Case Studies

Consider what CME has done for others…

  • CME was asked to assist a group of 35,000 lives with an overhaul of its health and welfare plans in order for the group to remain competitive and cost-effective in the marketplace. CME analyzed the plans and suggested several changes that resulted in savings of almost $80 million over a 10-year period for dental, vision, and prescription drug alone. CME also helped the group revamp its workers compensation program, while saving in excess of $100 million over that same period and turning the group’s program into one of the nation’s finest and most emulated.

casestudies

  • A group with 8,000 lives was concerned about the impending increases in its prescription drug plans. CME analyzed those plans and undertook a comprehensive RFP process to obtain competitive bids for the group’s renewal. Without changing the group’s plan design, the resulting renewal cost savings were over $1.7 million when compared to the prior year.
  • As a result of a detailed risk analysis, CME was able to save a small but growing client over $1 million in its first plan year. CME also increased the company’s cash flow, while not diluting its benefit offerings. This increased the appreciation of the plan by the employer and the employees.
  • A local company was growing nationally through internal growth and acquisitions. As the number of their locations increased, CME was able to identify the most appropriate networks for the company to utilize. CME completed analyses that enabled the client to consolidate several plans into one plan; thus, standardizing the benefit coverage for all employees as well as generate significant administrative savings for the client. This ensured a seamless implementation for the client and has resulted in the best possible coverage for employees, who are spread across the country.
  • A 1,000-life employee group was months behind in reconciling its insurance payments when it came on board as a client with CME. CME immediately became actively involved in reconciling the client’s accounts with both the client and its vendors. CME recommended ways to maintain accuracy moving forward and offered to provide semi-annual audits for each account. CME’s initial findings saved the group over $225,000 in overpaid premiums and proactively addressed those individuals who were not shown as active with the carriers. This resulted in a more realistic renewal trend for the client.
  • A non-profit agency with 400 employees had modified its benefit designs year-after-year in order to cope with the increasing costs of healthcare. CME worked with their senior management team and helped them develop a long-term strategy. This resulted in a solid and consistent approach that was easily followed by management. It was also easily communicated and well received by the employees. In the end, the group netted significant savings. Medical and Rx costs dropped by $132,055 (12%) in the first year and dental, disability, and life coverage costs dropped by $31,269 (15%) when compared to the prior year. Rates were then guaranteed for the next 3 years. All of this was achieved while also increasing the overall group benefit offerings.
  • A group with 8,000 employees had dental costs spiraling out of control on a Fee-For-Service plan. CME reviewed the case and analyzed the utilization, network, and demographics of the group. CME then developed an RFP and structured a dental program that was selected from a pool of applicants. As a result, CME was able to secure the client a 25% savings.
  • A group with 30,000 employees was on a cost-plus plan that had significant administration fees built into their rates. This caused the client to experience significant administrative challenges when attempting to book liabilities correctly and budget effectively for future years. CME developed an RFP that addressed the client’s needs by establishing a pooled plan, which produced significant savings. CME’s guidance helped to eliminate administrative difficulties, reduce overall costs, and increase the predictability of the client’s budgeting process.
  • A group with 700 employees was dissatisfied with the responsiveness of their current administrator and wanted to review its 401(k) plan. CME identified the best vendors for the company’s market segment, analyzed the product offerings, and assisted with the selection process. CME also provided guidance to the client during both the transition and implementation phases. In addition, CME partnered with the client to provide targeted communications and arrange for ongoing information sessions. As a result, investment options were better tailored for employees of different ages and risk tolerances. The client experienced lower administrative costs and higher than expected utilization from plan participants.
  • After a group with 230 employees became a CME client, it was discovered that the group had not been filing all required forms with the government. Consequently, the group was subject to fines in excess of $500,000. CME worked with the group and provided services to rectify the situation, including a negotiated settlement that reduced the exposure from $500,000 to a $4,000 liability.
  • CME annually reviews all stop-loss renewal pricing, independently assessing carrier assumptions and the development of new rates. In a recent case, CME reduced an initial increase from 24% to 3% by negotiating with the current stop-loss carrier. During this process, CME gathered 3 years of loss ratio and profitability information along with rate quotes from additional stop-loss carriers and successfully leveraged this information during the negotiation process. Acting on suggestions from CME, the carrier agreed to modify its rating assumptions based on the historical claims experience and limited the potential exposure of any existing high claimants.  The result was a significant reduction in rates with no coverage changes.
