The Open Solution™ Success Stories

health insurance success-stories

NICU Baby Car Dialysis $400K Surplus Furniture Savings Calculator

$1,349,949.49 Million Claim Was Re-priced at $187,277.33

NICU baby in UtahThe Open Solution™ saved one company from paying a $1.3 million dollar claim, using an auditing and re-pricing method. Their total payout was only $187,277.33, an 87% savings off of billed!

Offers High Quality Coverage and Is Able To Retain Employees

Small Manufacturing Company – Utah company with 80 employees was on the verge of abandoning it’s fully insured group health plan due to repeated annual increases. The adoption of The Open Solution™ has allowed the company to offer high quality health insurance coverage and retain employees.

Additional 15% Savings

Retirement Community – Care center with multiple locations insuring 350 employees already using a partially self-funded arrangement. By applying the The Open Solution™ model the company has enjoyed an additional 15% savings.

Experienced a 60% Savings On Health Insurance Claims

Automotive Business in North Carolina – Has not seen an increase in premiums since beginning on the plan. Hospital and health facilities have accepted dramatically reduced payments for services based on The Open Solution’s™ auditing and re-pricing formula. They have experienced a 60% savings on claims.

40% Savings The First Year

Home Furnishings Company – Experienced a 40% savings the first year after implementing new plan ($2.5M reduction on previous $6M expense). With 180 stores in five states, the company’s 1,800 employees are free of PPO network restrictions. Eliminating the burden of assembling a multi-state network has greatly simplified the health insurance plan and reduced costs. The Open Solution™ savings example: Reduced $140K hospital bill to $12K – a savings of more than 90%.

Set Aside $1,090,000 In Their Medical Account

Multi-State Consumer Finance Company – The plan was adopted over the objection of the insurance broker who was skeptical of The Open Solution’s™ approach to claims pricing. Since then the company has been able to set aside more than $1,090,000 in their medical account during the first two years on the plan, which would not have been possible previously. The broker is now a believer!

Reduced dialysis treatment from $10,000 to $975

Texas Service Company – Dropped Blue Cross PPO and reduced premiums by 68%. Additional savings allowed the company to provide free vision, dental and life insurance and establish a free medical clinic on-site for employees and their dependents.

Premium Vacation to Temporarily Redirect Cash Flow

Wyoming Oilfield Services Company – A startup company was able to plan a “premium vacation” in order to temporarily redirect its cash flow to finance additional equipment purchases.

Able to Increase Credit Rating and Reduce Borrowing Costs

Midwest Municipality – Indiana city was able to increase its credit rating and reduce its borrowing costs after credit rating company calculated the substantial savings expected by adopting The Open Solution™.

Cost Savings Exceed 25% Annually

Utah Call Center – Insuring nearly 100 employees the company switched to The Open Solution™ from a fully insured plan. Medical cost savings are exceeding 25%.

Successfully Reduced Dialysis Treatment Costs By 80%

Large Western Tribe – The tribe has many members who suffer from severe diabetes and require regular dialysis. The Open Solution™ Plan has successfully reduced dialysis treatments costs by 80%, with savings totaling millions of dollars.

Significant Savings Over Previous Insurance Model

City In Texas – Public entity with 540 employees and retirees (some union) has been using The Open Solution™ model for four years. Only one legal action against plan by hospital which was successfully defended. They have experienced significant savings over the previous old style way of insuring.

