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CASE STUDY 1

National Virtual Care Program | 900 Lives

A franchisor launched a telemedicine program for its franchisees. The program faltered as monthly billing and eligibility lagged. The service also was plagued by long hold and call back times. Memberly (FRANplan’s parent company) reorganized the program instituting billing and eligibility management together with branded member cards and brochures.

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CASE STUDY 2

Self-funded MEC Plan | 5 Employees

A franchisee was seeking an affordable option to health insurance. He was considering a MEC plan but the rates were also high – as much as $270 for a family MEC plan. With a small group of 5 employees, the group was below the minimum required for a Self-funded MEC. Nonetheless, Memberly secured a Self-funded MEC plan at $50 per employee or family saving the franchisee approximately $1,000 per month compared to a fully insured MEC.

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CASE STUDY 3

Self-funded Health Plan | 15 Employees

A manufacturer in the New England area was facing another 15% increase on their Tufts Pilgrim health plan. Memberly (FRANplans parent company) secured a Self-funded plan. In the first year the manufacturer received a refund of unused claims fund in the amount of $55,000. In the second year, they received a refund of unused claims in the amount of $50,000 bringing their 2 year savings to $105,000 or a net reduction in health plan cost of 30%.

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CASE STUDY 4

Self-funded Health Plan I 300 Employees

A staffing agency with a Self-funded health plan was facing a 38% renewal increase due to higher stop loss premium and agg factors. Memberly (FRANplans parent company) re-marketed the stop loss and reduced the administrative and network fees from $127 to $46 pepm. The combined savings reduced the increase to 8%. The plan remained contracted with a BUCA (Blue Cross, United Healthcare, Cigna, Aetna) network – Reference Based Pricing (RBP) was not used.

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CASE STUDY 1

National Virtual Care Program | 900 Lives

CASE STUDY 2

Self-funded MEC Plan | 5 Employees

CASE STUDY 3

Self-funded Health Plan | 15 Employees

CASE STUDY 4

Self-funded Health Plan I 300 Employees

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