Flexibility with Control—The Power of the Plan Document

For small institutions, the fear of self-insurance often stems from a lack of “manpower.” Tower School’s business office consisted of only two people, making the transition to a participatory model feel like a “crash course” in complexity.

• Budget Sensitivity: As a small school, Tower couldn’t afford a “bad year” to eat into tuition revenue.
• Lack of Visibility: Under traditional insurance, they were “dictated to” by carriers with no say in how their plan operated or how their money was spent.
• Rigid Rules: Traditional plans often leave employees stranded if their specific medical needs fall outside of standard “in-network” or “in-state” definitions.

Tower School leaned on the Captivated Health community and support team to bridge the gap in their administrative resources.

• The Protective Reserve: By building a healthcare reserve fund during “good years,” the school ensured that when hard years inevitably arrived, they didn’t have to pull money from tuition.
• Consumer Empowerment: They launched a clinical concierge app, to help their busy faculty research healthcare needs and find the best care instantly.
• The “Power of the Pen”: Unlike traditional insurance, Tower realized they owned their plan document. They utilized this flexibility to help their people when it mattered most.

“In Captivated Health, if the coverage needs to change, it’s always a possibility. I appreciate not being dictated to.”

1. Crisis Intervention

When a faculty member’s child had a serious accident while away at college, the standard plan wouldn’t have covered the necessary physical therapy. Because Tower was in control, they amended their plan document on the fly to provide the coverage, turning a moment of panic into a moment of profound support.

2. Peer-to-Peer Collaboration

Marge joined a “Captive Cell” of like-minded CFOs and HR managers. Instead of being an isolated buyer of insurance, she became part of a collective that meets annually to share data, discuss performance, and brainstorm better ways to keep employees healthy.

3. Reinvesting in Wellness

Despite a small budget, the school introduced lifestyle bonuses, such as gym credits, fostering a culture where “the school does better when the employees are healthy.”

Tower School proved that you don’t need a massive HR department to run a sophisticated health plan. What you need is control. By choosing a model that allows for plan amendments and reserve building, Tower transformed health insurance from a rigid expense into a flexible safety net for its community.