$200,000 unused claim dollars returned to Employer.

About the Client

A Midwest-based retail Employer with 180 employees who had previously received a 25% fully-insured increase from a regional HMO.

Pain Points & Priorities

Due to recent ACA regulations, the new community-based rating caused a much larger and unexpected increase in the Employer’s healthcare plan. Other fully-insured carrier options were uncompetitive and the Employer did not see a solution. The net increase was equal to $180,000.

Why Vista?

Lucent Vista’s level-funded approach was able to deliver a self-funded solution that matched the fully-insured benefits but also delivered rates that were equivalent to the pre-renewal rates.

In addition to the first self-funded savings, the Employer also had an exceptional claim year and received $200,000 in unused claim dollars. This positive claim experience for the Employer also drove a second year’s rate reduction as well.

Finally, the member was engaged at the very beginning of their medical journey and needed highly personalized support.

Impact & Results

Employer tracking of medical trend and plan financial performance was enhanced with Lucent Vista’s proprietary reporting and in-person reviews; this helped to drive:

  • $200,000 unused claim dollars returned to Employer
  • A second year of rate reductions and helped reduce trend
  • Employer now enabled to aggressively leverage customized plan performance data

Lucent Health's self funded product delivers deep savings.