Facing an annual average health insurance premium increase of 23.5% with their current carrier, Anthem, after enduring increases for the past three years, a New York-based employer with 800 employees was teetering on the edge of eliminating medical benefits entirely—a drastic measure that could profoundly impact employee welfare and significantly damage the employer's ability to attract and retain talent. This dire financial situation jeopardized the brokers' two-decade-long relationship with the client. It underscored a critical need for innovative ideas and a transformative approach, not just to revitalize the renewal conversation but also to salvage the relationship and stabilize the client’s healthcare spending.
To understand the depth of the crisis, consider the immediate challenges facing the client:
The broker faced their own set of challenges, particularly their need to not only assemble but also persuasively pitch a self-funding proposal to a client who had previously been led to believe that self-funding was not a viable option:
The pressure was intense with only a few months remaining to secure a viable solution for an effective date that was just over a month away. The broker needed to quickly align with a new partner who could deliver immediate results and long-term stability, making the case for EVHC’s expertise and resources all the more critical.
In partnership with EVHC, the broker team leveraged the potential of partially self-funded insurance, delivering significant cost savings and enhanced coverage options:
Extensive education on self-funding culminated in a significant "Ah-ha" moment for the client during the proposal presentation:
The switch to EVHC's tailored self-funded insurance plan resulted in an anticipated total savings of $2,332,602 in the first plan year.
EVHC was able to accomplish this by:
Partially self-funded insurance reduces costs by 28% with no coverage loss Save without Sacrifice Each year, health insurance premiums go up, forcing employers to shop around and, usually, ending up right back at square one. Whatever they do, companies end up paying more than they should because the alternative—reducing benefits or limiting network access—is simply not an option. Tired of the costs and headaches associated with fully insured options, one company began to explore the benefits of partially self-funded insurance and how it could help them: -Keep their margins (the difference between claims liability and actuarially expected claims) -Cut pharmacy spending -Retain access to the nation’s largest provider networks “We needed a solution that allowed us to save money while still providing our employees with access to the best provider networks. We weren’t getting that through traditional fully-funded insurance.” EVHC’s Partially Self-funded Insurance The company turned to EVHC, which offers custom plan designs that help companies save money without losing coverage. Through EVHC, the company had: -Access to three of the nation’s four largest provider networks -24/7 concierge-level customer service, including member education programs -Flexible plan designs -Greater price transparency “EVHC was easy to work with and a true partner. They were there every step of the way, from implementation to enrollment and beyond.” Thousands Saved, No Coverage Lost In just one year, the company experienced:
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Company Gains a Competitive Advantage Through Partially Self-funded Insurance Break down health insurance barriers A New York-based financial services firm that employs some of the world’s brightest young minds from the worlds of mathematics, computer science, statistics, physics, and more was looking to enhance employee productivity through better healthcare. The company competes with major corporations to recruit employees from some of the country’s top schools and has built an exemplary corporate culture onsite restaurants, gyms, and other amenities) that encourages productivity. The firm found that traditional fully funded healthcare plans didn’t fit with this culture. It needed solutions that were flexible, easy to use, and didn’t get in the way of employee productivity. Company management wanted their employees to focus on work, not overcoming the barriers (dealing with hard to work with carriers, navigating complicated networks and coverage plans, and more) typically associated with health insurance. The firm looked at partially self-funded insurance alternatives to help them: - Attract top-tier talent through health insurance benefits - Eliminate the number of hours employees waste talking to insurance carriers so they could focus on their jobs - Provide employees with great coverage options EVHC’s flexible partially self-funded plans The firm turned to EVHC, which offers highly customized and flexible partially self-funded insurance plans that allow employees to enjoy unparalleled coverage while providing companies with exceptional insurance benefits. EVHC provided the organization with: - A customizable plan that allows employees to use both in-network and out-of-network providers at little cost - Access to three of the nation’s four largest provider networks - 24/7 concierge-level customer service, including member education programs - Low individual deductibles - Greater price transparency - An easy-to-use HRIS platform for fast access to health insurance information, improving productivity and time savings - Insights into employee wellness across four categories (colorectal cancer screening, cervical cancer screening, flu vaccination, and breast cancer screening) Happier employees—and a competitive advantage The firm is now able to offer new and current employees with no hassle health insurance coverage that fits their culture and employees’ lifestyles. Many of the company’s employees are young, fresh out of college, and working hard at jobs they love. They don’t have time to worry about the hoops a fully funded provider will put them through. Now, they don’t have to. They can focus on being productive, driving business for the company, staying healthy, and enjoying the complimentary video games (and the firm’s many other great perks).
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