Sponsored: Pinnacle Actuarial Resources Inc.

A New Safe Harbor Is Empowering Captive Owners To Go It Alone

The emerging, independent captive changes the equation for risk distribution.
By: | March 28, 2018 • 6 min read

Risk distribution is a fundamental tenet of insurance.

Underwriting a large number of statistically-independent risks allows insurers to diversify losses and distribute risk across a pool of insureds, minimizing the damaging impact of a large loss from any one policyholder.

“If I insure five buildings, I have way too much volatility; I lose everything if all five burn to the ground. But if I insure 1,000, I decrease that volatility significantly,” said Rob Walling, FCAS, MAAA, CERA, Principal and Consulting Actuary, Pinnacle Actuarial Resources, Inc. “Spreading out the risk is central to successful insurance operations.”

But captives change the equation.

The relationship between insurer and insured as one and the same can make it more difficult for captive owners to effectively distribute risk within their own organizations. In order to successfully mitigate risk and satisfy insurance risk distribution requirements, captive owners have leveraged two primary safe harbors to achieve the level of required risk distribution.

One is the group captive — pooling the risks and resources of multiple insureds under one structure. Combining the exposures of 10 to 15 different companies ensures the loss potential is adequately dispersed.

Reinsurance facilities represent another safe harbor. These involve using reinsurance to pool risks from unrelated third parties. For companies which lack the resources and diversification to be single-parent captive owners, these two structures offer ways to enjoy the flexibility and control of being self-insured by substantially reducing the captive’s risk volatility.

But now a third safe harbor is emerging — one that enables companies with enough statistically-independent risk units to form fully-owned, independent captives without reinsuring unrelated third-party risks based on internal risk distribution. By going solo, more single-parent captives no longer have to assume third-party risk and the uncertainty that comes with it. An independent structure can also be more streamlined and allow for more control.

Setting the Precedent for Risk Units

Rob Walling, FCAS, MAAA, CERA
Principal and Consulting Actuary

To shed group captives or reinsurance pools, companies can demonstrate risk diversification and reduced loss volatility by breaking down their exposures into definable, statistically-independent risk units. The U.S. Tax Court has long been pushing the captive insurance industry to embrace risk units as a way of measuring risk distribution.

Some recent cases show that the industry is finally embracing the idea that a risk unit approach is an effective way for companies to achieve enough internal distribution to form single-parent captives.

In a 2014 decision around Rent-A-Center, Inc. (RAC) and Affiliated Subsidiaries v. Commissioner, the Tax Court determined that the number of insured parties was less important than the number of discrete risk units covered by a captive.

The Court found that “RAC’s subsidiaries owned between 2,623 and 3,081 stores; had between 14,300 and 19,740 employees; and operated between 7,143 and 8,027 insured vehicles. RAC’s subsidiaries operated stores in all 50 states, the District of Columbia, Puerto Rico and Canada. RAC’s subsidiaries had a sufficient number of statistically-independent risks.”

“In several captive insurance decisions since 1991, tax courts have said: Stop worrying about corporate structure and retention of unrelated risk. Pay more attention to internal unrelated risk units,” Walling said. “It came to a crescendo in the Rent-A-Center case, where the argument was stated most directly and most loudly.”

“We are seeing more and more medium to large businesses pursue captive formations without reinsurance facilities. Reinsurance pooling structures are facing increased scrutiny, and satisfying risk distribution internally can be a viable alternative,” Walling said.

Measuring Risk Distribution

There is currently no clear-cut way for companies to determine how many independent risk units will satisfy risk distribution and reduce volatility sufficiently to justify a single-parent structure.

“No test exists that says 50 trucks is enough, but 25 isn’t. Five thousand customers are enough, but 2,000 are not,” Walling said. “This is becoming a real challenge.”

Pinnacle developed a methodology called Expected Adverse Deviation (EAD) to determine how much of the volatility associated with any individual risk unit is diversified away by the insurance program overall. EAD refers to the average amount of loss that an insurance company incurs when losses are greater than expected.

“EAD is computed using a stochastic simulation model based on the anticipated claim frequencies and severities for the captive,” Walling said.

The ratio of expected adverse loss to expected loss indicates how much volatility or “down-side” risk an insurance program is taking on. The higher the EAD ratio, the greater the loss volatility. Conversely, the lower the EAD ratio, the more risk distribution.

“The idea is to focus on the units of risk that matter for each line of coverage,” Walling said. “If we’re dealing with workers’ compensation, then we focus on payroll or number of employees. For commercial auto coverage, it’s the number of vehicles. For a hospital’s professional liability, it may be number of beds and/or doctors.”

Companies can then use their EAD ratio to determine how many of those risk units their captive needs to reduce volatility to a level at which forming a single-parent captive would be prudent and acceptable. It provides an actuarial standard to assess whether there is sufficient internal risk distribution.

Pinnacle’s actuarial team has also computed the EAD results of existing group captives or reinsurance facilities to evaluate the results of EAD in relation to existing risk distribution safe harbors.

