OUR PROJECTS

STRATEGIC BENEFIT DESIGN & PRICING

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The Issue

A client was experiencing significant cost increases in its health care plan. As the employee benefits consultant, we were asked to assess and restructure the current plan offerings and propose a multi-year strategy that would target health care increases to fifty percent of the national trend.  

The Solution

We created a strategy and new design for all components of the benefit programs by first determining what the underlying drivers of the current health care increases were.  Since some of the options provided were almost identical but were priced differently there was a strong potential for adverse selection. 

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Using the company’s data as well as external benchmarking data, we developed a Health Care ROI for the client in both hard and soft dollars; from this, we could measure and reduce costs through:

• Administrative savings using competitive bidding,

• Partnering with health care vendors in order to create an opportunity for more disciplined management claim costs

• Encouraging employees to become more effective purchasers of health care through employee education, sensitized plan design, and pricing 

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The savings generated above enabled us to work with the client to enhance offerings, e.g., by developing targeted wellness and disease management programs and providing the time and measures that would increase effectiveness and enable the client to assess ongoing strategic and design changes.

The Summary

In partnership with the client, we provided several key changes and future options:

• Designed and implemented a comprehensive set of health care program options designed to provide meaningful choice and priced to create employer neutrality and to reduce utilization entitlement.

• Identified and implemented alternative funding solutions to promote cost savings.

• Developed a framework for making future benefit design changes that were tied to the underlying cost of services and to where services were delivered.

• Developed metrics to measure success now and in the future in concert with Finance and HR teams.

• Created a multi-year roadmap for restructuring the current plan offerings, introduced “next generation” plan design and wellness initiatives, and created identifiable ROI criteria to manage costs and investments going forward.

MERGERS & ACQUISITIONS

The Issue

A client was acquiring a larger organization. As the employee benefits consultant, we were asked to analyze and present current plan design strategies and propose a future strategy for the larger organization as a whole.  The primary objective of the newly merged organization was to develop a benefits strategy and tie it to provide a highly competitive benefits package that would meet the financial objectives.

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We developed a roadmap clarifying the legal and financial implications of creating an integrated benefits package that incorporated the added complexities of numerous locations, the merger of two different organizations with the need to align cultures, benefits plans, funding arrangements, and ownership structures. 

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The Solution

Our proposed strategy incorporating all key aspects of the benefits program first demonstrated our understanding of what the new management team envisioned for the combined organization and what they were trying to achieve as a critical end result.  That, in turn, enabled us to craft the strategy with our knowledge of the benefits provider marketplace and to benchmark benefit data maximizing recruitment potential and retention of the workforce.  

Using the company’s current benefits experience information as well as available benchmarking data, we were able to advise the new management on the prevalent practices for design of all benefits plans. Through our relationships with providers, including insurance providers, TPAs, stop-loss carriers, PBMs, and other legal and financial expertise,  we assessed the complexities of setting up multiple plans, developed a strategy for transitioning to a single plan that could take advantage of economies of scale, and provided a communication plan to help minimize employee disruption during the transition.

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The Summary

Five key objectives were met:

• A comprehensive benefits package that is competitive in the marketplace, is understandable and attractive to employees and that meets the financial objectives of the new organization.

• Alternative funding solutions providing cost savings and enabling added layered-on savings in the years ahead.

• Client support for all employee and employer questions.

• Financial and service-related metrics to measure success in the present and over time.

• A benefits structure that supports future strategies and allows time to add additional wellness and benefits initiatives.

EMPLOYEE TERMINATION

The Issue

Two current clients had similar employee termination issues within weeks of each other. Managers at each company wanted to immediately terminate an employee who they felt was not performing at the level required to keep their position. After reviewing the performance issues and the documentation presented, both clients were advised that there was not enough documented performance deficiencies to terminate for poor performance at that time and that additional steps were to be taken prior to termination.

The Solution

We presented a 30-day performance improvement plan to give each of the employees as a final, structured, and documented opportunity to immediately show measurable improvement. The plan included:

• A written document with both the manager and the employee signing their agreement and understanding of the plan and the consequences of not achieving the required results within 30 days.

• A weekly meeting between the manager and the employee to discuss and update the progress and address any challenges or concerns, to ensure the support and resources were available to the employee for their performance improvement success.

The Outcome

One client agreed to initiate the performance improvement plan. The other decided to terminate immediately, as the manager was insistent that the employee needed to be terminated with or without additional documentation. The employee on the improvement plan did not show improvement after 30 days. Both employees were terminated for poor performance, and both filed a claim for wrongful termination. The client who initiated and documented the final improvement plan won the claim resulting in no money paid to the employee. The client who did not follow the advice lost the claim. As a result that client paid attorney fees, spent months in time and resources, and finally settled for a substantial amount awarded to the employee.