Number of Employees: 60
Current Medical Claims Per Employee Per Year Benchmark: $679
Current Prescription Claims Per Member Per Month Benchmark: $19.85
SUMMARY
APU has been a client for several years, and have been “fully-insured” up until 2023 when they transitioned to High Plains Health Plan. Prior to that move, APU was experiencing average increases of 9.5% annually on their medical insurance. Their fully insured plans had a base plan with a deductible of $5,000, and a Silver Buy-Up option with a $1,500 deductible. Due to premium levels, most employees were enrolled in the High Deductible plan.
APU explored self-insuring for a few years before making the transition. The last year they were fully-insured, their total plan expenses were approximately $433,000, and they received a 36% renewal increase, which would have pushed organizational expenses over $500,000 annually.
RESULTS
APU’s medical and pharmacy claims benchmarks are far below national averages. In the first year of being with High Plains Health Plan, APU has seen the cost of claims plummet. APU is one of the highest utilizers of our Tier 1 Preferred Network, which dramatically impacts the unit cost of care.
The Tier 1 HPHP Network boasts average discounts of over 70%, while the Tier 2 “wrap” network only averages a 56% discount.
In their first year of being with High Plains Health Plan, APU’s total organizational costs were $235,176, netting tremendous savings for the company. In addition, APU employees have not had a rate increase in three years. Future plans include lowering employee premiums for each tier (EE Only, EE/Spouse, EE/Children, and Family). Their employees enjoy $0 Deductibles in the Tier 1 Network, along with $0 Copays for primary care, specialist care, urgent care, chiropractic care, physical therapy, hospital care and generic prescriptions.