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PRESENTATION
PREPARED FOR:
Modernize Healthcare
Eliminate employee’s out-of-pocket
expenses while guiding them to the
highest quality healthcare
Healthcare costs are rising faster than ever!
MEDICAL LOSS RATIO
ANTHEM
UHC
CIGNA
$63.61
$33.16
$36.77
MARCH 23, 2010 OCT 12, 2022
ANTHEM
UHC
CIGNA
$63.61
$33.16
$36.77
MARCH 23, 2010
$468.83
$501.94
$290.38
OCT 12, 2022
Inpatient DRG 470 (major hip and knee joint replacement)
across 5 hospitals in SEATTLE
Inpatient DRG 470 (major hip and knee joint replacement)
across 5 hospitals in SEATTLE
Facilities, Hospitals, AND Individual Doctors
GBS STRATEGIC PROCESS
TAKE BACK CONTROL - CASE STUDY
How it started...
➔ Fully insured Bronze plan with a $6000 deductible
➔ No guidance for employees for accessing highest quality care
➔ Using manual processes for HR functions
➔ Open Enrollment was done via group meetings and paper
➔ EE only rate of $614 per month
How it’s going...
➔ Level funded plan with $0 deductible
➔ Medical Advocacy team provides guidance to highest quality care options
➔ Integrated technology solution for HR (reducing administrative burden)
➔ Open Enrollment done via self-service portal with call center support available
➔ EE only rate of $532 per month (15% savings at renewal)
Employee testimonial about the program!
MEDIA
The American Benefits Conundrum: Realigning Healthcare Incentives

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