Find ways to save money on your company's health insurance
Type in how much your company pays for health insurance each year.
Check the boxes next to strategies you want to explore. Click "Learn More" for details.
Green = No employee impact. Blue = Low impact. Orange = Medium. Red = High.
Use the slider to set your implementation style (Conservative to Aggressive).
Review projected savings. Note that results are capped at 50% max.
A Health Maintenance Organization (HMO) is a type of health plan where you pick a primary care doctor who coordinates all your healthcare.
Your insurance company negotiates lower prices with a specific network of doctors and hospitals. You pay less, but you must use doctors in the network and get referrals from your primary doctor to see specialists.
Impact is LOW because employees need to choose a primary care doctor and may need to change doctors if theirs isn't in the network. Some coordination is required for specialist visits.
HMOs negotiate lower rates with doctors and hospitals because they promise to send them more patients. By narrowing the network and requiring referrals, they reduce unnecessary specialist visits and duplicate testing. The coordinated care model means your primary doctor manages everything, preventing wasteful tests. This saves about 4% compared to broad PPO networks.
A Preferred Provider Organization (PPO) plan where employees pay more out-of-pocket before insurance starts covering costs.
Employees can see any doctor they want, but the deductible (the amount they pay before insurance kicks in) is higher than before. This shifts some costs to employees who use more healthcare.
Impact is LOW because employees keep their doctors and don't need referrals. The change is mainly financial - they pay more upfront if they go to the doctor, but their flexibility stays the same.
Higher deductibles reduce premiums by 8-12% since the insurance company has less immediate risk. Employees with "skin in the game" also use 5-8% less healthcare because they're more thoughtful about what they truly need. Combined, this creates 6% savings while maintaining full network access and doctor choice.
Virtual doctor visits via video call or phone instead of going to a physical office.
Employees download an app or use a website to talk to a doctor from their phone or computer. Good for simple things like colds, rashes, or prescription refills. Often free or low-cost for employees.
Impact is NONE because this is a NEW option added - employees don't lose anything. Their regular doctors are still available. This just gives them a faster, easier choice for simple medical issues.
Telehealth visits cost $40-60 compared to $150-200 for in-person urgent care or $500-800 for emergency room visits for simple issues. When 15-20% of employees use telehealth instead of urgent care or ER for minor issues, you save about 2%. Plus, employees miss less work time since they can do visits during lunch breaks.
Programs that help employees stay healthy through free health screenings, gym discounts, or wellness challenges.
Company offers things like annual health check-ups, flu shots, fitness challenges, or rewards for healthy behaviors (like getting 10,000 steps per day). Participation is usually voluntary.
Impact is NONE because these programs are optional - employees choose whether to participate. Nothing changes about their regular healthcare, this just adds helpful extras that can prevent expensive health problems later.
Preventive care catches problems early - finding high blood pressure now costs $50, but treating a stroke later costs $40,000. Flu shots reduce sick days and spread of illness. When 30-40% of employees participate actively, wellness programs prevent expensive health events and reduce absenteeism, creating 3% savings through avoided costs.
A Health Savings Account (HSA) is like a special bank account where you and your employer put in money tax-free to pay for healthcare. It comes with a high-deductible health plan.
Employees get a lower monthly premium (what the company pays) but a higher deductible (what employees pay first). The company often contributes money to the HSA to help cover the deductible. Money in the HSA rolls over year to year and is tax-free.
Impact is LOW because there's some learning required - employees need to understand how to use the HSA and plan for the higher deductible. However, the tax savings and employer contribution usually make up for it.
Three sources of savings: (1) High-deductible plans have 10-15% lower premiums since employees pay more upfront, (2) When employees have "skin in the game" with the deductible, they shop for better prices and avoid unnecessary care, reducing utilization by 8-12%, and (3) HSA contributions are tax-free, saving 20-30% on federal and state taxes. Combined, these create 12% average savings.
A Health Reimbursement Arrangement (HRA) is an employer-funded account that reimburses employees for healthcare expenses.
Company sets aside money for each employee. When employees have medical expenses, they submit receipts and get reimbursed from their HRA account. The company controls unused funds.
