More than $6 million in premium refunds and concessions negotiated for public school system

Client

An Indianapolis-based education employer with more than 5,400 covered lives engaged Apex as a strategic advisor during its 2017 renewal

Challenge

Under their prior advisor’s tenure, the client’s rates were increasing at an astounding rate.

After renegotiating 2017 renewal terms with the client’s carrier, Apex was able to secure concessions totaling $4.3 million related to plan years 2016 and 2017. For 2018, Apex negotiated a reduction to overall costs by 10 percent with no change in benefits and offered additional plan options and employer contributions to employees’ health savings accounts.

Solution

After renegotiating 2017 renewal terms with the client’s carrier, Apex was able to secure concessions totaling $4.3 million related to plan years 2016 and 2017. For 2018, Apex negotiated a reduction to overall costs by 10 percent with no change in benefits and offered additional plan options and employer contributions to employees’ health savings accounts.

A premium refund arrangement was negotiated with a projected return for the plan year of at least $2 million. For 2019, a zero percent increase was negotiated with benefit enhancements to expand the number of preventative prescription medications.

Results

Prior to Apex becoming the strategic advisor, this client also had a near-site clinic available to all members on the medical plan. After a thorough review of clinic data, our team found that the cost per visit exceeded $225 due to low utilization. The client was paying for lab work and pharmacy costs that would have otherwise run through the plan.

After analyzing the benefit plan design and clinic ROI, we determined the clinic was not in the best interest of this client. Our Kinetiq Health team developed programs to replace the clinic and deliver those at more than 50 client locations.

Current programming includes three dedicated health coaches trained in exercise science, dietetics and behavioral health.

Employees can meet one-on-one with health coaches or in group settings to create a behavioral change plan that drives down costs associated with chronic conditions.

Onsite engagement also includes health challenges, screenings, flu shots, access to telemedicine, and lunch and learn educational programs.

Case Study

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