Number of Employees: 137
Rosie Award Recipient: Top 50 Health Plans in America
Current Medical Claims Per Employee Per Year Benchmark: $5,043
Current Prescription Claims Per Member Per Month Benchmark: $54.59
SUMMARY
When they were introduced to Butler Benefits, DISCO had been self-funded for 30+ years with the same TPA. They had never worked with an independent consultant before. They had experienced three consecutive years of major healthcare costs, rising stop-loss premiums, and no Aggregate coverage at all.
In addition, the prescription drug coverage was very outdated and almost non-existent for employees. They had asked questions of their TPA to find innovative ways to reduce costs, but were met with a lack of answers. Leadership knew there had to be better ways to manage risk, and they were looking for solutions.
RESULTS
Butler Benefits first focused on the stop-loss side of their plan, securing affordable Aggregate coverage that the previous TPA said was “unnecessary”. A TPA and PBM change was made, and DISCO became a client of High Plains Health Plan.
Deductibles and copays were reduced to $0 for thousands of medical services, and the prescription drug benefit was completely overhauled. In that overhaul, $0 copays for all generic medication was implemented.
Organizational costs were reduced for DISCO by approximately $300,000 in the first 12 months following the change. Today, DISCO employees can see primary care physicians and specialists at a $0 copay in our Tier 1 Network