A Personal Experience- Self-funded Employee Benefit Plan

By: Adam Russo, Esq.

Yesterday, I posted a personal experience I had with the very first employee benefit plan I ever designed – my own. The Phia Group’s self-funded employee benefit plan is not just the plan my employees are on, it’s the plan my wife, four kids, and I are on. I pay a lot of attention to the experiences of our covered individuals so that we can make our plan better and in turn, the thousands of plans across the country that we represent. I woke up yesterday feeling pretty horrible so I went to an urgent care facility with whom we directly contract. The experience lasted 30 minutes. I had no co-pay and the generic drugs I needed had no co-pay as well.  The total cost to the plan was $250 for the visit and the prescription.

If I walked into a hospital emergency room the cost to the plan would have been $2400 and my out of pocket would have been $250. I wonder if I would still be in the waiting room. So many people have no idea that urgent care facilities are quality places with short waiting times and low costs. Educate your employees and incentivize them to want to lower the cost of healthcare.