Client

A manufacturing employer in the private sector with a national employee base of 340 and about 500 total lives on the benefit plan.

Challenge

The client decided to switch brokers during the fourth quarter, and chose Kinetiq Health, knowing it could help them deal with rising health care costs. However, with open enrollment season rapidly approaching, Kinetiq Health had a short timeline to help the client receive a competitive renewal.

The client’s insurance provider would not release the detailed claims data and clinical case notes needed to help Kinetiq Health negotiate the renewal. Therefore, competing stop-loss carriers were comfortable with the risk profile only if able to “laser” one claimant at $1 million.

Solution

Using their clinical knowledge and expertise, the Kinetiq Health team secured a medical release form and connected directly with doctors at a hospital in New York to access case notes on the plan member’s prognosis. While the prognosis was a rare cancer claim, the information Kinetiq Health received proved to underwriters the $1 million laser was a much larger amount than was necessary.

Results

Upon delivering the information to the competing stop-loss carriers, Kinetiq Health was able to negotiate a much lower laser liability of $400,000. That resulted in potential savings of $600,000 for the client.