Wentzville Fire Protection District is a public fire district in Wentzville, Missouri. They are one of the largest fire districts in their county, covering 88 square miles. The fire district has 64 employees currently using their health plan. Prior to transforming their health plan in 2022, they were fully insured and suffering 15%-20% increases year-over-year. Today, they have reduced their per-employee annual spend to $6,500 per employee – a savings of 20%.
In July 2022, the fire district transitioned to an innovative benefits design that rewards patients who use a custom-built network of direct contracts with the local hospital systems. Their health plan uses independent, high-quality vendors for third-party administration, pharmaceutical benefit management, specialty drug solutions, and healthcare navigation. Patients who access care through these contracts pay zero in most cases. For example, one member was able to use Connect DME to obtain a CPAP machine for $0. Another member is in need of knee surgery and their benefits advisors are working very closely to ensure that they are in-network, pre-authorizations are completed, and the entire process goes smoothly from start to finish.