Building a Prevention Culture

Consortium Actual/Budget Claims Well Below Threshold Chart

The Consortium’s vision statement includes promoting a culture of preventative health care for the wellbeing of its subscribers. Supporting this vision is the task of the Owning Your Own Health Committee. We believe that building a culture of preventative wellness not only makes us happier and healthier, but also reduces health care costs.

A good example of the Consortium’s preventative care culture is our high rate of flu vaccinations. 227 Consortium subscribers took advantage of worksite flu clinics last fall. Primary care physicians provided an additional 768 vaccines, and ProAct pharmacies administered 449 vaccines. In all, 1,444 of us protected ourselves with flu vaccines this season. 

By comparison, for the 2016-2017 flu season, 1,301 Consortium subscribers had vaccines. That’s a 10% increase over last year. As a risk pool, 28% of our subscribers have had flu shots. Our numbers compare favorably with Excellus’ other groups’ vaccination rate of 16%.

The Board of Directors will save the Consortium $70,000 per year. How did they do it? By paying attention to our data: 

Since inception in 2011, the Consortium’s actual claims have varied from the budget by between +5.5% in 2016 and -10.6% in 2015. The average variation between actual claims and budget is 2.5%. NYS Article 47 requires the purchase of Aggregate Stop-Loss Insurance, which pays a $1 million benefit should actual claims exceed the budget by 25%. 

Our experience, as illustrated in the graph below, demonstrates that this insurance benefit will never be paid. The Consortium’s Board reasoned that the premium for Aggregate Stop-Loss insurance was not a prudent expense, so they argued to the NYS Department of Financial Services that the Article 47 requirement should be waived. After deliberation on our petition, the Aggregate Stop-Loss insurance waiver was granted to begin in 2018. 

This action will save the Consortium (and our collective premiums) $70,000 per year going forward. It’s another way the Board has subscribers’ interests in mind.