Background: In the realm of employee healthcare benefits, few situations present as complex and morally challenging as the case of a dedicated, long-serving employee diagnosed with Hepatitis C. The treatment option, Sovaldi, stood as a beacon of hope, offering a potential cure. However, the drug came with an exorbitant price tag of $88,000 for a three-month course, not covered by the group health insurance plan.

Problem: A small-sized company with 48 employees faced a significant challenge in managing the increasing costs of their traditional group health insurance plan. Additionally, they were unable to meet the strict participation requirements imposed by insurance carriers. The company’s workforce was aging, with employees earning annual wages ranging from $35,000 to $55,000, which made healthcare affordability a pressing concern for both employees and their dependents.

XYZ Corporation, a midsized company with 125 employees, was facing the challenge of rising health insurance costs while striving to provide quality benefits for their workforce. In 2020, they made the strategic decision to transition to a level funded health insurance program to improve cost control and enhance employee benefits.

Palmetto Insurance Group has introduced a groundbreaking risk management and tax savings program designed to alleviate these challenges while simultaneously benefiting both employers and employees. This case study explores how Palmetto’s solution is addressing these issues, leading to improved financial stability, enhanced employee well-being, and sustained business growth.