Risk Reduction:

Eliminating $800k of Claims Expenses

190%

Initial fully-insured renewal from carrier

2 CLAIMANTS

Identified 2 high-cost claimants

12%

Crumdale’s risk control brought the group’s renewal to 12%

The Situation

A lumber company in the Northeast had been offering a fully insured medical and prescription drug program for over 50 years. During that time, they tried to find a balance between price and competitive plan design options.

In the midst of a worldwide pandemic, the company received a 190% renewal increase from their insurance carrier. Absolutely shocked to receive such an increase, they asked their broker to conduct a market survey and contact DOBI.

Not surprisingly, the market was hesitant to provide a quote to an employer receiving such a large increase. The broker contacted Crumdale Specialty to see if there was an alternative approach to handling this employer’s health plan.

The fully insured carrier was unwilling to provide any de-identified claims information, so the broker partnered with Crumdale to promulgate an Individual Medical Questionnaire process to better understand the employer’s risk profile

Goals

CLIENT:

Allow the broker to have more control over the health plan to continue balancing plan costs with design changes.

BROKER:

Obtain the ability to better manage high-cost claimants to avoid significant increases in the future.

Before & After

Before After
Program Struc