Nick Cianci, PresidentToday, the Compass team works with employer groups all over the country, enrolling thousands of employees and specializing in employee benefits programs primarily for the blue-collar workforce, with a focus in the Long-Term Care (LTC) sector.
In an interview with Manage HR, Nick Cianci, President of Compass Total Benefit Solutions, talks about the wide array of solutions the company offers and how their proprietary medical plan is designed to address the LTC industry pain points.
Could you elaborate on your proprietary medical plan?
Oftentimes employers are held captive by either a budget or compliance called the Affordable Care Act (ACA). When the ACA rolled around, every employer needed to create a plan that met a minimum value and maintained affordability for this population. An employer could charge an employee about 100 dollars per month for a traditional plan, which would have a $6,000 deductible. With employees that make less than $20,000 per year, most can’t afford a $6,000 deductible. This alienated a large part of the population of caregivers in the US.
This drove Compass to create a user-friendly solution that would focus on that employee’s needs. While doing the fieldwork, we found out from the frontline staff that the most important things for them were low copays for office visits and prescriptions as well as paycheck affordability when adding their children or spouses to the plan. The Compass Plan was developed as a limited medical plan that would give employees and dependents access to the things they need the most without paying for things they don’t need. For instance, our plan provides three primary care physician visits per year at a $20 copay, while a traditional plan would have unlimited PCP visits per year at a $20 copay. Most people don’t need unlimited visits, but traditional plans make them pay for unlimited visits.
We’ve also added a Teledoc benefit that is free and unlimited to cater to the younger workforce and busy parents. Being able to give an employee something that they could actually use is a better benefit for the employer as well. It is also more cost-effective than a traditional plan would be for both the employer and the employee. Employers are able to contribute anywhere from 0 to 100% of the premium depending on how they want to utilize the offering.
What are the prescription benefit plans you offer clients?
The Compass Plan has a six-tier prescription offering that includes a $1 low-cost generic. The $1 low-cost generic is a typical drug like Amoxicillin or Penicillin that you receive if you go to the doctor with a minor sickness. However, our plan doesn’t cover long-term or catastrophic maintenance such as Insulin for Diabetics. People who are dependent on insulin or chemotherapy drugs need a more traditional plan. That’s why we suggest employers run this alongside their traditional plan and give the employees choice.
The same thing goes for hospital benefits. As an alternative to a costly traditional hospital benefit, we integrated fully insured hospital indemnity plans into our benefit offerings. With the administration done on the same card, it means an easier process for the employee with no claims to file.
The major difference between Compass plans 1 and 2 is the level of hospital benefits. Compass Plan 2 covers a good portion of traditional labor and delivery, which is popular as a lot of the workforce in low pay and high turnover industries are younger women. We were particular about addressing the concerns of the employees and targeting coverage benefits they would actually need and use.
Could you shed some light on your third party partnerships and how it benefits clients?
Instituting national partnerships ensures employee health concerns are addressed whenever and wherever needed. For the PPO network partnership in the Compass Plans, we utilize PHCS. They have over 900,000 providers that members can go to for in network services. Citizens RX is our pharmacy benefit manager providing us with a six-tier formulary at over 60,000 retail pharmacies nationwide.
Leveraging the latest technology and resources of established industry partners creates efficiencies and simplifies the benefit enrollment process. Claims adjudication and administrative services are done by Regional Care Inc. (RCI), a third-party administrator out of Nebraska. We also work with a group called Progressive Benefit Solutions who are one of the top administrators of the Employee Navigator platform in the country. Our plan is built onto Employee Navigator as the system of record which creates ease of administration for all the benefits that an employer wants to utilize. We also have a great partnership with Ep6ix, which is a group of benefit counselors that helps educate and enroll employees one on one in 45-minute time settings.
Could you share a customer success story?
We were associated with a non-profit health care facility, located in Southwest US with 100-120 employees, which participates in our program with the American Health Care Association. The board of directors in charge was considering shutting the facility down due to the increasing cost of operations. We stepped in to analyze their traditional benefits and to offer a solution. We found that their $850,000 spend for roughly 70 employees was high on an average aggregate basis. We started taking in the data and looking at analytics, went through their market, and determined Blue Cross to be overpaying the providers more than what they were willing to accept.
The key factor is that we are not just focusing on the insurance itself but focusing on the employer and employee experience
As a solution, we created a custom benefits package for the employer based on a payment system around Medicare, called Medicare Reference Based Pricing. We would pay any one of the providers in their area 130 percent of what Medicare would normally pay them, while Blue Cross Blue Shield may have been paying them 160 or 170 percent.
Consequently, we were able to drive their costs down to over $250,000 per year, saving over a million dollars in four years.
What are the key differentiating parts that help you stand out from other competitors in the marketplace?
We work in difficult sectors. We find industries or opportunities that are typically overlooked by insurance carriers and underserved by insurance brokers. We even work in the 1099 gig economy, which is not the norm. We have the ability to create not just an employer-employee relationship, but rather a group policyholder and independent contractor relationship that traditional plans fail to do.
There are thousands of people in the industry who can do the quoting and bidding and any type of work a traditional insurance broker or administrator would do. Compass goes far beyond that by creating a start-to-finish solution. We are designing and pricing out benefit programs, but that’s really only half the battle itself. We provide employers with employee education that enables better engagement with the employees. This allows employees to fully appreciate and comprehend what they are getting from their employer.
Employees, too, have options to choose between their benefits as well as the flexibility with online scheduling tools, meeting with benefits counselors, etc. In addition to the full suite of services we offer like medical, dental, vision, accident, critical illness, cancer, life insurance term, and permanent life insurance, we have tailor-made offerings as well. For instance, there were employers who asked us to implement pet insurance and others who asked us to look at online shopping malls for their employees, where they could make payroll deductions for purchasing major appliances.
Catering to both the employer and employee ensures a major impact on the end result with the satisfaction of everyone involved. We are also going one step further with the technology integration of payroll, human resources information system (HRIS) and cloud-based enrollment systems to ensure everything is working in tandem like a well-oiled machine. The key factor is that we are not just focusing on the insurance itself but focusing on the employer and employee experience.
What is the future roadmap for the company?
Currently, Compass is heavily focused on its partnership with AHCA and providing solutions for skilled nursing and assisted living all across the country. As we have a version of the Compass Plan approved in all 50 states plus DC, we look forward to new partnerships that will help us expand the use of our plan to help with the recruiting and retention of frontline staff workers in these continued uncertain times.
