Expanded Network and Plan Options at a Lower Cost
Who we worked with
A growing Optometrist practice with employees of all ages. This business has mixed demographics from young single employees just losing dependent coverage on their parents plan to middle-aged employees with families. The challenge was the very different needs of each
Where they started
The company was using a defined contribution strategy on the SHOP Marketplace, offering dual plan options. Employees were unsure which plan would best fit their families. They had many unanswered questions and a lack of confidence in choosing a plan due to the lack of education and information provided on the Marketplace.
The largest concern was the HMO network that limited the available hospitals and providers and did not include the local Children’s Hospital. The group was also facing a double-digit increase and wanted to find other options that would better fit the needs of their group.
What we did
Knowing the market, we knew we could expand their options with a larger PPO network at very similar cost. Using the medical information, we were able to get a level-funded carrier and offer four options to fit a variety of needs. We communicated the options with plan comparisons to employees through a dedicated enrollment portal, also giving them access to benefit summaries, prescription formularies, and network search.
How we helped
The Solution:
- Alternate funding medical plan with four available plans to fit that include PPO network
- Access to telehealth and EAP
- Benefit Administration platform to manage employee elections and compliance documents
- Annual savings of 14%
- Client received claims refund of $4,448.00
Company feedback
Employees are very happy with the larger PPO network. The expanded network means they are no longer forced to stay with one hospital system and a narrow list of providers.
Employees now have access to OhioHealth/Riverside, OSU, Mt. Carmel, and Nationwide Children’s Hospital.
The employer is approaching a second-year renewal and another claims refund looks promising. We are looking at new ways we can use the refund to benefit participants of the plan.
Partnerships
