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Case Study (Retiree Health Benefits) - #3

Forbes Top 50 Employer Transitions 4,200 Retirees to AmWINS Retiree Benefits Program

BUSINESS CHALLENGE

An oil industry giant was saddled with administrative headaches as a result of sponsoring multiple self-funded retiree benefit plans. The accumulation of plans, due to acquisitions, union negotiations and grandfathered status, combined with the ERISA responsibilities, audits, actuarial work, FASB calculations and  resources. The employer worked with their outside consulting firm to explore a Medicare Exchange but opted against this option because they felt it would violate a commitment of paternalism to retirees and would be detrimental to a group that had a high use of prescription drugs. The company also felt that the added layer of a Health Reimbursement Account (HRA) would create additional confusion and complexity around a transition.

SOLUTION

The company determined that a selection of three fully-insured group plans, including full coverage through the prescription drug donut hole, would help the organization achieve its goals. They also felt that retirees would enjoy the ability to choose from these plans to find the appropriate price point for their specific budget and health care needs, yet providing benefit parity to the current program.

RESULTS

The outcome was that this company created its own Private Medicare Exchange: There were multiple plan options, outsourced administration and a fixed employer cost, but without the confusion that accompanies a program shift, pushback from invested parties, or the added layer of HRAs. Perhaps most importantly, the transition went smoothly for retirees, which provided a necessary benefit to such a high profile organization.

OBJECTIVE BENEFITS ACHIEVED
Outsource administration AmWINS handled all billing, eligibility and customer service.
Simplified program offering A choice of three plans to fit all retiree budgets and health care needs; comparable to current coverage
Match of current prescription drug plan (including no donut hole) High prescription drug utilizers would not be penalized by donut hole limitations found in Medicare Exchanges
Ease transition for retirees Retirees were invited to education meetings and received branded communications including a website
Maintain retiree goodwill Retirees felt the company was helping them. This avoided anxiety, satisfied unions and related parties, and did not result in a public backlash

 

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