Client

Public sector, township fire department with 222 employees

Challenge

The client had a long-term relationship with their broker and medical/Rx insurance carrier. Their renewals increased year after year due to large claimants on their plan and their broker was not helpful in assisting the client contain these costs. The client sought a partner to help them identify effective strategies to provide the quality care the firefighters needed yet also cut costs so they could continue to afford the benefits offered.

Solution

Apex immediately identified areas of significant savings. First, the client had a $1,600,000 million financial liability to the fact that their plan was underfunded. Second, high-cost prescriptions were driving plan costs and accounted for more than one-quarter of their overall plan spend.

Results

By changing medical carriers, plan members were able to access a larger network with higher quality providers. This change also resulted in increased discounts and a savings of $740,000 annually.

Stop loss liability was reduced to $465,000, resulting in a potential reduced liability of over $1,100,000 annually.

The Kinetiq Health Pharmacy Benefits Consulting team was able to outsource the Township’s pharmacy benefits to a more transparent Pharmacy Benefit Management (PBM) vendor with better discounts. This resulted in savings totaling more than $500,000.