- About the Client:
Press Release
honored at the inaugural “Rosie Awards” presentation in Chicago with a national award for health plan excellence and stewardship. Fifty employers or unions with memberships ranging from 27 to 300,000 were honored by over 700 healthcare and benefits professionals, industry experts, and thought leaders who gathered at the Chicago Navy Pier on August 7-9, 2023, to discuss strategies for delivering better care at a lower cost while improving patient outcomes.
The 2023 Rosie Award winners were chosen from plans recommended by benefits advisors, solution providers, or clinical leaders who met two important criteria: a high Plan Grader (TM) score and excellent use of their “Health Rosetta Dividend”.
The HR team at Oradell and our advisors developed four main goals:
- Evaluate Member Contributions Strategy
- Minimize Member Disruption
- Take advantage of alternative underwriting protocols
- Reassess current plan design
- Approach:
Oradell and BritePath evaluated the existing plan designs, contribution structure, member allocation and did a market evaluation of the existing self-insured health plan.
The incumbent carrier responded to market analysis with a projected 30%+ increase in stop loss premiums, as well as a significant increase to an existing laser.
- Year One Results:
- $1 million reduction is annual medical claims
- $300K reduction in paid Rx claims
- $184k reduction in excess stop loss claims
- 56.51% under maximum claims exposure
- $433k reduction in high-cost claimant
- $845k under budget
The transformation of the plan from status quo to high-performance has been nothing short of remarkable.
Since our team approach started in 2019, the Qosina plan has had significant successes. Gaining control of out-of-control premiums was easier than expected. Enhanced benefits make recruiting and retaining talent easier which is especially important in the growth mindset of the organization.
- Advanced Reporting & Analytics
The next phase will focus on the introduction of proprietary technology that allows our benefit team and Qosina’ s leadership to gain insights in to the medical and Rx claims and evaluate alternative cost control/benefit enhancement opportunities, as well as alternative funding options available to groups of their size.
On the Horizon:
Navigation tools so members are better equipped to make informed health care decisions, avoid unnecessary out-of-pocket costs and be better ambassadors of the organization.