One of our clients is a small, self-funded organization with fewer than 30 employees. During the annual plan renewal, their stop-loss carrier identified a member who was recently diagnosed with an orphan condition that required a maintenance medication costing $300,000 annually.
Based on this staggering amount, few stop-loss carriers were willing to quote their business, and if they did, they provided lasers on the high-cost medication.
With this feedback, the company began to strongly consider returning to a fully-insured plan. They decided to meet with their broker and Crumdale Specialty to discuss potential solutions.
Crumdale implemented a program that allowed the employer to alternatively source high-cost specialty drugs at substantially reduced costs.