One of UK’s new limited liability corporations is based in Grand Cayman. Why?

When the University of Kentucky purchased King’s Daughters Medical Center in Ashland in 2022, it also assumed control of a little-known limited liability company called International Health Insurance Limited.

That limited liability company, now called Insure Blue, is based in Grand Cayman, records show. Insure Blue is one of several limited liability companies UK officials have created in recent years.

Insure Blue’s registration as a Cayman Islands company came to light through the Lexington Herald-Leader’s analysis of three years of UK travel records for five top officials for 2023, 2024 and 2025, the only UK travel records publicly available.

Those travel records show two top administrators took five trips from 2023 to 2025 to Grand Cayman and London, England, for Insure Blue board meetings. UK officials have denied the newspaper’s requests for receipts and other travel records for those trips, citing a section in the state Open Records Act that allows taxpayer funded entities to deny those requests if the requests are overly burdensome.

Before the UK purchase, King’s Daughters used the limited liability company to purchase catastrophic medical malpractice insurance; it’s now a practice the university has adopted, said Jay Blanton, a spokesman for UK.

Insure Blue is a captive insurance company, which is a subsidiary of a company that sells insurance to the corporation. Many captive insurance companies are based in the Caymans and other Caribbean islands for both tax and regulatory purposes.

UK says Insure Blue is heavily regulated, meetings are live-streamed

UK officials say the university has to comply with Caymanian regulations governing captive insurance companies, which are stringent.

“The Cayman government heavily regulates Insure Blue and requires external audits and various disclosures,” Blanton said.

The Caribbean territory’s government had to okay the transfer of Insure Blue from King’s Daughters to UK. The board of directors had to undergo background checks, he said.

Insure Blue board members include UK General Counsel Bill Thro, Executive Vice President for Finance and Administration Eric Monday, Associate Vice President of Administration James Frazier, UK Deputy General Counsel Margaret Pisacano and Stephen Addington, a consultant.

“Under Cayman laws and regulations, Insure Blue must hold two board meetings per year, and those meetings must be in Cayman or a British Commonwealth country,” Blanton said. “Also all board meetings of Insure Blue are livestreamed and can be watched by anyone. The meetings are noticed under the Open Meetings Act and meeting materials are available through the Open Records Act.”

The Cayman Islands is a British Overseas Territory.

During the board meeting in London, the group meets with Lloyd’s of London to purchase reinsurance for catastrophic medical malpractice claims, Blanton said. Lloyd’s of London practice is to have face-to-face meetings with potential clients or buyers, another reason why UK officials traveled to London, Blanton said.

Blanton and UK officials said buying insurance for its healthcare system through Insure Blue has saved UK millions.

“Over the last three years, we have saved an estimated $5.7 million by insuring our medical malpractice coverage through Insure Blue rather than the commercial market. That estimate has been made examining our actual costs versus premiums in the commercial marketplace,” Blanton said.

Beth Musgrave

Lexington Herald-Leader

Beth Musgrave has covered government and politics for the Herald-Leader for more than a decade. A graduate of Northwestern University, she has worked as a reporter in Kentucky, Indiana, Mississippi, Illinois and Washington D.C. Support my work with a digital subscription