A small municipal group.
Under 50 employees.
The kind of group most people assume is stuck.

Before:
– Fully insured through Blue Cross Blue Shield
– Community-rated pricing
– Rising premiums
– Deductibles and out-of-pocket exposure
– Dependent coverage largely unaffordable

They were doing what most groups do:
Absorb the increase.
Shift a little cost.
Hope next year is better.

Instead, we rebuilt it.

After:
– Transparent claim/premium structure
– Direct contracts @ $0 cost to members
– Eliminated deductible + out-of-pocket

Results:
– About 50% reduction in employee-only premiums
– $0 deductible
– $0 out-of-pocket exposure
– Dependents added at little to no cost

Participation increased significantly.

Let that sink in:
Same group.
Same people.
Completely different outcome.
This is what happens when you stop accepting the system…
and start redesigning it.