Thank you for taking part in the Captive Insurance Times Healthcare Captive Survey, which informs our reporting on the healthcare captive market. It takes around five minutes and is almost entirely multiple choice.

A few questions invite an optional comment if you'd like to expand. All responses are confidential.

If you leave a comment, you can choose whether to be attributed by adding your details at the end; otherwise your responses remain anonymous.
SECTION 1: About you

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1. Which best describes your primary role in the captive market?

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2. Which best describes your involvement with healthcare captives specifically?

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3. In which region are you primarily based?

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4. What size of organisation do you primarily work with on healthcare captives?

SECTION 2: What you're seeing now

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5. Which healthcare risks are you seeing drive the most captive interest? (Multiple choice, select up to 3)

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6. Which captive structure are you most commonly seeing used for healthcare risk?

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7. Are the healthcare captives you've seen recently mostly…

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8. For group medical captives, which employer size are you seeing join most?

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9. High-cost drugs, including GLP-1 weight-loss and diabetes medications and other specialty pharmacy treatments, have become a growing share of health-plan spend. Over the last 18 months, have you seen these costs push employers towards captives?

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10. Over the last 18 months, medical stop-loss pricing at renewal has…

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11. In the last two years, how often have employers in the healthcare captives you know of received premium refunds or dividends?

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12. Thinking about the healthcare captives you see, how important is each of the following as a reason employers use them right now?

  Very important Important Minor Not a factor
Cost savings
Data & claims transparency
Plan-design flexibility
Underwriting profit retention
Reinsurance access
Managing emerging risks (cyber, etc.)
SECTION 3: Where it's heading

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13. How do you expect healthcare captive growth to develop over the next 3 to 5 years?

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14. Beyond medical and health-benefit lines, which do you expect to grow fastest in captives generally? (Multiple choice, select up to 2)

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15. Which domicile do you expect to see the strongest healthcare captive growth?

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16. For healthcare captives, momentum between onshore and offshore is heading…

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17. Do you expect third-party / employee-benefit business inside captives to grow over the next three years?

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18. What's the biggest barrier to wider healthcare captive adoption ahead?

SECTION 4: Regulation, tax & the profession

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19. Which regulatory or legislative area poses the greatest risk to healthcare captive growth?

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20. Which change would most help healthcare captive growth?

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21. How would you rate the current regulatory environment for healthcare captives?

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22. What impact do you expect AI to have on healthcare captive management over the next five years?

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23. The biggest opportunity or threat facing healthcare captives in 2026/27 is…

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24. If you would like your comments to be considered for publication with attribution, please add your details below. All quotes are confirmed with you before they appear. Leave blank to remain anonymous.

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