TOSH, INC

Getting Ahead of the Curve on Inflated Healthcare Bills

At a glance

Cash and Check Advance Service

Headquartered in Provo, UT, Tosh, Inc. has 37 Check City stores in three states. Each location offers a variety of high-quality financial services that range from basic check cashing to complete tax, insurance and short- term loan solutions. The company is dedicated to making quality financial services easy, affordable and convenient.

Challenge

In 2013, Tosh, Inc. decided that rising healthcare costs required a closer look. With the cost of their health plan going up along with other business expenses, they knew it was time for a change.

The management team agreed that shifting more of the healthcare costs to employees was not an option, so they began searching for a new, sustainable solution that would support a quality affordable healthcare offering.

Solution

The company was already self-insured when their TPA introduced them to ELAP Services.  The combination of ELAP’s reference-based pricing solution with Tosh, Inc.’s self-funded health plan presented an excellent opportunity for significant cost savings.  They did their homework on ELAP and its full-service claims auditing solution, and liked what they learned:

• ELAP pioneered the reference-based pricing model and was a leader in the industry.
• ELAP’s solution includes a strong member advocacy program backed by legal expertise, reassuring Tosh’s leadership team that their employees would be in good hands.
• ELAP’s co-fiduciary status on the health plan was an important differentiator that supported a collaborative relationship.

After reaching out to client references to understand their experiences first hand, the company made the switch to ELAP Services.

Through its partnership with ELAP, Tosh, Inc. was able to take control of their claim costs by paying provider bills based on the actual cost of service instead of inflated billed charges. This is a fundamental shift from the traditional PPO model, where health plans pay the discount off billed charges negotiated by their insurance provider.

Results

ELAP’s reference-based pricing solution helped Tosh, Inc. transform its bottom line while keeping its employees’ health plan affordable.

“Savings for employees has been a big deal for us. Employees see the savings and tell me how happy they are to have ELAP. We wanted to manage our costs by dealing with the actual claims cost, not just tinkering with the employee premiums.”

KARLIE STELLMON, DIRECTOR OF HEALTH AND WELLNESS, TOSH, INC.