2 May 2024ArticleAnalysis

Captives are key to multinationals managing workforce health

Using a captive can help employers provide tailored solutions for employees' unique healthcare needs, says MAXIS GBN.

MAXIS GBN recently released its brand-new report, “How do industry, culture and gender affect your workforce’s health?” The report uses MAXIS’ vast claims data and looks in-depth at how these important factors impact health outcomes for employees. It also suggests how multinational employers can use their employee benefits (EB) plans to meet the related health and wellness needs of their people.

But what role can captives play in helping multinationals address these challenges? Paul Lewis, Chief Business Development Officer at MAXIS GBN, explains.

What factors are impacting employee health?

This is obviously a very broad question and there are so many factors at play when it comes to employee health. But the data we analysed found a very clear correlation between employee health and the industry someone works in, their gender and their culture. 

Let’s look at some examples from the report. While claims for mental healthcare make up only a tiny proportion of our total data (1.6%), mental health accounts for 22.9% of claims incidence in the retail sector – at nearly a quarter of all claims, this is really significant for employers in the retail industry. Having said that, it’s also important to look at how culture plays a part here too – does such a low proportion of claims for mental healthcare in our total data mean that mental health isn’t a big issue for multinational employees? Or is it that mental health is spoken about less in some cultures, or even missing from wellness plans, meaning people do not, or cannot, claim for it? The latter seems much more likely. 

Another big issue for multinationals is musculoskeletal conditions (MSK), and this is across the board. MSK was the top cost driver in 11 of the 12 industries covered by our data, with spending on MSK care more than tripling from US$26 million to $95 million between 2018-2022. While MSK conditions are prevalent across every industry, there is an interesting correlation when we look at whether an industry is more sedentary or active in the type of work employees are doing. Multinationals might need to think about the kind of work their people are doing and how that links to MSK issues. 

And finally, what role does gender play? In the report we delve into a number of often underdiagnosed health conditions which predominantly impact women, such as lupus and endometriosis. It’s clear that male and female employees are not experiencing the same health concerns and therefore do not necessarily need the same healthcare solutions from their employers. 

In summary, if multinational employers want to address the specific needs of their people, it’s clear that they need to move away from a one-size-fits-all approach to healthcare and carefully consider the factors impacting their workforce, and the different groups and demographics within it specifically. 

Three key takeaways for captives

1. The benefits of a global programme

As an employee benefits network, our role at MAXIS is to bring together policies from local insurers in markets all around the world to form a global programme (often through reinsurance). The most mature and sophisticated multinationals are taking full advantage of their captives to write their EB risks.

Whether it’s a captive, pool or another form of global programme, there’s real value for multinationals in the data these programmes provide, particularly in the medical space. This data provides valuable insights into the health conditions that employees are claiming for worldwide. 

As the saying goes, “knowledge is power”, and by working with an EB network, multinationals gain access to this invaluable data and the insights that come with it, allowing them to start delving into the key trends in the regions and markets their people are working in. This gives employers the opportunity to address these key trends and start providing employee benefits that really matter to their people around the globe and address their specific health and wellness concerns. 

But how can employers actually start using this data to make concrete changes and ensure a happy and healthy workforce? That’s where captives come in …

2. The role of captives in plan design

One thing that’s clear from our report is this: employees experience different health concerns and stresses depending on the industry they work in, the culture they live in, and their gender. 

And while the aggregated data we presented in the report is a great place to start, employers looking to care for their people’s needs should use it as just that – a starting point. 

Overall trends and insights provide a wealth of useful information about the kinds of factors that impact employees in different markets and the key physical and mental health conditions to look out for, but employers should delve deeper into the make-up of their own workforce and discover the unique factors impacting their people specifically. By doing so, they can begin to tailor their employee benefits programmes to meet the specific needs of their employees and move away from the ‘one-size-fits-all’ approach to EB that has been adopted traditionally. 

Multinationals writing their EB risks into a captive are particularly well-positioned to do just that. 

Employee benefits captives can play an important role in health and wellness. With multinationals taking on the risk, they have greater control over plan design and can adapt the coverage they offer to their people more easily. By using a captive, multinationals can start to make meaningful change to their employee benefits offering and ensure they’re providing the benefits their people want and need, wherever they are in the world.

Multinationals looking to set up a captive, or those who already have a captive that isn’t being used for employee benefits now, should consider the value that can come from gaining ultimate control over plan design and begin addressing the specific needs of their workforce.

3. Reinvesting underwriting profits

As the ultimate risk-bearer, multinationals writing EB into a captive also retain underwriting profits. 

While that can be beneficial for the bottom-line, many multinationals we work with either look to write their portfolio at break-even or reinvest any profits back into services that care for their people’s health and wellbeing. These can be services such as employee assistance programmes (EAPs), fertility and family-building support, digital wellbeing apps and more. In doing so, employers can tackle their workforce’s specific needs directly – for example, if there is a high incidence of MSK among their people, they could use these profits to provide specialist support services for MSK conditions. Or if they operate in a market where mental health might be a cultural taboo, they can offer digital services via their EAP. 

Not only is this an excellent way for multinationals to show their people that they really care for them, allowing them to attract and retain the best and most valued talent, but it’s good for business success too. 

By designing EB programmes with their people at the forefront and using underwriting profits to implement health and wellness solutions that really get to the core of employee needs, multinationals can see better organisational resilience and an eased pressure on healthcare costs, helping to improve the bottom line while keeping their workforce happy, healthy and productive. 

If you want to find out more, please contact the MAXIS GBN team at

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