A 100-employee technology company was facing unsustainable increases in health insurance, culminating in a 30% renewal hike to $923,000. Faced with this rising cost challenge, this group wanted to find a way to preserve their robust employee benefits while also reducing claim expenses to prevent future premium hikes. To address these concerns and to find a solution, they enlisted the help of one of our knowledgeable agents.

To counteract the rising costs, we transitioned this company into a partially self-funded program through the Benefits Insider plan. This strategy allowed the group to pool their insurance purchasing power with over 200 companies, effectively functioning as a cooperative. By doing so, this enabled them to secure protections that made their partially self-funded plan safer and more cost effective than their previous fully insured arrangement. Alongside this plan we implemented programs specifically designed to reduce waste and prevent overcharging by healthcare providers. The financial impact was significant, saving them 30% in the first year and a 60% cost reduction compared to their fully insured plan.

One notable cost saving initiative was the introduction of a concierge surgical navigation program. This service provided employees access to high quality providers with negotiated prices far lower than traditional network rates. Employees could either continue with their standard network provider or opt for the concierge program at no cost. In one instance, an employee required knee replacement surgery. By using the concierge program, the surgery cost $20,000, whereas the same surgery with the same surgeon and hospital would have cost $60,000 through the group’s traditional network. This switch resulted in $40,000 in savings in claims costs. Additionally, because the employee chose the concierge program, their out-of-pocket expenses were completely waived, allowing them to receive care without personal financial burden.

Another impactful cost saving measure involved sourcing high-cost medications for chronic conditions. We found a high-cost medication for one employee, saving the company $30,000 annually. Previously, the employee had to pay $5,000 per year out-of-pocket for the medication. Under the new arrangement, the medication was sourced at no cost to the employee, reducing the financial strain on both the company and the employee.

By making strategic changes to their funding structure and implementing innovative cost-containment programs, Hotchkiss helped this group reduce their healthcare expenses while enhancing employee benefits. In the first year this saved them $200,000 and dropped by 6% in the following years. This case highlights the effectiveness of creative and proactive solutions in addressing rising healthcare costs, proving that companies can maintain comprehensive benefits without sacrificing financial stability.