PARETO CAPTIVE SOLUTIONS
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