3 innovative employers providing better benefits in the Sunshine State

Just about anywhere in the U.S., healthcare costs too much. It’s a huge drain on the American economy — and my home state of Florida is no exception. But over the past few years, some of my local employer clients have been courageously swimming upstream in different directions, in their shared pursuit of building better benefit plans for less money. 

Here are some examples of how they’re changing the game and improving benefits for their employees in the Sunshine State: 

Guardian Fleet Services, West Palm Beach
Controller Mark Beckel and CFO Mike Welch were quick to embrace strategies to control the frequency and severity of claims at the Southeast’s largest ESOP-driven transportation company. Even though they wanted to implement a plan of action quickly, their fully-insured carrier wouldn’t share claims data, and told them they would take the renewal off the table if they kept pushing for the information. They played along, renewed for one month and then found a carrier that would agree to share data with them.

Read more: What role do advisers play in finding solutions to rising healthcare costs?

Fast forward 12 months: With their data in hand, they knew they were ready to move to a partially self-funded plan to provide higher quality benefits for less money. A new pharmacy benefits strategy ensured that health plan medications were sourced at the best possible value. The company also set up systems to pay providers and hospitals fairly — all the while cutting employee deductibles in half and holding their costs in check. 

These steps allowed them to meet their fiduciary responsibilities of managing a plan in the best interest of employees. The new plan design’s flexibility reduced a $950,000 retail hospital charge down to a Medicare rate. In addition, one health plan member was able to move from a “nonprofit” teaching hospital for care to one with a higher quality score and avoid paying 30 times the Medicare rate. 

Friendly Kia, New Port Richey
Founder John Gilliss and controller Jamie Corey implemented several strategies for one of the highest volume Kia dealerships, including pharmacy cost-containment and quick-pay options for hospitals. High deductibles have been replaced by zero deductibles, and employees have faced no cost increases for three years. Moreover, direct contracting with a local hospital network enables their employees to basically receive free care for most services, other than a modest copay in place for ER and imaging to encourage smart consumerism. 

It all started about a year ago, when the west central Florida region of AdventHealth, under Michael Lemell’s leadership, began working with advisers to meet and discuss direct-contracting arrangements. The result has been a better member experience at fair pricing for the employers they serve. It also has been beneficial to the hospital, which no longer has a member-collection concern because the employer is the one that is paying the invoices. 

Read more: Advisers can help HR teams and the C-suite speak the same language

We are finding members who previously deferred care because of prior high-deductible costs finally getting the care they need. This is all very rewarding work for advisers. The movement to keep healthcare local and affordable is working.

Generx Generators, Oldsmar
Dia Preston, CFO of this electrical installation contractor and large distributor of Generac generators, was an early adopter of direct primary care (DPC) memberships when they first entered the Florida market. They share in the membership cost with health plan members, and program adoption has increased every year.

They initially implemented DPC alongside a fully-insured plan. Today, they are on a funding platform where they will receive greater rewards when employees use their relationship with their DPC provider rather than running to the urgent care or emergency room because they are evacuating claims from the insurance plan.

A movement to direct contracting with primary care doctors has been growing across Florida in large part because Eric Crall, M.D., has been able to get many doctors to work together to benefit Florida employers. We have seen fully insured, level-funded and partially self-funded employers setting up direct relationships with primary care doctors. DPC doctors spend serious time with employees. A typical first visit is about 60 minutes. They have the luxury of time to treat the whole patient under this increasingly popular proactive healthcare model, and are available 24/7 virtually or with same to next-day appointments. 

Read more: To become highly effective producers, advisers should put service before the sale

The Florida market is short on doctors —  it can take weeks to schedule a visit. This direct relationship is a big win for both employees and employers in terms of getting everyone back to work quickly. It also allows providers to meet patients at their time of need to receive appropriate care. 

The doctors are happy because they are able to have smaller practices and treat the whole person. This is critically important today, since mental health is a major concern. If doctors are able to spend enough time to really learn how their patients are doing, then diseases that stem from anxiety and depression can be treated quickly with a better outcome at a reasonable price.