1. Join other like-minded employers for a day of education and innovation
Join other like-minded employers for a day of education and innovation! Employers’ Health Coalition will introduce strategies and cost saving programs that will cure your health insurance BLUES!

2. Advocating Value and Innovation in Healthcare by way of these Key Actions:
Representing Employers in Negotiations for the Highest Quality Healthcare at the Lowest Possible Cost
Promoting Transparency in Healthcare Costs and Quality
Providing Educational Opportunities Across all Levels of Coalition Membership
Providing a Vehicle for Employers to Exchange Ideas & Information about Healthcare
The Mission of Employers' Health Coalition is to arrange and promote programs and activities designed to benefit employer/employee provided health care; to promote access to and information about quality healthcare thereby enhancing the general health of the community. 

3. What’s frustrating to the “C Suite” about their health insurance program?
No Control
Lack of Transparency
Unjustified Rate Increases
Little (or no)
Claims Info
Stuck in a
Bad Pool
You’re too small to be self-funded
Challenges in Implementing Wellness
Forced to react -
Not Strategic

4. Health Benefits Cooperative “Swimming in a HEALTHIER pool!”

5. What is a group cooperative?
Captive Insurance Company
Company
“…a self-insured health fund with individual stop-loss contracts and funded to the maximum liability that gives members the ability to control their claim costs, learn and apply best practice strategies, flexible payment options AND advantage a “healthier pool!”
Plus, when you become a member you also become a stakeholder with like-minded business owners partnering together to spread the risk of insurance and reap the rewards of a well-managed fund.”

6. COOPERATIVE STRUCTURE (member groups total 2,500 – 5,000 employee lives)
Paid Monthly to Stop Loss Carrier
Stop Loss $300,000+
Member “Shared” Cooperative Layer
Shock Absorber $25, $300,000 A
25k B C
35k D
40k E
50k F
75k G H I J
$300,000+
Paid Into Coop Shared Layer from Stop Loss Premium
$25,000+ $300,000
Claims Paid by Employer “UP TO” the SIR
Employer “owns” and greatest savings opportunity
$25,000+
Individual Self Insured Retention
Layer (SIR)

7. Sample Company vs. Fully Insured $1M Annual Premium
$750,000 Total Claims (not a “great” claims year)
$500,000 claims less than $25,000 (SIR claims)
$250,000 claims paid from shared layer
Specific and agg stop loss, admin, broker fees, risk mgmt., coop mgmt. fee
$200,000 Expenses
Cooperative Portion
$200,000 Cooperative Loss Funds
$0 - $25,000/claimant
$500,000 Total Claims
$100,000 Total Savings
$900,000
Total Pay In
Carrier renewal estimate =
13% - 18%
Cooperative
renewal estimate =
7% - 12%

8. SAMPLE CAPTIVE A B C D E F G H I J 10 Members $2,000,000 Loss Funds
80% LF Loss Ratio = $400,000 Remaining
10% pro-rata portion = $40,000 -

9. SAMPLE COMPANY $140,000 Total Savings $750,000 Total Claims
$500,000 claims less than $25,000
$250,000 captive layer
Specific and agg stop loss, admin, broker fees, risk mgmt., coop mgmt. fee
$200,000 Expenses
Captive Portion
$200,000 Captive Loss Funds
$0-$25,000/claimant
$500,000 Total Claims
$100,000 Total Savings
$900,000
Total Pay In
Captive Layer Profits
$40,000 Distribution
$140,000 Total Savings
$860,000 Net Cost

10. Health Benefits Cooperative “Swim in a Healthier Pool!”
Risk Management and Wellness Program Coordination
Population health and trend forecasting data analytics
Multiple plan designs and emphasis on PCP benefits
ECRx pharmacy BENEFIT program
Patient portal with health education tools
Value Based Benefits and Risk Saving Programs
High value provider networks*
Patient concierge services
$0 co-pay telemedicine
Free diabetic testing supplies for patients and health coaching
Bundled surgery payments for certain procedures
Interventional orthopedics
Well-being, employee engagement and employee assistance programs
* Where networks are available

11. Health Benefits Cooperative
Quarterly Calls/Annual Business Meeting
Members “Own” the Solutions
Member Commitment to Risk Control
Focus on retention as a growth strategy
Shared Best Practices – Peer to Peer
Common Bond of Employer Members

13. “Delivering value for EACH member!”