From Annual Rate Shock to Clearer Control Over Health Benefits

Story Overview

An Oregon-based nonprofit that supports people with developmental disabilities needed a better way to manage employee health benefits. After years in a traditional insurance arrangement with limited transparency, rising costs, and little practical support for employees, the organization joined a nonprofit medical stop-loss captive and worked with IMA to make the transition without reducing benefits.

Challenge

The client was facing the same renewal problem every year: rising costs, limited claims visibility, and few meaningful options to improve plan design. Leadership could not clearly explain cost changes to its board, plan confidently around budget timing, or address employee frustration with deductibles, copays, and claims issues. The previous broker also had not provided the level of employee education or ongoing support the organization had requested.

When costs became clearer, planning became easier.

IMA’s Strategy and Actions

IMA’s captive and employee benefits team acted to support the client by:

• Guiding the client into a nonprofit captive structure built for aligned organizations with similar values and operating realities
• Modeling expected costs and helping leadership compare the move against prior spending before enrollment
• Coordinating the transition so existing benefits, copays, and core plan features were preserved rather than reduced
• Providing employee education sessions and clear materials so staff could better understand and use their benefits
• Adding advocacy and reporting support to help the client navigate claims issues and gain more visibility into plan performance

Why It Worked

IMA helped the client make a complex move feel manageable. The team combined program management, analytics, implementation support, and employee communication, which gave leadership more confidence and reduced the burden of change. Just as important, the client gained ongoing transparency and access to a peer group facing similar workforce and cost pressures.

Key Takeaways

This case shows how a nonprofit employer can move away from a fully opaque insurance arrangement without taking value away from employees. IMA’s role was not just structuring the program, but helping the client understand the tradeoffs, protect benefit quality, and give employees support they had not received before.