Let’s Change The Discussion!
Our Health Claims Management program was built to answer every small and midsize employer’s question; “how can I pay less for my health insurance”? We answer the question by changing the discussion with employers about how and why Health Claims Management works:
- Claims are about 80% of an employer’s fully insured premium so it makes sense to focus on reducing claims cost.
- HealthKeys has assembled a menu of Cost Containment programs designed to measurably reduce medical and RX claims costs.
- An employer must be self-funded to access these Cost Containment programs.
- Health insurance carriers and PBM’s have an outdated business model, including certain contractual obligations, which prevents them from implementing most meaningful Cost Containment programs.
- We have coordinated our Cost Containment products with a Third Party Administrator, a Transparent PBM, and several Stop Loss carriers to maximize savings and provide a seamless experience for employers and employees.
- Employee engagement is the most important and overlooked piece in lowering claims costs. Our Communications Portal is designed to resolve that challenge.
- Savings are always transparent so employers can easily determine program efficacy.
How Much Savings Are Available?
Employers of any size can expect routine claims such as certain outpatient claims or brand name drugs to generate about $100,000 in claims savings for every 100 employees on the health plan. Our large claim savings programs are more difficult to estimate because the claims occur less frequently, but it would not be unusual for our Manufacturers Assistance Program and our Large Claim Purchase Program to produce savings of $50,000 to $100,000 each, for a single medication or a single medical event.
Once an employer sees the savings, they are in the enviable position to determine how much of the savings will be shared with the employee. It could be anywhere from hundreds to thousands of dollars. Increased employee engagement means more savings for the employer and more money in an employee’s pocket!
Employers are frustrated by the status quo which includes undisclosed costs, contractual mumbo jumbo, and fuzzy “ROI” calculations. We keep it simple; employers and employees see exactly how we achieve the savings, what is required to access those savings, and all fees are disclosed and paid only when the savings far exceed the expenses.