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The Open Solution Founder Phyllis Merrill

 

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We're neighbors you can talk to...
Where else can you get a direct line to a claims adjudicator, plan manager or even the President of the company? Only at MBA Benefit Administrators. We’re the big third party administrator for health plans with personal service that you can only wish others would provide. Like talking to a friend over a fence, we have that neighborly feel…but we provide world class advantages.
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…and we prove real solutions do exist for escalating healthcare costs.
We’ve received national kudos for our multiple, proven strategies which reduce claims and plan costs without harmful benefit reductions for our clients’ employees. Proof of MBA’s effectiveness in this is in the numbers. Our clients see:

  • An immediate average reduction of up to 25% in maximum health plan costs the first year,
  • Flat renewals after that, and because of this and our commitment to impeccable service…
  • Our clients remain with us an average of 12 years…an unheard of accomplishment in the health insurance industry.
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With “outside the box” flexibility in health plan administration…
Since 1987 MBA Benefit Administrators has successfully served large and small employers, public entities, associations, tribal nations, school districts, non-profit organizations and insurers. We have the capability to administer anything from single-plan 25-life groups to complex employee organizations with multiple medical, dental and vision benefits or employees in multiple states. We also provide a wide array of ancillary services such as COBRA and HIPAA administration and HSAs. When you discover:

  • The depth of our experience
  • The flexibility we offer in benefit design
  • Our commitment to technology to make your life easier
  • Our can-do attitude toward service

 

…we’re confident you too will see why MBA is a national leader in third party administrative healthcare benefits.

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…and state-of-the-art technology for painless administration and integration of services, we make your life easier.
No one thinks about making your life easier and more efficient than MBA Benefit Administrators. Our technological investments are totally integrated across services so that employees and employers – with HIPAA-compliant and appropriate need-to-know safeguards – can view at a glance their standing for benefits, claims, plan reporting and other services. These advancements provide:

A Comprehensive On-Line Enrollment Wizard: Employee self-enrollment or HR department enrollment methods, including ancillary program enrollments and billings.

HR On-line Capabilities: View, adjust and approve on-line employee eligibilities; check claims status, print reports and plan documents all from one place.

Multiple Employee Access Channels: Employees can view on-line their claims status, eligibility and account balances of reimbursement plans such as HRA, HSA, Flex and Executive Reimbursement plans. In addition, we offer all employees our MBA App, where they can:

  • Carry a virtual ID card,
  • Check on the status of a claim,
  • Submit secure documentation to MBA,
  • Contact our support team,
  • …and more!

On-line Document Management: In one place view specific documents such as:

  • Plan Documents
  • Temporary ID Cards, and
  • Employee Communications and Forms

HSA Services Integration: MBA seamlessly integrates HSA plans with HealthEquity Services. Claims information is electronically transferred from MBA’s claims system to HealthEquity employee accounts. There is no need for paper claim filing or second-guessing the eligibility of expenses. Even employee eligibility is updated through MBA data feeds.

HRA Reimbursement Plans: MBA’s administration processes allow clients and their participants to rely on accurate and timely processing of reimbursements. Eligibility, billing and remittance of claims, integrated scanning and storage allow for real-time remote access.

Section 125 Flexible Spending Plans: MBA Benefit Administrators coordinates with employers to offer Section 125 Flexible Spending administration and help employees save money on medical expenses. Providing this benefit for your employees is like getting a 30% discount on Medical Premiums, uncovered medical expenses and dependent care.

COBRA Administration: MBA Benefit Administrators can handle all of your COBRA requirements. We will mail and track notifications, coordinate COBRA payments, receipts and reporting and ensure claims match “paid through” dates, plus give you on-line access to all activities.

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At MBA employers are cared for too…
MBA goes the extra mile to ensure that as an employer your health plan does not complicate your life. We give you things like:

  • Business intelligence for advanced reporting and critical analysis of your plan’s performance, costs, payouts, claims analysis and large claims submitted for insurance.
  • Billing and Funding services integrated with enrollment, customized to your specifications and handled electronically.
  • Account balancing systems produce cost accounting reports and perform bank reconciliation activities, available for review at any time.
  • And the ability to review multiple reports regarding your plan; check registers, active employee reports, YTD recaps, claims reviews and lots more.
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...with powerful health care and claims management systems to save them money.
We believe your investment in a health plan should be treated like any other aspect of your business, with upfront knowledge of the costs and all attempts to weed out waste. MBA saves employers more than nickels and dimes with many methods of management, including:

Metrics Based Pricing: Why rejoice over a 30% discount on a claim that is 1000% too high? Metrics Based Pricing reduces claims to a “cost of service + reasonable margin” level by auditing claims for unfair markups and inaccurate or fraudulent billing. This results in an average $1500 per employee savings – AND WE DO IT WITHOUT RESTRICTIVE NETWORKS!