Impact is LOW because employees need to save receipts and submit them for reimbursement, which takes a little extra work. But it's their regular healthcare with financial help from the company.
HRAs are typically paired with plans that have higher deductibles but lower premiums. The employer saves 8-12% on premiums, then funds HRAs with a portion of that savings (usually 50-70%). Since not all employees use their full HRA amount, the company saves the difference. Plus, unused HRA funds stay with the company, creating 8% net savings.
A Flexible Spending Account (FSA) lets employees set aside money from their paycheck (before taxes) to pay for healthcare expenses.
Employees decide how much money to contribute each year. That amount is divided across their paychecks and taken out before taxes. They use an FSA debit card or submit receipts for reimbursement.
Impact is NONE because FSAs are optional - only employees who want one enroll. It actually saves employees money on taxes while helping them plan for expected healthcare costs.
FSAs reduce payroll taxes for both employers and employees since contributions come out pre-tax. When 40-50% of employees participate and contribute an average of $2,000 annually, the company saves about 7.65% in payroll taxes on those contributions. Additionally, employees who forfeit unused FSA balances ("use it or lose it") create savings, resulting in about 2% overall savings.
Software tools added to your existing health plan that help employees compare prices and quality ratings before choosing where to get care.
Employees use an app or website to search for services (like an MRI or physical therapy) and see costs at different providers along with quality ratings. Think of it like comparing hotel prices on a travel website, but for healthcare.
Impact is NONE because this is an optional tool added to existing benefits. Employees can use it or not - nothing about their insurance changes. The main challenge is that typically only 5-15% of employees actually use these tools, which limits how much money gets saved.
When employees use the tool to compare prices, they can choose lower-cost providers for things like MRI scans, lab work, and physical therapy. For example, an MRI might cost $400 at one place and $1,200 at another. When employees pick the $400 option, your company saves $800. The problem is most employees don't use the tool, so savings are modest (around 3%).
A one-time check to make sure everyone covered on your health plan is actually eligible to be there.
A third-party company reviews all dependents (spouses, children) on the plan and asks employees to prove they're eligible. Common ineligible dependents include divorced ex-spouses or children over age 26.
Impact is NONE for employees who have eligible dependents. Those with ineligible dependents will need to remove them, but they shouldn't have been covered in the first place. Typically finds 5-8% ineligible dependents.
Most audits find 5-8% of covered dependents are ineligible (divorced spouses, children over 26, ex-stepchildren). Removing these dependents creates immediate savings since you're no longer paying premiums for them. At $12,000 per dependent annually, removing 5-8% saves 2-3% of total costs. This is a one-time audit, but ongoing monitoring maintains the savings.
Instead of paying an insurance company a premium that never comes back, you pay a predictable monthly amount and might get money back if your employees don't use much healthcare.
You pay a fixed amount each month to cover expected claims, administration, and stop-loss insurance (protection against huge claims). At the end of the year, if claims were lower than expected, you get a refund.
Impact is NONE because employees see absolutely no change. Same ID cards, same doctors, same coverage. This is purely a behind-the-scenes financial change that employees never notice.
Traditional insurance includes 12-18% built-in profit margin and premium taxes. Level funding eliminates most of these costs - you only pay for actual claims plus a small admin fee and stop-loss premium. If your employees are healthy, you get a refund at year-end (typically 20-40% of employers receive refunds averaging $50,000-150,000). This creates 7% average savings while maintaining predictable monthly costs.
Your company pays employee medical claims directly instead of paying premiums to an insurance company. One vendor handles everything.
A Third-Party Administrator (TPA) handles claims processing, you buy stop-loss insurance for big claims, and join a captive (group) for better rates. All from one vendor, making it simple.
Impact is NONE because employees experience no change whatsoever. Same doctors, same network, same ID cards. The only difference is who pays the claims behind the scenes - you instead of an insurance company.
