The group
Covered members + dependents190
Octi fee
$
%
Claims you fund
$
Share of claims spend removed by correctionsaudit vendors report 10 to 20% on the claims they audit
%
Your renewal
$
Claims corrected, as a share of premiumaudit vendors report 10 to 20% on the claims they audit
Does your carrier set your renewal on your own claims?Small groups are usually priced on the carrier's pool, not their own claims. Larger groups are priced partly or fully on their own claims.
Plan design
With a safety net under them, more people choose the higher-deductible option at renewal.
%
People
Fewer departures, fewer sick days, more focus at work.
$
%
%
Octi record and benchmarks
%
%
Share of members' large bills that reach Octi
Bills a year that reach Octi
$
$
%
$
%
The book
$
Agency terms and benchmarks
%
%
%
%
Self-funded group
Employer ROI, hard dollars
0x
ROI, all value 0x
Each bill Octi handles is cut by
$0
Employer ROI, per year
Your people
Two of Octi's cases
On a fully-insured plan, corrected claims are the carrier's money first. They come back to you as a smaller increase at renewal, to the extent your carrier prices you on your own claims. The lever you control outright is plan design, and the premium difference between plan options is real money, not an estimate.
Level-funded: corrected claims leave more in the claims fund, and your contract returns a share of that surplus at renewal. A better claims year also sets a lower funding level and a better stop-loss rate next year. Neither is counted here.
A better claims year also improves your stop-loss renewal. Not counted here.
Assumptions and sourcesevery number here is editable on the left
Sources
One client
Year one
$0
Five years, cumulative
$0
Your book
Year one
$0
Five years, cumulative
$0
Year by year