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Case Study: Reducing Benefit Plan Costs

Helping employers manage health plans

How moving from fully insured to self-insured can save employers and employees money

Who they are

This financial institution has nearly a dozen retail bank locations in the Midwest region. Their employee base is 55% female and the majority of the staff is between 35 and 50 years old.

What they had

When we started working with this business, they were fully insured and expecting a large increase for their renewal—with very limited plan designs available. They had trouble controlling claims costs. The goal here was to increase the scope of benefits offerings while reducing plan costs.

What we did

Year 1

  • Moving this group to a self-funded plan allowed us to get more data on claims and prescription costs and pinpoint problem areas.
  • Setting up online enrollment resulted in increased benefit plan participation and awareness while reducing administrative burden and human error.
  • Implementing financial wellness and health concierge programs helped guide employees to lower cost providers and mitigate bills and invoices.
  • Employee education efforts empowered plan participants to make better and more cost-conscious healthcare choices.
  • HR education allowed the team to understand the benefits and ROI of moving toward a self-funded model.

Year 2

  • Implementing direct contracting with a regional hospital system nationally ranked for high quality allowed employees to get the care they needed at a lower cost.
  • Employees still had options, but incentives like reduced deductibles encouraged people to use the designated hospital system.
  • Employers loved the savings and Employees were happy to receive quality care at reduced costs.

How we helped

Year 1:

  • $210,000 in premium savings plus $142,000 in their claims reserve fund for a total savings of $342,000. This is a 20% savings on healthcare costs for the employer.
  • Employees saw a reduction in their payroll withholdings for healthcare of as much as 30%.
  • The overall average cost per employee dropped by over $2,200.

Year 2:

  • This happy employer was able to hold all the savings in the benefit contributions from year one.
  • Employees saw no increase in their benefits costs.

What employees say

“I am reaching out to brag on our coverage. Today I received an invoice from the direct contracting hospital system for an MRI. I specifically chose to go to our contracted facility and they were so great. Very patient focused. The initial charge was $2,000 and after it processed through our insurance, my balance was only $41.53. That is INCREDIBLE!

I have been to this facility three times and each time has been a very positive experience. They have impeccable customer service skills. I am VERY impressed with this hospital network and excited about our group’s healthcare partnership with them. Just wanted to pass on the good news!”

Get in touch to learn more!