This Central Oklahoma nursing home and assisted living facility (144 employees) grappled with high claims costs on their fully insured BCBS plan, limiting their ability to enhance employee benefits without increasing expenses.
We addressed high claims through a claims audit, then transitioned them to a level-funded plan with improved benefits, including zero-cost surgeries, labs, and imaging. Employee education and care navigation further optimized costs.
Since 2020, the company achieved cost parity with their previous plan while delivering richer benefits, including $0-cost surgeries, labs, and imaging. Savings were primarily from optimized medical claims and prescription costs, enhancing value without raising premiums.
