ParetoHealth (Pareto) has developed a savings model to estimate the cost savings from participation in its captive programs, which offer medical stop loss (MSL) coverage, access to Pareto’s pharmacy benefit manager agreements, and other cost-management programs. The cost impact is calculated by comparing expected premiums and claims under a traditional insurance arrangement to those under Pareto’s captive model, including savings derived from pharmacy rebates received or avoided stop-loss lasers. Pareto commissioned Milliman to independently assess this model. Our report:

• Summarizes Pareto’s captive program
• Reviews the methodology used to estimate savings
• Discusses potential limitations of Pareto’s methodology
• Outlines important caveats regarding our review

This report was commissioned by ParetoHealth.