Self-Funding Miracle: Premium Refunds and Increased Benefits
Challenge
A company with over 1,500 employees—many in entry-level roles—struggled with low healthcare participation due to unaffordable premiums. Nearly one-third of employees had opted out of coverage.
Solution
To better support its workforce, the company sought a more affordable healthcare option with expanded coverage. It transitioned from a fully-insured to a self-funded plan, which provided cost savings and access to employee health data.
Implementation
With health data in hand, the company identified key issues—such as diabetic employees skipping medications and tests due to high out-of-pocket costs. In response, it waived deductibles for routine meds and tests to remove financial barriers.
Results
In year one, the company saved $1.7 million and refunded 8 months of premiums to over 1,000 employees. In year two, it refunded 3 months of premiums and reduced overall employee costs—achieving lower costs, broader coverage, and increased participation.
There’s never been a better time to break free from bottlenecks. If you’re ready to discover how a new model could transform efficiency, scalability, and profit—without sacrificing your team’s safety—get in touch with CSSA today. The next chapter of stability and growth begins now.
About the Author
Deborah S. Adkins, MSA, CPA, CFF, CGMA
Co-Founder and CEO
Extensive senior financial team member for numerous companies, ranging in size from start-up operations to $1.5 billion in annual revenue. She offers insights into the many challenges and creative solutions she has implements with private, public and nonprofit companies over the span of her 35+ career.