  • As part of CME’s renewal process, we review all plans and plan designs in order to identify ways to lower employer costs without increasing employee contributions. For a client, CME was able to lower employer costs by 18% as a result of adding a Point-Of-Service option as the core plan. Employees still had a choice of enrolling in the PPO or POS plan. Employees who selected the POS plan paid less in contributions than in the prior year. CME prepared a simple, yet effective, communication strategy for all employees to help them understand the differences between the PPO and POS plan. Because of the communication strategy and contributions structure, 100% of employees voluntarily migrated to the POS plan.
  • For a national account, CME was able to lower employer costs by recommending a low option PPO to be offered along with a high option PPO. In this case, the client already offered an HMO and PPO option, but by developing a higher deductible PPO option, those employees, who did not want an HMO option, had a second PPO option that was less expensive for both the employee and employer.
  • CME represents a large municipal employer, who was looking to reduce expenses. After analyzing the employer’s overall benefit plan, CME recommended implementing an employee opt-out program. The analysis identified over $6 million of potential savings to the employer without modifying the current plan designs, increasing any employee contributions, or reducing access.
  • With another large municipal employer, CME was asked to review the group’s existing self-insured prescription drug plan. CME initiated a comprehensive RFP process that required each vendor to unbundle all elements of its pricing. In addition, CME required each vendor to actually re-price every prescription drug claim that the client had incurred in the prior year, using the pricing they were proposing. As a result of this RFP process by CME, the client saved nearly $2 million per year.
  • A self-funded group with 220 employees contracted with CME to assist with its benefits program. After a thorough analysis of the current TPA, network, and stop-loss vendor, CME determined that the group was paying too much for administrative costs and stop-loss premium. In addition, CME determined that the current network did not provide the group with the best discounts, given the group’s specific utilization and geographic location of its employees. CME assisted the group in changing their TPA, networks, and stop-loss carriers. In doing so, the client saved $820,000 (33%) the following year.
  • A self-funded client had an unexpected shortfall in its available funding. After much discussion internally, the client determined it was not going to be able to make any form of payment towards its next two claim calls on their account, which totaled approximately $100,000. CME convinced the carrier to eliminate any and all late fees that would have occurred if the group had merely been late or only made partial payments. As a result of CME’s efforts, the client was able to keep its employees happy; thus, allowing the company to meet its other financial responsibilities during this challenging time. The client was also able to create an ongoing partnership with the carrier that would not have been possible were CME not involved.
  • A CME client was involved in a billing dispute with a large insurance carrier. By the time CME was notified, the dispute had grown in excess of $917,000. This amount had been developing over years and CME determined that it would be both difficult and time consuming to reconcile accurately. After working with both parties to identify the full scope of the problem, as well as possible solutions, CME arranged a meeting with the carrier and the client. As a result of CME’s research, recommendations, and ongoing business relationship with the carrier, the disputed difference was reduced by over $433,000. This not only saved the client $433,000, but also the countless hours they would have needed to reconcile the accounts if CME had not been able to broker this agreement. As part of the agreement, CME also negotiated for the carrier to both accept a monthly electronic file from the client and reconcile that data with their own system, so that any discrepancies could be handled immediately. Accordingly, the client and the carrier’s eligibility and billing are now in sync and future discrepancies will be better resolved with ease and efficiency.
  • As part of CME services, each client’s renewal is reviewed internally to observe how CME’s rating compares to that of vendors. By tracking both premium and claims throughout the year, CME is able to eliminate surprises that many clients typically face when contracting with other brokers. Additionally, CME’s ability to accurately determine if the renewal provided by the carrier is fair, as well as which line items are able to be adjusted, works well in the clients favor. Recently CME identified errors in both the trend and income portions of a client’s renewal. As a result of CME’s detailed process, the initial 6% increase for medical was reduced to 3% and the 2% increase for Rx was reduced to a 4% decrease over the prior year without making any changes to the current level of benefits. CME’s due diligence and expertise saved this client over $321,000.
  • A manufacturing company with 1,000 employees contracted with CME in June of 2006. The new HR team wanted to move away from paper enrollment; however, most of the employees did not have access to the internet as they were primarily “line” employees. CME assisted the group and helped coordinate the implementation of an online enrollment system that provided both carrier and payroll links. By October of 2006, the group was ready to conduct a web-based enrollment for all employees for all lines of coverage. Since then, the group has utilized the web-based system not only for open enrollment but for new hires, life event changes, and custom HR reports. Without CME’s assistance and expertise, the system could not have been implemented in a four month period.

…We promise to help you achieve your benefit goals!