True Captive Insurance, a medical stop-loss captive for employer groups, has selected Gradient AI’s SAIL solution to help reduce group healthcare insurance costs.
The demand for more control over company insurance plans has seen health insurance captives increase in popularity over recent years, with the captive model allowing employers to leverage healthcare coverages at rates previously reserved for larger employers.
True Captive makes a financial investment in each member group through the True Funded captive programme to enhance health plan management and offer long-term stability and control over employee health plan expenses.
As a software provider of artificial intelligence (AI) solutions in the insurance industry, Gradient AI’s solution will be implemented as the key technology enabler of True Captive’s business model.
The medical underwriting solution will provide True Captive with an improved understanding of the prescription and medical data required to optimise decision-making for the benefit of group members.
SAIL also leverages a large medical dataset and machine learning to evaluate group health risk at a more granular level to improve True Captive’s loss ratios and profitability as it will allow the group captive to predict underwriting and claim risks with greater accuracy.
David Voorhees, founder and CEO of True Captive, explains: “SAIL offers accurate and deep risk assessments providing access to both prescription and medical data. This enables us to work with our members to reduce their insurance costs. For example, we can identify instances where an expensive drug or treatment may be sourced at a lower cost or perhaps replaced with step therapy as an effective alternative treatment.”
“We believe the holy grail of health insurance is delivering quality care at a lower cost, and Gradient AI’s SAIL solution is key in helping us reach this goal. It is the most robust group healthcare analytics and data solution on the market, requiring little to no human intervention to obtain deep data insights.”
