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6 Hartford Business Journal • March 26, 2018 • www.HartfordBusiness.com By Matt Pilon mpilon@HartfordBusiness.com S elf-insuring employee healthcare claims takes significant capital and a stomach for volatility, which is why it's long been the domain of large companies with hun- dreds or even thousands of workers. But smaller companies in Connecticut and across the country are increasingly finding ways to self-insure, spurred by the ever-rising cost of group health in- surance and aided by policy protections that smooth volatility and spread risk. Now, leaders from various Connecti- cut chambers of commerce are working on a novel self-insurance strategy, one they hope can slow premium growth and let their small and mid-sized member companies share in the savings during years with low claims activity. Just as important, chambers hope the new offering will bring them greater relevance following years of stagnant and shrinking memberships. "We have to really offer value and we have to do it in a different way," said JoAnn Ryan, president of the Northwest Chamber of Commerce for the past 18 years. "It can't be all networking events." Stephen Glick, who has led a benefits exchange for Connecticut chambers since 1992, is orchestrating the effort. He and other chamber leaders are trying to convince businesses with at least 40 employees to enroll in a self-insurance plan offered through Nationwide Insurance and an Ohio- based alternative risk transfer special- ist called Roundstone Insurance. Nationwide offers medical stop-loss policies to self-insured employers, which mitigates a company's risk if there are unexpectedly high claims. Stop-loss defines the maximum dol- lar amount that employers must pay for their claims for both individual em- ployees and the overall company. After a certain threshold is reached, the insurer picks up the remaining tab. An out-of-state captive insurer owned by Roundstone reinsures the Nationwide policy. While captives and stop-loss protec- tions aren't new in Connecticut, the effort to group relatively small and otherwise unrelated chamber mem- bers into a risk pool is. The idea is to spread stop-loss claims over a larger group, mitigating financial risks to any single employer. Glick said he spent about two years researching and evaluating Round- stone's model, and is convinced it can help smaller employers better control healthcare costs. "We have a new direction," said Glick, a long-time insurance agent who is president and founder of the Chamber Insurance Trust (CIT) in Orange. Obamacare's impact CIT's effort harkens back to a pre- Obamacare era in which chambers marketed to their members custom- designed health plans, which were seen as true perks and helped drive up chamber membership counts. However, many insurers pulled back from such offerings in the wake of the Affordable Care Act, which beefed up coverage requirements and mandated certain benefits, limiting plan design flexibility and making chamber prod- ucts — and many other group plans Spreading Risk Chambers of commerce eye self-insurance model for small-employer health benefits Stephen Glick (left), of the Chamber Insurance Trust, is promoting a self-insurance healthcare plan to Connecticut chamber members with the help of chamber leaders like Candice Corcione (right), head of the Tolland County Chamber of Commerce. HBJ PHOTO | STEVE LASCHEVER Small Firms Turning to Self-insured Models While big U.S. companies are far more likely to offer at least one self-insured plan, the model has been gaining steam among smaller firms. Below are the percentages of U.S. companies with fewer than 100 employees that offer a self-insured plan. Source: Employee Benefits Research Institute 2011 2012 2013 2014 2015 2016 0% 5% 10% 15% 20% % of employers