

Layer 3Reinsurance

Catastrophic reinsurance covers claims above the attachment point (~$40,000). Major events are fully protected.

How a Claim Works

Patient: Male, age 37, Idaho, HDCP plan

Healthy Year

No claims that year. The full premium allocation stays in the Reserve and carries forward.

Moderate Year

Some medical claims during the year. Claims are paid from the Reserve after the deductible, and the remaining balance carries forward.

Major Event

A major medical event. The employee pays the deductible from the Reserve, Plan Coverage absorbs the bulk of the cost, and reinsurance covers the catastrophic remainder. The employee's out-of-pocket is limited to the deductible.

Why Your Employees Get Better Care at Lower Cost

The Provider's Perspective: Dr. Sarah Chen, Solo Family Practice, Rural Idaho

1,400 patients

Panel size before Enough! Health Insurance

40%

Providers who participate see simplified billing and faster payment

2.1 hrs/day

Admin time saved (525 hrs/year — 13 work weeks)

Dr. Chen's practice accepted commercial insurance and spent 2+ hours per day on prior authorizations, claim submissions, and denial appeals. When a portion of her panel became Enough! Health Insurance members, those patients moved to self-pay pricing through the Care Approved Card. Instant payment. No credentialing paperwork. No prior auth. No denials. Higher net margin per encounter despite a lower gross rate — because the administrative cost disappeared.

"I get paid within 48 hours of seeing a patient. I haven't had a claim denied in 14 months. I set my own rates. This is what medicine was supposed to feel like."

— Dr. Sarah Chen, Family Medicine, Idaho

Frequently Asked Questions

How is this different from a traditional group plan?

Traditional group plans route premiums to the insurer, who keeps what isn't paid in claims. In a Captive Group plan, a defined share of premium goes directly to Member Premium Reserve accounts held in each employee's name. Employers retain talent better.

Who holds the Reserve accounts?

Reserve accounts are held in the employee's name at a qualified custodian — not Enough! Health and not the employer. The balance stays in the employee's name regardless of employment status (after vesting) and remains spendable on qualified care.

What happens to the Reserve when an employee leaves?

Reserve balances vest based on a tenure tier schedule (details provided at enrollment). Fully-vested employees take their Reserve balance with them. Non-vested balances return to Plan Coverage.

What are the two plan designs?

HDCP (High Deductible Care Plan) starts at $400–450/month employer contribution. HDHP (High Deductible Health Plan) is HSA-compatible and starts at $425–475/month. Both include reinsurance and all ACA essential health benefits.

Is this ACA compliant?

Yes. Enough! Health Captive Group plans are ACA-compliant and include all 10 essential health benefits. We are pursuing state insurance licenses in our launch states.

A new kind of group health plan — premiums stay in your employees' names instead of disappearing to the carrier.

With most group plans, the premiums your employees pay disappear to the insurer at year-end. Here, a defined share of premium stays in an account in the employee's name, and unused balances carry forward instead of being lost. Your employees stop losing their benefits and start owning them — and you retain talent better.

Enough! Health is not a retirement account, investment vehicle, or brokerage product. The Reserve is a health plan feature, not a securities product.

Ready to build a benefit your employees will actually care about?

Schedule a consultation and get a custom employer cost analysis.