This rural Northern Oklahoma hospital (85 employees) faced consistent overcharges on their fully insured plan despite low MLR, limiting their ability to offer top-tier benefits while controlling costs.
We reviewed claims data, negotiated fairer renewals aligned with loss ratios, and transitioned them to a captive self-funded plan in 2025. This included concierge services for free scans, labs, and medications, plus employee education on care navigation.
Since 2015, the hospital saved $80,000 in 2025 alone by moving to self-funding, with zero or low single-digit member contribution increases compared to the industry’s 11% average. Savings were driven by free surgeries, imaging, and prescriptions, with notable support for a member with a cancer diagnosis via care navigation.
