$200,000 unused claim dollars returned to Employer.
About the Client
A Midwest-based retail Employer with 180 employees who had received a 25% fully insured increase in cost from a regional HMO.
Pain Points & Priorities
Due to recent ACA regulations, the new community-based rating caused a much larger and unexpected cost increase of the Employer’s healthcare plan. Other fully-insured carrier options were uncompetitive and the Employer did not see a solution. The net increase in cost was equal to $180,000.
Lucent Vista’s level-funded approach was able to deliver a self-funded insurance solution that matched the fully-insured benefits while delivering rates that were equivalent to the pre-renewal rates.
On top of savings realized from the self-funded health plan, the Employer also had an exceptional claim year and received $200,000 in unused claim dollars. This positive claim experience for the Employer drove a rate reduction in the second year as well.
Finally, the member was engaged at the very beginning of their medical journey and received highly personalized support.
Lucent Health Level Funded is “Self-Funding Made Simple” and specifically designed for those Employers who have received an unfair fully-insured renewal from a national health insurance company. For Employers with 25-150 employees, Level Funded provides Employer savings, plan flexibility and full transparency with tons of data. More importantly, Lucent Health provides multiple managed-care options designed to give the Employer a long-term solution providing plan savings and better benefits for their employees.
Impact & Results
Employer tracking of medical trend and plan financial performance was enhanced with Lucent Vista’s proprietary reporting and in-person reviews, helping to drive:
- $200,000 unused claim dollars returned to Employer
- A second year of rate reductions and decrease in trend
- Employer now enabled to aggressively leverage customized plan performance data