CGI News

Pareto Captive Solution

Case Studies



Client: ME Assisted Living Facility

Enrolled Employees: 300

Current State: 

  • Fully Insured struggling to contain rising healthcare costs
  • Several employees with high-cost drugs negatively impacted group’s claims experience
  • Limited options in plan designs and network to alleviate fully insured increases

Out of options with their broker

CGI’s Solution

CGI proposed the Pareto Captive with a Pharmacy Benefit Management (PBM) carveout solution:

  • Several employees qualified to get their medications at NO COST through the PBM grant program
  • Employer saved $235K in the first 3 months as a result of drugs being covered by grant program
  • Employer created specific plan design to meet the needs of current and future employees
  • Positive employee feedback was immediate; group now has competitive benefits package