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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Healthcare shouldn’t mean jumping through hoops, waiting on hold Waiting on Hold Instead of Getting Care An investment research company based in New York, needed an insurance company that would work with them—not against them. More specifically, the owner’s wife found herself constantly dealing with the burden of multiple phone transfers, being put on hold, and fighting to fill prescriptions and gather essentials for their diabetic son. With over 200 employees, it became clear that if the owners were seeing this amount of hassle just to maintain their basic healthcare needs, then their employees must be struggling as well. They needed a healthcare provider that would: - Eliminate the need for constant calls and follow-ups, freeing up personal time - Make employees feel heard, appreciated and respected - Maximize the cost-to-coverage balance, without dramatically upping prices - Find lasting solutions with flexible options “I can’t be the only one who is filled with dread when I hear hold music! Watching family members deal with health issues is stressful enough without having to jump through hoops to merely fill a prescription. It felt like my wife was constantly fighting with our insurance company, instead of them being on our team.” Partially Self-Funded Insurance, With a Personal Touch This financial investment company found their home with EVHC and our customized partially self-funded insurance plans. A key aspect of that customization is the fact that EVHC provides a one-on- one personal concierge-level service meant to make employees feel supported. EVHC provided: -24/7 concierge-level customer service, including member education programs -A personal EVHC account manager, who works tirelessly to ensure every item that employees, their families, and kids need is covered -Direct member engagement, where people’s needs and concerns are not just heard, but addressed -The ability to consolidate basic services into a mail order prescription offering, so essential supplies are received on a quarterly basis -Flexible plan designs, including home healthcare and diabetes treatment options “The whole point of health insurance is to make employees feel protected and supported. Insurance shouldn’t feel transactional or complicated. For the first time, our employees and families are getting the support they need—around the clock—instead of having to fight for it.” Peace of Mind and Saved Time In just the first year, this company experienced: -All their healthcare needs and services fulfilled without having to continuously call or wait on hold to ensure basic needs were met -Fewer headaches dealing with health insurance, more time to devote to the business -The peace of mind that comes with personalized service and support Partially self-funded insurance is already a paradigm shift, but EVHC is taking it to the next level by offering personalized coverage and support. For far too many, dealing with insurance providers has required speaking to a computer, constantly being put on hold, and having to jump through hoops for the most basic of care. Time that should be spent with loved ones and furthering business needs is instead spent stuck in frustrating customer service cycles.
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