Traditional insurance adds 15-20% on top of actual claims for profit, risk charges, and premium taxes. Self-funding eliminates these costs - you only pay actual claims plus administration (typically 8-12%). If employees have a healthy year, you keep the savings instead of giving profits to an insurance company. Bundled TPA makes this simple with one vendor, creating 9% average savings.
Same as bundled self-funding, but you pick separate best-in-class vendors for each service instead of one package.
You separately contract with a TPA for claims, a stop-loss carrier for large claim protection, and a pharmacy benefit manager. More work to coordinate but you can negotiate each piece and switch vendors if needed.
Impact is NONE for employees - still no visible change. This is for sophisticated employers with dedicated benefits staff who can manage multiple vendors for 2-3% additional savings.
All the benefits of bundled self-funding (9% savings), PLUS you can negotiate each vendor separately and create competition. You might save an extra 1-2% on TPA fees, 1% on stop-loss premiums, and 0.5% on PBM costs by picking specialists. Each vendor competes harder knowing you can switch them individually. This competitive pressure creates an additional 2% savings beyond bundled self-funding, totaling 11%.
A modern type of health plan that eliminates deductibles and uses an app to show exact costs upfront, with lower prices for high-quality doctors and hospitals.
This is a completely different plan design (offered as an option alongside traditional plans). Employees use an app to search for any doctor or service and see the exact copay before making an appointment. The app shows lower copays for providers who deliver high-quality, cost-effective care. No deductible to worry about - coverage starts immediately. Uses major national networks.
Impact is MEDIUM because employees must switch from their traditional plan and learn a new system. However, 82% of members say they understand this plan better than their old one. It's simpler in many ways (no deductible confusion), but requires using an app. Note: Employees with HSAs would lose that option since this isn't compatible with HSA accounts.
Savings come from three sources: (1) The app makes 100% of employees engage with costs (vs 5-15% with optional price tools), (2) Lower copays automatically guide employees to high-value providers without them having to research, and (3) Eliminating deductibles means people get preventive care instead of avoiding it and getting sicker. Research shows 12% fewer surgeries, 10% fewer ER visits, and 30% more use of cheaper telehealth. Multiple employer studies document 11% average savings.
Switching to a Pharmacy Benefit Manager (PBM) that charges you fairly and passes back 100% of drug manufacturer rebates instead of keeping hidden profits through spread pricing.
Traditional PBMs make money through "spread pricing" - they pay the pharmacy $100 for a drug, charge your company $130, and pocket the $30 difference. They also keep rebates from drug manufacturers. Transparent PBMs eliminate spread pricing - they show you the actual pharmacy cost, charge a simple admin fee (like $3-5 per prescription), and pass 100% of rebates back to you.
Impact is NONE because employees use the same pharmacies and often pay lower copays since you're not paying markup. This is a behind-the-scenes vendor change. Most employees never notice the switch or actually benefit from lower prescription costs.
Traditional PBMs hide profits in two places: (1) Spread pricing adds 15-25% to drug costs (you pay $130 for a $100 drug), and (2) They keep 20-50% of manufacturer rebates. By eliminating spread pricing and getting 100% of rebates returned, you save 10-12% on pharmacy spending. Since pharmacy is typically 25-30% of total health costs, this creates about 10% overall savings. Transparent PBMs make money on flat admin fees instead of hidden markups.
Managing expensive weight-loss and diabetes drugs (like Ozempic and Wegovy) to make sure they're used appropriately and effectively.
Requires prior authorization (doctor proves medical necessity), BMI requirements (usually 35+), trying cheaper options first, and pairing the medication with nutrition and exercise programs. Includes ongoing monitoring to ensure the drug is working.
Impact is LOW because these drugs are still covered - employees just need to meet criteria and participate in support programs. GLP-1 drugs now represent 10.5% of all healthcare claims and cost over $1,000/month, so smart management saves significant money without denying access.
GLP-1 drugs cost $1,000-1,500 per month and now represent 10.5% of all health claims. Without management, anyone who asks can get them, including for cosmetic weight loss. Management programs require: (1) Prior authorization proves medical necessity (BMI 35+, diabetes, or cardiovascular disease), eliminating recreational use, (2) Step therapy tries cheaper weight loss options first, (3) Lifestyle programs must be attempted, and (4) Ongoing monitoring ensures the drug is working. This reduces inappropriate use by 40-50%, creating 5% overall savings while still covering legitimate medical needs.