“The goal of the EAD model is to recognize that each insurance coverage has its own exposure and measure how that mitigates risk in a captive insurance company,” Walling said.

Leaders in Captive Risk

Pinnacle’s new methodology grew out of its work in captive funding studies, which it has performed for decades. The company focuses exclusively on property/casualty risks, and is among the largest independent P/C actuarial firms in the U.S.

Two-thirds of its client base are captives and other alternative structures like risk retention groups and self-insurance pools. It’s also heavily involved in captive regulatory work and works frequently with state insurance departments.

The Expected Adverse Deviation model demonstrates Pinnacle’s key areas of expertise: the actuarial science of measuring risk, the U.S. tax code, and the regulatory parameters set around captive solutions.

That expertise is also demonstrated through its actuarial consultants’ dedication to educating and advocating for the captive industry. With more than 30 consultants and credentialed actuaries participating in more than 50 industry events each year, Pinnacle’s team takes pride in providing thought leadership and fueling innovative solutions.

“We have a group of very talented actuaries writing thoughtful articles, speaking from prominent podiums and serving amazing clients,” Walling said. “We take the idea of supporting our industry quite seriously.”

To learn more about Pinnacle Actuarial Resources, visit https://www.pinnacleactuaries.com/.

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This article was produced by the R&I Brand Studio, a unit of the advertising department of Risk & Insurance, in collaboration with Pinnacle Actuarial Resources, Inc. The editorial staff of Risk & Insurance had no role in its preparation.




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4 Companies That Rocked It by Treating Injured Workers as Equals; Not Adversaries

The 2018 Teddy Award winners built their programs around people, not claims, and offer proof that a worker-centric approach is a smarter way to operate.
By: | October 30, 2018 • 3 min read

Across the workers’ compensation industry, the concept of a worker advocacy model has been around for a while, but has only seen notable adoption in recent years.

Even among those not adopting a formal advocacy approach, mindsets are shifting. Formerly claims-centric programs are becoming worker-centric and it’s a win all around: better outcomes; greater productivity; safer, healthier employees and a stronger bottom line.

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That’s what you’ll see in this month’s issue of Risk & Insurance® when you read the profiles of the four recipients of the 2018 Theodore Roosevelt Workers’ Compensation and Disability Management Award, sponsored by PMA Companies. These four programs put workers front and center in everything they do.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top,” said Steve Legg, director of risk management for Starbucks.

Starbucks put claims reporting in the hands of its partners, an exemplary act of trust. The coffee company also put itself in workers’ shoes to identify and remove points of friction.

That led to a call center run by Starbucks’ TPA and a dedicated telephonic case management team so that partners can speak to a live person without the frustration of ‘phone tag’ and unanswered questions.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top.” — Steve Legg, director of risk management, Starbucks

Starbucks also implemented direct deposit for lost-time pay, eliminating stressful wait times for injured partners, and allowing them to focus on healing.

For Starbucks, as for all of the 2018 Teddy Award winners, the approach is netting measurable results. With higher partner satisfaction, it has seen a 50 percent decrease in litigation.

Teddy winner Main Line Health (MLH) adopted worker advocacy in a way that goes far beyond claims.

Employees who identify and report safety hazards can take credit for their actions by sending out a formal “Employee Safety Message” to nearly 11,000 mailboxes across the organization.

“The recognition is pretty cool,” said Steve Besack, system director, claims management and workers’ compensation for the health system.

MLH also takes a non-adversarial approach to workers with repeat injuries, seeing them as a resource for identifying areas of improvement.

“When you look at ‘repeat offenders’ in an unconventional way, they’re a great asset to the program, not a liability,” said Mike Miller, manager, workers’ compensation and employee safety for MLH.

Teddy winner Monmouth County, N.J. utilizes high-tech motion capture technology to reduce the chance of placing new hires in jobs that are likely to hurt them.

Monmouth County also adopted numerous wellness initiatives that help workers manage their weight and improve their wellbeing overall.

“You should see the looks on their faces when their cholesterol is down, they’ve lost weight and their blood sugar is better. We’ve had people lose 30 and 40 pounds,” said William McGuane, the county’s manager of benefits and workers’ compensation.

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Do these sound like minor program elements? The math says otherwise: Claims severity has plunged from $5.5 million in 2009 to $1.3 million in 2017.

At the University of Pennsylvania, putting workers first means getting out from behind the desk and finding out what each one of them is tasked with, day in, day out — and looking for ways to make each of those tasks safer.

Regular observations across the sprawling campus have resulted in a phenomenal number of process and equipment changes that seem simple on their own, but in combination have created a substantially safer, healthier campus and improved employee morale.

UPenn’s workers’ comp costs, in the seven-digit figures in 2009, have been virtually cut in half.

Risk & Insurance® is proud to honor the work of these four organizations. We hope their stories inspire other organizations to be true partners with the employees they depend on. &

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]