The Challenge

Stop recurring high-cost claims while offering a choice of quality carriers to employees

The formation of the RFK Community Alliance resulted from the amalgamation of two esteemed non-profit entities: the Doctor Franklin Perkins School and RFK Children’s Action Corps. This union in 2020 not only brought their organizational strengths together but also merged their health insurance claims. At the time of the merger, each entity was grappling with around a 20% surge in their respective health insurance costs. To address this, Tony Macsata, a senior benefits consultant at Brown & Brown, orchestrated the integration of the two plans into a single comprehensive scheme.

However, the consolidation of health insurance plans didn't prove sufficient to counterbalance the escalating premiums for the organization. A substantial concern was a singular significant claim from RFK amounting to approximately $900,000 annually. In addition, there were a few instances of cancer-related claims ranging from $300,000 to $500,000. When combined, these factors led to a daunting 140% loss ratio that persisted for three consecutive years without any apparent resolution.

In 2022, Macsata succeeded in reducing a renewal increase of 27.5% to a more manageable 14.5% through strategic alterations to the plan's design. Nonetheless, in 2023, RFK was confronted with yet another substantial increase of 21.5%. Derek Padon, RFK’s Senior Vice President of Human Resources, emphasized their commitment to shield employees from bearing the burden of escalating healthcare expenses. This philosophy had held firm for years, but the current circumstances seemed poised to challenge it.

Padon was also keen on expanding the array of plan options available to employees. Many employees expressed a preference for retaining either their Blue Cross Blue Shield or Harvard Pilgrim plans that were in place before the merger. However, these preferences clashed with the conventional group model they were operating under.

Padon underscored the significance of employee satisfaction as a pivotal factor. The organization operated in an industry prone to high turnover rates, and any negative occurrences within the organization exacerbated this issue. The adverse effects cascaded across various stakeholders – from residents and existing staff to the overall financial bottom line. Maintaining a positive atmosphere and employee contentment were integral not just for the workforce but for the holistic success of the organization.

The Solution

Thinking outside the box; if you have 50 or more eligible employees, this solution is for you!

Brown & Brown showed substantial savings for RFK by transferring the risk of its high utilizers to the much larger individual market. It also allowed employees to select the plans they loved and were used to, meaning they could re-enroll with BCBS or Harvard Pilgrim into plans that were similar to the ones they had previously.

RFK's imperative for a seamless implementation process demanded the presence of a steadfast and dedicated HR partner. This encompassed not only the crucial aspects of employee education, but also the intricacies of impeccably managed onboarding and the intricacies of open enrollment. In this pivotal juncture, it was the unwavering competence of Brown & Brown that rose to the occasion and delivered with unparalleled excellence. Through their meticulous efforts, RFK's workforce was equipped with the knowledge and resources necessary to navigate these transitions seamlessly. The comprehensive support provided by Brown & Brown facilitated a truly streamlined onboarding experience, ensuring that new employees integrated seamlessly into the organization. Additionally, the deft management of the open enrollment process by Brown & Brown engendered a sense of assurance and clarity among employees, empowering them to make informed decisions about their benefits. In this dynamic collaboration, Brown & Brown emerged as not just a service provider, but a strategic partner, propelling RFK toward operational effectiveness and employee satisfaction.

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