Using biosimilar drugs (similar to generic versions) instead of expensive brand-name specialty medications when possible.
When a specialty drug has a biosimilar available (like for Humira), the plan requires trying the biosimilar first. These cost 20-40% less but work essentially the same and are FDA-approved as equally safe and effective.
Impact is LOW because some patients need to switch medications, which requires doctor coordination and monitoring to ensure the new drug works as well. But biosimilars are FDA-approved as just as safe and effective as the originals.
When a biologic drug's patent expires, biosimilar versions can be made (like generics for regular drugs). Biosimilars cost 20-40% less than the brand version but are FDA-approved as equally safe and effective. By requiring step therapy (try the biosimilar first), you shift 60-70% of specialty drug users to lower-cost versions. Since specialty drugs are 50%+ of pharmacy spending, this 20-40% reduction on those drugs creates 4% overall savings.
A smaller network of high-quality, cost-effective doctors and hospitals instead of every provider in your area.
Instead of having 50 hospitals to choose from, you might have 10-15 that are known for good outcomes and fair prices. Employees still have choices, just fewer. Often includes an Accountable Care Organization (ACO) where providers coordinate care.
Impact is MEDIUM because some employees may need to change doctors if theirs isn't in the narrower network. Requires good communication about why these providers were selected and how to find in-network care.
Instead of including 50 hospitals in your network (including expensive, low-quality ones), you contract with only 10-15 high-performing hospitals. These providers get the promise of more patients in exchange for 15-25% lower rates. Since they're high-quality, they have fewer complications and readmissions (complications add 30-50% to procedure costs). You also eliminate the 5-10 most expensive hospitals entirely. Combined, this saves 12-17% on medical costs.
A doctor's office at or near your workplace that provides free or low-cost primary care to employees.
Employees can see a doctor during work hours for things like colds, annual check-ups, prescriptions, and minor injuries. Often free with no copay, which encourages use and reduces emergency room visits.
Impact is LOW because this is an added convenience - employees can still see their regular doctor. Many employees love having quick access to care without taking time off work or paying copays.
Onsite clinic visits cost you $50-80 compared to $150-200 for regular doctor visits or $500-800 for urgent care. Free to employees means they use it more - catching problems early before they become expensive. Also prevents ER visits for minor issues (saving $500-1,500 each time). Employees miss less work since care is convenient. When 40-50% of employees regularly use the clinic, you save 8-12% on primary care and urgent care costs.
Special programs for employees with diabetes, heart disease, or chronic back/joint pain that provide extra support and prevent expensive complications.
Employees with chronic conditions get a care coordinator, regular check-ins, help with medications, and education on managing their condition. Programs are voluntary and often include free equipment (like glucose monitors for diabetics).
Impact is LOW because programs are voluntary and provide additional support. Employees with these conditions usually appreciate the help, which prevents emergency room visits and hospitalizations.
Employees with diabetes, heart disease, or chronic pain represent 20% of your workforce but 50-60% of costs. Without management, they end up in the ER or hospital with complications. These programs provide health coaches, free equipment (glucose monitors, blood pressure cuffs), medication adherence support, and regular check-ins. By preventing complications, you avoid expensive hospitalizations ($15,000-30,000 each). For every dollar spent on disease management, you save $3-6 in avoided ER visits and hospitalizations, creating 6% net savings.
Expanded access to therapy, counseling, and mental health support - often through virtual visits.
Employees get access to online therapy, mental health apps, and more in-network therapists. Often includes programs for stress, anxiety, depression, and substance abuse. May be free or low-cost to encourage use.
Impact is NONE because this adds options without taking anything away. Mental health issues often lead to 30-40% higher medical costs overall, so addressing them reduces emergency visits and improves medication adherence.
