Case Studies

Industry: Health Care

Employees: 600

Issues: The company's medical plan faced double-digit trend in costs for their two medical plans - an HSA and a buy-up plan. The buy-up plan had such high utilization that most employees could not afford that option and were confused with the HSA.

Services: IPS Advisors, Inc. provided the following services:

• Analyzed claims cost and utilization with the Zywave Decision Master Warehouse tool - identified particularly high utilization for non-emergencies in the Emergency Room and a high concentration of members with chronic conditions.
• Utilized Quest Analytics, hospital quality mining tool, to identify numerous high cost procedures performed at a local hospital with a low quality rating.
• Redesigned benefit model based on Zywave's predictive modeling and implemented Disease Management programs to meet cost containment objectives.
• Built plan incentive to steer members to hospitals with higher quality ratings utilizing our proprietary systems.
• Implemented a third plan option to provide desired benefits.
• Developed custom employee communication pieces designed to enhance perception and enrollment in the HSA plan.

Results: As a result of our assistance, the plans' renewal increase went from +22% to -3%, an overall savings of $350,000. Employee morale was raised by implementing the third plan option with affordable contributions keeping utilization stable and offering desired benefits. Participation in the HSA plan increased 5%.

Industry: Education

Employees: 2,500

Issues: The organization was understaffed in Human Resources. Human Resources needed tools to communicate and enroll benefits quickly and efficiently, as well as administer those benefits going forward.

Services: IPS Advisors, Inc. provided the following services:

• Implemented a custom employer website with MyBenefitsView allowing employees access from office or home, to all current benefit information including plan designs, contributions, eligibility, network search tools, forms, and contacts.
• Provided an online enrollment portal for open enrollment specifying employees' current benefits and new benefit options with cost calculations.
• Distributed Benefit Confirmation Statements to employee homes to verify online enrollment results.
• Transmitted enrollment electronically for new and ongoing enrollment changes on a weekly basis to the insurance carriers providing one point of entry for Human Resources.
• Submitted payroll deduction files bi-weekly for payroll to load employee deductions.
• Produced remittance statements, list bills, and charge summaries to Human Resources to submit payment to the insurance carriers.
• Implemented the Health Advocate service for employees to call with benefit questions or issues needing resolution.

Results: As a result of our assistance, the client saved approximately $65,000 - the total cost of hiring another staff member in HR. The HR staff saved at least 80 hours of productive time spent processing enrollment forms during the open enrollment period. In addition, further savings were generated through system setup which identified employees who did not have appropriate deductions taken for partial-contributory and voluntary coverages thus creating a revenue leak for the organization.