Client: One of the country’s leading multimedia companies

Situation

The client was concerned about the high claims cost and low network utilization associated with their dental plan. A majority of employees were enrolled in plan while paying for 2/3 of the cost of the plan.

Challenge

Find/create opportunities for cost-savings for both the employer and employees, while improving access to in-network providers.

Approach

Given the client’s size, the high percentage of employee enrollment and the growth of many dental networks over the past few years, we believed that all of the client’s goals could be achieved. Our thorough collection and methodical review of the data confirmed this assumption. We:

• Analyzed recent experience data.
• Compared the data to other like-sized companies with similar program utilization.
• Analyzed the current plan design, funding arrangement, network access and network discounts.

Outcome

Through a thorough financial analysis, we recommended that the client move to a fully insured program with another carrier whose network and deeper discounts could provide significant savings – with minimal provider disruption for employees.

As a result, the client:

• Reduced overall program spend by 5% while transferring all program risk to the carrier.
• Locked-in a 3 year contract with rate caps for years 2 and 3, which are less than current dental trend.
• Increased access to currently utilized providers by 46%.
• Added performance guarantees to monitor new carrier and network performance.