Meet a Health Plan Hero

Shine Solar

Industry: Solar Power
Number of Employees: 85
Headquarters: Arkansas

Shine Solar is a solar panel home solution company headquartered in Arkansas and operating in three other neighboring states and Utah. The company has 152 employees using the health plan, and prior to transforming their health plan, the company was paying over $600,000 per year to United Healthcare, including almost $7,000 per employee. Today they’ve reduced their annual spend to $455,000, and a per-employee annual spend of $5,000, savings of 26 percent. These savings did not originate from cost-shifting to employees. Employees now have zero deductible for most services and high-touch concierge care navigation.

Starting in January 2021, the company switched to an innovative benefit design that rewards patients who use a custom-built network of direct contracts with the local hospital systems. The plan uses independent, unconflicted, transparent and high-quality vendors for third-party administration, stoploss coverage, pharmaceutical benefit management, brand and specialty drug sourcing, surgery bundled contracts, and imaging procedures. Patients who access care, including more than 500 brand drugs, through these contracts pay zero in most cases. 

These vendors are managed by a transparent, unconflicted benefits advisory firm, who designed the plan around employer/employee goals and no other interests.

When it comes to patient cost-sharing for premiums and out-of-network benefits, the plan is a dramatic improvement over the company’s previous offerings from United. Patients who seek care using the direct contracts have no cost-sharing, but even those who choose to go elsewhere have out-of-network cost-sharing that is lower than the best of the UHC plans from the year prior. The concierge customer service approach is to personalize problem-solving so that the plan always does right by the patient. For example, a member needed a specialized eye surgery with an out-of-network surgeon. The plan negotiated a special contract with the surgery center that saved the patient $1500 on their out-of-network deductible and saved the plan $1000 on the cost of the surgery.