Crumdale’s risk control brought the group’s renewal to 12%
A lumber company in the Northeast had been offering a fully insured medical and prescription drug program for over 50 years. During that time, they tried to find a balance between price and competitive plan design options.
In the midst of a worldwide pandemic, the company received a 190% renewal increase from their insurance carrier. Absolutely shocked to receive such an increase, they asked their broker to conduct a market survey and contact DOBI.
Not surprisingly, the market was hesitant to provide a quote to an employer receiving such a large increase. The broker contacted Crumdale Partners to see if there was an alternative approach to handling this employer’s health plan.
The fully insured carrier was unwilling to provide any de-identified claims information, so the broker partnered with Crumdale to promulgate an Individual Medical Questionnaire process to better understand the employer’s risk profile
Allow the broker to have more control over the health plan to continue balancing plan costs with design changes.
Obtain the ability to better manage high-cost claimants to avoid significant increases in the future.
Before & After
Fully Insured (12 equal premium payments)
Third-Party Administrator (TPA)
Pharmacy Benefit Manager (PBM)
Transparent PBM Contract
Medical Stop Loss
Resolute Underwriting Strategies
Claim Review & Monitoring
Plan Document Review
ERISA Guidance & support
Patient Advocacy / Engagement
Alternative Funding Programs (RX)
Crumdale Custom Reporting
# of Employees
Differential @ Max
The Group saved $815,461.80 vs renewal with a 12% increase from current costs.
FAVORABLE DISCOUNTS, TERMS, AND CONDITIONS
DECREASE RENEWAL VOLATILITY
ALLOWS FOR STRATEGIC PLANNING & FINANCING
How We Did It
THE CLIENT HAD MANY ISSUES WITH THEIR PRIOR FULLY INSURED HIGHMARK BCBS PLAN.
The fully insured carrier was unwilling to provide any de-identified claims information
The fully insured renewal saw the
employers cost almost triple