Medical Management Services: Proven to reduce hospital admissions and the average length of stay.

HealthSteps™: Wellness plans and initiatives that do make a difference in the overall health of your workforce and drive down health claims.

Prescription Benefit Management: With an average reduction of 9.4%.

Internet Prescription Bidding: Allowing employees to save up to 87%.

Actuarial Projecting: The projection of benefit costs and savings is one of our underwriting core competencies. Go ahead – suggest benefit changes, add or drop a plan component, change eligibility: MBA will accurately determine the financial impact on the plan and offer suggestions to tweak the benefits to suit your objectives. We offer the facts then you call the shots.

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1. It’s an “easy in”.
Almost every larger employer (50+ employees) annually shops their company’s health insurance. Rapidly rising rates and diminishing benefits have traditionally caused them to shop this aspect of company insurances more than any other.

With very little work this easily opens a lot of doors you wouldn’t otherwise get through. Furthermore, local employers like local expertise. They welcome the neighborhood broker who can answer service questions or help with the employee enrollment process. All you have to do is be ready with competitive products at the appropriate time.

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2. Group health opens the door to other profitable sales.
There are a lot of needs that are begging for solutions within the corporate world, whether that world employs 50 or 5,000. CEOs and business owners want to retain key employees or prepare themselves for the future. Employees need guidance during life changes, such as an impending retirement, the buying of a new house or the birth of a child.

If you wander the halls of your group clients under the guise of service, you’ll be surprised what you uncover and how much more you can sell – just because you’re accessible.

With very little work this easily opens a lot of doors you wouldn’t otherwise get through. Furthermore, local employers like local expertise. They welcome the neighborhood broker who can answer service questions or help with the employee enrollment process. All you have to do is present your own insurance lines and solutions – the same products you currently sell – when the need arises…and it will!

• Key Person Insurance
• Buy/Sell Agreements
• Deferred Compensation
• Disability
• Estate Planning
• Retirement Plans
• P&C Products – Both Business and Personal

…the list could go on and on. MBA doesn’t provide these products, but with the group health business already captured you’ll be in a position to favorably present your own policies and services.

Each easy cross-sell has the potential to be very profitable as now you, the group health broker, are a trusted resource. Make one sale and it won’t be long before everyone wants to talk to you just because you are the tacit face of insurance within a group client’s company.

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3. The larger group health market offers long term financial stability.
It is a proven fact that the more products you have in place within a group the less likely it is that some other broker will be stealing your business. With a competitive group health plan, a passion for service and additional products in place, employers think twice about switching brokers. MBA, for example, has an average client retention rate of 12 years.

Group health is rarely a stand-alone product. With today’s tax codes a group health plan almost always immediately calls for HSAs, COBRA administration and the like. In addition you’ll be finding a lot of ancillary sales.

That’s a good, stable building block for a broker’s income. Year after year the same commission is paid the broker and year after year the deep well for cross-sells keeps on giving.

In the meantime, adding new groups just keeps the broker’s income growing to the upside.

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4. Commissions are recurring and high, perhaps higher than any other product line.
To put things into perspective:

• What’s the average commission on a home owner’s or auto policy?
• How often do you dig up on your own a million dollar life policy or high 6-figure annuity?
• How easy is it to scrape up new business?

Contrast that with the group health broker. MBA, for example, pays brokers handsomely (on average $25 per employee per month) for every group they sign up. On top of this are your multiple cross-sells for several product lines. With a good base group health income and constant cross-sells, a commission from one group can rack up quickly.

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