Get a grip!

How a Move to Self-Funding Lowered Costs and Increased Access to Data


The Company

  300+ employees
  Fully insured health plan

The employer support is strong, both from a monetary and policy standpoint, and employees also support their employer. Leadership does an excellent job communicating and engaging with employees to help make their benefits a substantial part of the employees’ overall package.

The Challenges

   Medical renewal started at a 40% increase
  A 30% final increase was paid the year prior
   Lack of data provided by insurance companies

The company grew increasingly frustrated with the costs (rate increases equated to millions of dollars) and the lack of data provided by their insurance companies. They were given overall numbers and loss ratios but no actual data—certainly nothing, such as claims data that would help them create programs to control healthcare costs and improve wellness for their employees.


The Solution

   Worked with Rubicon Benefits to explore the self-funded market

   Used Rubicon Benefits’ access to vendor-partners to select the best-fit providers

    Designed a self-funded program that will provide transparency and the means to effect change and control costs on a long-term, sustainable basis

With nationwide access to countless vendor-partners, we explored Third Party Administrators (TPA), stop-loss carriers, pharmacy benefit managers (PBM), and local and national networks.


The Results

   First-year expected costs lower than prior year costs

   High six-figure savings over revised renewal and other fully insured quotes

   Better service and attention in the employer/employee relationship

   Receiving complete plan and utilization data for the first time

Seeing data trending more favorably than anticipated

   Long-term stability and increased employee satisfaction with plan, benefits, and employer

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