Real Employer Outcomes

Strategic Benefits Advisory conducts a full risk and plan structure analysis to determine whether alternative funding strategies could provide greater cost control and transparency.

Sample Client Outcomes:

Pacific Northwest municipality

— captive transition

Manufacturing company

— level funded migration

Technology firm

— self-funded optimization

Real Employers. Real Results.

$633,000

Savings

Largest annual savings identified through risk assessment

50%+

Reduction

In fixed healthcare costs for some employers

ZERO

Benefit Reductions

in every case study presented among these studies

Saving $633,000 Without Changing Benefits

Employer: Municipal Government
Employees Covered: 126

The Situation

The City faced a 7.28% renewal increase on its fully insured health plan despite stable claims.

Renewal premium:

$2,965,595 annually

The Strategy

Instead of shopping carriers, the city completed a health plan risk assessment.

The analysis showed the group qualified for a self-funded structure with stop-loss protection, allowing the city to fund actual claims instead of paying carrier margin.

Importantly:

• Same benefit design
• Same provider network
• Same employee experience

The Numbers

Plan Structure Annual Cost

Renewal Premium $2,965,595

Expected Self-Funded Cost $2,332,496

Projected Savings $633,099

Risk Protection

The strategy included built-in safeguards:

Individual Stop Loss:
$100,000 claim cap per member

Maximum Employer Cost:
$2,697,947

Even in a worst-case claims year, the cost remains lower than the renewal premium.

The Outcome

✔ Reduced projected healthcare costs by $633K annually
✔ Maintained identical employee benefits
✔ Capped financial exposure through stop-loss protection
✔ Potential to retain $370K in surplus reserves

Key Takeaway

The city didn’t change carriers.

They changed how the plan was funded.

That shift turned a renewal-driven insurance purchase into a long-term healthcare strategy.

Cutting Fixed Healthcare Costs in Half

Industry: Apparel / Retail
Employees Covered: 40

The Situation

Company was paying $661,116 annually for a traditional fully insured health plan and experiencing low participation.

Like many growing companies, the business had no visibility into claims drivers and no control over future premium increases.

The Strategy

A risk assessment revealed the group qualified for a captive self-funded health plan structure.

This allowed the company to:

• reduce fixed insurance premiums
• protect against catastrophic claims
• retain unused claim funds

The Numbers

Plan Structure Annual Cost

Traditional Fully Insured $661,116

Expected Captive Cost $307,181

Maximum Cost Exposure $577,832

Plan Structure

The new model separates healthcare spending into fixed and variable costs.

Fixed Costs

Administrative fees + stop loss protection: $244,578 annually

Projected Claims Fund

Expected claims: $328,254

If claims come in lower than expected, the employer retains the difference.

Risk Protection

Individual Stop Loss: $50,000 claim cap per member.

Large claims beyond that threshold are covered by reinsurance.

The Outcome

✔ Reduced fixed healthcare costs significantly
✔ Protected against catastrophic claims
✔ Improved transparency into healthcare spending
✔ Opportunity to retain unused claim dollars

Key Takeaway

Instead of buying insurance every year, company moved to a risk-managed funding model that stabilizes healthcare costs long term.

Stabilizing Healthcare Costs for a 75-Employee Workforce

Industry: Manufacturing
Employees Covered: 75

The Challenge

The company faced double-digit renewal increases year after year on a traditional fully insured health plan.

Annual premiums had climbed to $1.8M annually despite stable claims utilization.

The Strategy

A risk assessment revealed the employer qualified for a level-funded health plan structure.

This allowed the company to:

✔ stabilize monthly healthcare spending
✔ reduce carrier risk margin
✔ gain visibility into claims drivers

Financial Impact

Fully Insured Renewal $1,800,000

Level-Funded Expected Cost $1,550,000

Projected Savings: $250,000 annually

The Outcome

✔ Lower annual healthcare spend
✔ More predictable monthly costs
✔ Access to claims data and plan performance insights

Key Takeaway

Many employers assume self-funded strategies are only for large corporations.

In reality, many mid-sized employers qualify for hybrid funding models that offer stability and savings.

Reducing Renewal Volatility Through Captive Participation

Industry: Construction
Employees Covered: 60

The Challenge

The company experienced large swings in premium increases, making it difficult to forecast healthcare costs.

Renewals ranged between 8% and 18% annually.

The Strategy

A risk assessment determined the employer qualified for a healthcare captive structure.

This allowed the company to:

✔ pool risk with other qualified employers
✔ stabilize renewal volatility
✔ participate in long-term cost management strategies

Financial Impact

Fully Insured Renewal $1,250,000

Level-Funded Expected Cost $1,050,000

Projected Savings: $200,000 annually

The Outcome

✔ Reduced renewal volatility
✔ Greater transparency into plan performance
✔ Potential dividend distributions when claims perform well

Key Takeaway
Captive structures allow qualified employers to participate in risk structures typically reserved for larger organizations.

Transitioning From Renewal Shopping to Long-Term Strategy

Industry: Professional Services
Employees Covered: 45

The Challenge

The firm had changed insurance carriers three times in five years to control costs.

Each switch created:

• employee disruption
• administrative complexity
• limited long-term savings

The Strategy

A risk assessment revealed the firm qualified for a self-funded health plan with stop-loss protection.

The plan maintained:

✔ the same provider network
✔ identical benefit structure

Financial Impact

Fully Insured Renewal $720,000

Level-Funded Expected Cost $580,000

Projected Savings: $140,000 annually

The Outcome

✔ Reduced healthcare spending
✔ Greater cost transparency
✔ Long-term funding strategy instead of annual carrier changes

Key Takeaway

Many employers don’t need a new carrier.

They need a different funding strategy.

Interested in Exploring a Similar Strategy?

If your organization is experiencing rising healthcare costs or unpredictable renewals, Strategic Benefits Advisory can help evaluate alternative funding models.

Request a Risk Assessment

Our Approach

Why continue paying fully insured premiums designed to protect carrier margins…

Strategic Benefits Advisory works with employers to evaluate healthcare funding strategies beyond traditional fully insured models.

Our process includes:

Population risk analysis
Strategy design
Market placement
Ongoing plan optimization

Every employer population is different. Our approach ensures the funding strategy aligns with the actual risk profile of the organization.

Request Your Risk Assessment

If your organization is experiencing rising healthcare costs or unpredictable renewals, Strategic Benefits Advisory can help evaluate alternative funding models.

Request a Risk Assessment

Real Employer Outcomes

Real Employers. Real Results.

Saving $633,000 Without Changing Benefits

The Situation

The Strategy

The Numbers

Risk Protection

The Outcome​

Key Takeaway​

Interested in Exploring a Similar Strategy?

Our Approach

Why continue paying fully insured premiums designed to protect carrier margins…

Request Your Risk Assessment

The Outcome

Key Takeaway