Untreated mental health issues drive 30-40% higher overall medical costs through: (1) More ER visits for crisis situations, (2) Poor medication adherence leading to complications, (3) Higher rates of chronic disease from stress, and (4) More presenteeism and absenteeism. By providing easy access to mental health care (especially virtual therapy), you catch issues early. Virtual therapy costs $100-150 per session vs $500-2,000 for ER mental health visits. This creates 4% savings through avoided ER visits and better overall health.
Paying hospitals based on a fair reference price (usually a percentage of Medicare rates) instead of accepting whatever the hospital charges.
Instead of networks with negotiated rates, you pay hospitals 140-200% of what Medicare pays for the same service. No traditional networks. Requires strong member advocacy to handle any balance bills (when the hospital bills the employee for the difference) or disputes.
Impact is HIGH because employees have no networks to reference and may receive balance bills (where hospital bills them for the difference). Requires dedicated support team to negotiate these. Can save 20-40% but needs careful implementation and excellent member support.
Hospitals charge wildly different prices for the same procedure - a knee replacement might be $25,000 at one hospital and $75,000 at another, with no quality difference. Instead of negotiating discounts off inflated "list prices," RBP pays a fair amount based on Medicare rates (usually 140-200% of Medicare). A $50,000 hospital bill at 160% of Medicare might result in a $20,000 payment. Hospitals can either accept it or bill the patient for the difference (balance bill), which your advocacy team negotiates. This saves 20-40% on facility costs, which are 40-50% of total medical spend, creating 25% overall savings.
Offering both Reference-Based Pricing and a traditional PPO network, letting employees choose which to use.
Employees can use reference-based pricing for better coverage (maybe 90% instead of 80%) or stick with the traditional PPO network if they prefer. Creates a "safety net" while encouraging the cost-saving option through better benefits.
Impact is MEDIUM because there are two systems employees need to understand, but they have a choice. Less disruptive than full RBP since the PPO option remains available for those uncomfortable with the change.
Same RBP savings mechanics as full RBP (paying fair prices based on Medicare rates), but only for employees who choose that option. Typically 40-60% of employees choose RBP because it offers better coverage. Those employees generate 20-30% savings on their claims. Since they represent about half your population, this creates 15% overall savings while maintaining a traditional option for employees who prefer it.
Designated high-quality hospitals for specific procedures (like knee replacements or heart surgery) with bundled pricing and travel covered.
For certain surgeries, employees must use designated "Centers of Excellence" known for best outcomes. The facility charges a single bundled price covering surgery, hospital stay, and follow-up care for 90 days. Often includes travel expenses if facility is far away.
Impact is LOW because it only affects employees needing specific surgeries (small percentage of workforce), they get better outcomes and bundled pricing, and travel is covered. Most employees appreciate going to the best facility.
For complex surgeries (knee replacements, bariatric surgery, cardiac procedures), you designate specific high-volume centers. These facilities do hundreds of these procedures yearly and have the best outcomes. They charge a single "bundled price" covering surgery, hospital stay, and 90-day follow-up. Because they're efficient and have fewer complications, the bundle costs 25-40% less than traditional fee-for-service at average hospitals. You also cover travel costs for the patient and companion, which is still cheaper than local expensive care. Since complex surgeries are only 3-5% of procedures but 15-20% of costs, this creates 12% overall savings.
Negotiating directly with hospitals and doctor groups for transparent, pre-set prices instead of using insurance company networks.
Company (or benefits consultant) negotiates directly with health systems for flat rates on services. For example, $15,000 for any knee surgery regardless of complications. Eliminates surprise bills since prices are agreed upfront.
Impact is LOW because employees must use contracted facilities, but they benefit from transparent pricing and no surprise bills. Usually includes high-quality systems that want direct relationships with employers.
Traditional insurance networks negotiate "discounts" off fake list prices. Hospitals inflate their charges and give 40-50% "discounts," but you still overpay. Direct contracting bypasses this - you negotiate flat, bundled prices directly with hospitals. For example, agreeing to $12,000 for any knee surgery vs paying $18,000-25,000 through traditional networks. By cutting out the insurance middleman and negotiating real prices, you save 14-20% on facility costs while getting price transparency and eliminating surprise bills.
