Engineering A Successful Self-Funded Plan With The Alliance®

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How do you put employees first in your self-funded health benefit strategy – and use benefits to recruit coveted workers in a highly competitive environment – without breaking the budget? For Promega, the answer is based in self-funded health benefits backed by the strengths of The Alliance network.

Based in Madison, Promega Corporation is known for extraordinary health benefits that are paired with a wellness-oriented culture and a strong overall benefit plan.

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Communicating, Advising and Informing a Self-Funded Plan

Clark sees raising awareness as the first step to engaging employees in better health care choices. It is essential to help enrollees understand which providers deliver in-network care, which saves money for the company and reduces out-of-pocket costs for employees.

Clark highlights The Alliance Find a Doctor tool daily as she responds to questions from employees seeking in-network care or other information. Employees can also use the online tool to look up cost and quality information about doctors, clinics and hospitals.

By using The Alliance network, Promega gets savings without forcing employees into a narrow network that would limit their choice of where to get care. Clark sees that as a big advantage of being a member of The Alliance cooperative.

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Promega Corporation Profile

• Headquartered in Madison, Wis.
• Number of Employees: 1,400+
• Number of Products: 3,500+
• Self-funded health insurance since 2013
• Member of The Alliance since 2013
• QualityPath Participating Employer since 2017

Read more about Promega > >

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Keeping It Simple & Affordable

By being self-funded Promega is able to create and design their own health benefit plan. Their goal is to keep it simple and affordable. They offer two plan design options: a low deductible plan ($1,000 per family) and a high deductible plan ($3,000 per family).

“I am really proud of our benefit plan design as I believe it is easy to understand and it provides a lot of services that employees are not used to seeing.” Clark noted.

Unique offerings in the self-funded benefit plan include:

• Morbid Obesity Treatment
• Transplant Services
• Infertility Treatment
• Allergy Injections
• Biofeedback

Promega partners with a select group of vendors to make their benefit plan rich including a third-party administrator (TPA), The Alliance, employee assistance program (EAP), dental network, vision network and flexible savings account (FSA) vendor.

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QualityPath Saves Promega Money  

Adding QualityPath in 2017 quickly proved to be a win-win for Promega and its employees.

After just one year in QualityPath, Promega was pleasantly surprised by the number of employees who moved from hospitals to QualityPath providers for diagnostic CTs and MRIs.

Reducing out-of-pocket costs to zero for most employees who get CTs and MRIs is a great incentive, Clark said. Employees quickly responded.

“Naturally you are going to say, what’s the catch?” Clark said. “There’s no catch. It truly is a win-win for both the employer and employee.”

Promega’s 2017 QualityPath Savings and Utilization Report:

• Hips and Knees: Utilized 67% of all hip and knee replacements. More than $24.4K saved.
• MRI: Utilized 67% on all MRIs. More than $43.1K saved.
• CT: Utilized 13% on all CTs. More than $3.1K saved

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Homegrown Benefit Marketing

Promega aims to communicate to employees with self-funded benefits using a homegrown health benefit marketing plan that includes:

• Benefit orientation meetings for new employees
• Annual postcard mailing to employees home
• Customized employee health benefit tutorial video from Guide Spark
• Promotion of benefits information that includes tabletop signs, posters, an eight-page brochure and ads on TV monitors.

Employees are urged to have a relationship with a primary care provider. That helps them use primary care instead of seeking unnecessary emergency services, but it also has the side effect of making it difficult to persuade employees to shop beyond the health system affiliated with their doctor.

Offering Convenient Care

Promega’s onsite clinic exists to support the health and wellbeing of employees because they believe it is its responsibility to do so. It also plays an important role in its strategy by lowering its overall claims spend while offering convenient access to some primary care services.

• Blood Draws
• Urgent Care
• Physical Therapy
• Immunizations
• General Health Care Consults

Employees love the convenience and cost savings of the onsite clinic. Promega also saves on the cost of care and by getting employees back to work sooner after sicknesses and surgeries.

Self-Funded Educational Events = Learning Opportunities 

Clark said that there are many advantages from being a member of The Alliance, one of which includes educational and networking events. Through these events The Alliance offers trending topics to keep employers up-to-date with the latest news and best practices employers put in their benefit plans. By participating in these events Promega learns from other employers on what benefits they offer as well as what new things are in the marketplace to make the Promega culture an even better experience for employees. “I love to learn how to keep things fresh and provide different approaches within the workplace” said Clark.

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