Voluntary program where employees can travel to high-quality, lower-cost facilities for major surgeries, with travel expenses covered and incentives provided.
For surgeries like hip replacements or bariatric surgery, employees can choose to travel to accredited facilities (domestic or international) and save 40-60%. Plan covers travel for patient and companion, hotel, and often waives all copays/deductibles as incentive.
Impact is MEDIUM because it requires travel and time away, but is completely voluntary. Employees who choose it get excellent care, save money, and often treat it as a mini-vacation. Popular with employees who appreciate the zero out-of-pocket cost.
The same surgery that costs $60,000 at a U.S. hospital costs $15,000 at an accredited facility in Mexico or $25,000 at a specialized center in another state. By covering all travel costs (flights, hotel for patient and companion) and waiving deductibles/copays as an incentive, you create a $0 out-of-pocket option for employees. About 10-15% of employees choose this for major surgeries, generating 40-60% savings on those procedures. Since you're only covering voluntary participants, this creates about 8% overall savings with no forced participation.
A dedicated team that helps employees navigate healthcare and negotiates bills on their behalf when problems arise.
When employees have large claims, balance bills, or confusing healthcare situations, they call the advocacy team. The team negotiates with providers, finds errors in billing, and guides members through complex healthcare decisions.
Impact is NONE because this is a support service added to help employees. They experience better service and lower bills. Particularly important with advanced strategies like reference-based pricing where balance billing can occur.
Healthcare bills contain errors 30-40% of the time - duplicate charges, wrong codes, services not provided, excessive quantities. Advocacy teams review every large claim (typically $5,000+) and negotiate directly with providers. They identify billing errors, negotiate down inflated charges, and ensure fair pricing. For every $1 spent on advocacy services, you save $4-8 in reduced bills. This typically creates 6% savings while also improving employee satisfaction with benefits.
Using patient assistance programs, manufacturer copay support, and sometimes international pharmacies to get expensive specialty drugs at much lower costs.
A specialty team helps employees access manufacturer patient assistance programs, aggregate copay assistance dollars, and legally source medications internationally when appropriate. Can reduce $100,000/year drugs to $20,000/year or less.
Impact is MEDIUM because there can be 60+ day delays getting set up in assistance programs, requires extensive paperwork and financial disclosure, and coordination with multiple parties. But for employees on $50,000+ medications, the savings are life-changing.
Specialty drugs for things like cancer, rheumatoid arthritis, and MS can cost $50,000-150,000 per year. Three sourcing strategies: (1) Patient assistance programs from manufacturers can reduce costs by 50-80% for eligible patients, (2) International sourcing (where legal) saves 40-70% since other countries negotiate better prices, and (3) Aggregating copay assistance maximizes manufacturer support. By dedicating a team to navigate these options for your highest-cost drugs, you save 40-60% on specialty medications. Since specialty drugs are 50%+ of pharmacy spend, this creates 10% overall savings.
Having experts review all claims to find billing errors, duplicate payments, and overcharges that can be recovered.
A specialized auditing firm reviews paid claims looking for mistakes like duplicate bills, incorrect coding, services never rendered, or pricing errors. They recover overpayments on your behalf, usually on a contingency basis (only paid when they find errors).
Impact is NONE because this happens completely behind the scenes. Employees never know it's happening. Studies show 3-5% of claims have errors, making this an easy win with no employee disruption.
Studies show 3-5% of healthcare claims have errors: duplicate bills (same service billed twice), wrong coding (billing for services not actually provided), incorrect quantities (billing for 10 when patient received 5), or pricing mistakes (overcharging). Specialized auditing firms review every claim using software and clinical experts. They identify errors and recover overpayments from providers. Since they only get paid when they find errors (typically 20-30% of recovered amounts), there's no upfront cost. Recovering 3-5% of annual claims creates 3% net savings after paying the auditor's contingency fee.
0 strategies selected
Please fill the details below
Research-Based Calculator • All estimates from 2024-2025 industry studies • Maximum 50% savings cap • Individual results vary based on implementation quality and employee demographics