Company Profile
A Florida-based retail organization operating six locations across South Florida employed 250+ team members, primarily hourly workers in customer-facing roles. The workforce was diverse, multilingual, and included a mix of full-time and part-time employees across varied age groups and health literacy levels. Leadership was committed to offering competitive benefits but faced mounting pressure from year-over-year premium increases and low employee engagement around preventive care.
The Challenge
For three consecutive years, the employer experienced major medical premium increases averaging 12-15% annually, driven by rising claims costs, poor preventive care utilization, and a claims experience heavily weighted toward emergency room visits and urgent, avoidable conditions. Employees were delaying care due to cost concerns, confusion around plan design, and lack of accessible options for everyday healthcare needs.
The organization’s HR team identified several specific pain points:
- Low preventive care engagement: Annual physical exam completion rates were below 20%, contributing to undiagnosed chronic conditions and higher downstream costs.
- High out-of-pocket expenses: Employees reported financial strain from deductibles and copays, particularly for prescriptions and urgent care visits.
- Emergency room overutilization: Nearly 35% of ER visits were classified as non-emergent and could have been handled through primary or urgent care.
- Poor plan understanding: Multilingual employees struggled to navigate plan documents, leading to confusion about covered services and network access.
- Renewal uncertainty: Leadership lacked real-time visibility into utilization patterns and cost drivers, making it difficult to evaluate plan performance or negotiate renewals proactively.
The HR director described the situation as “reactive and unsustainable,” with rising costs threatening the company’s ability to maintain competitive benefits while supporting business growth.
The Solution
RM Legacy Group worked with the employer to design a more intentional benefits architecture that integrated the CHAMP Plan as a front-line care and health engagement layer alongside the company’s existing major medical coverage. The strategy was built around three core objectives: improve everyday care access, reduce friction around preventive services and prescriptions, and create better visibility into utilization and cost drivers.
Implementation Strategy
The implementation followed a structured 75-day roadmap:
Discovery & Planning (Weeks 1-3)
RM Legacy conducted a detailed census review, claims analysis, and stakeholder interviews with HR, finance, and frontline managers. The team identified prescription costs, urgent care utilization, and lack of preventive engagement as the top cost drivers. Contribution strategy was designed to position CHAMP as a voluntary enhancement with employer subsidization for full-time employees.
Build & Structure (Weeks 4-7)
Plan documentation was finalized, and the CHAMP Plan was structured to provide covered urgent care access through the First Health network, 24/7 virtual care with licensed physicians, formulary prescription support, and preventive care navigation. Enrollment materials were translated into Spanish and Creole to support the multilingual workforce. Digital ID cards and member portals were configured for mobile access.
Launch & Education (Weeks 8-10)
RM Legacy coordinated on-site enrollment sessions at all six locations, with bilingual support staff available to answer questions and guide employees through plan selection. Digital communications, posters, and manager toolkits reinforced the message that CHAMP was designed to make everyday healthcare simpler and more affordable. HR hosted Q&A sessions and distributed FAQ materials addressing the most common concerns.
Ongoing Stewardship (Month 3+)
Monthly utilization reporting was delivered to leadership, showing virtual care usage, urgent care visits, prescription fills, and preventive service engagement. RM Legacy held quarterly strategy reviews to identify trends, adjust communication strategies, and refine the benefits structure heading into renewal.
Results and Outcomes
Within the first 12 months, the employer observed measurable improvements across multiple dimensions:
Care Access and Employee Engagement
- Virtual care adoption: Over 40% of enrolled employees used virtual care services within the first six months, primarily for minor illnesses, prescription refills, and routine consultations. This represented a significant shift from the prior pattern of delayed care or costly ER visits.
- Urgent care utilization: Covered urgent care visits through the First Health network increased, while non-emergent ER visits declined by approximately 18%, suggesting employees were accessing more appropriate care settings.
- Preventive service engagement: Preventive care completion rates improved as employees gained clearer navigation support and reduced out-of-pocket costs for covered services. The HR team noted a noticeable increase in annual physical exam completions and routine screenings.
- Prescription access: Employees reported fewer barriers to filling routine prescriptions, with formulary coverage helping reduce out-of-pocket costs and improve medication adherence.
Employer Cost Discipline and Visibility
- Utilization transparency: For the first time, leadership had real-time visibility into utilization patterns, cost drivers, and employee engagement metrics. Monthly reporting enabled proactive decision-making rather than reactive responses at renewal.
- Renewal positioning: The employer entered renewal conversations with clearer data, stronger negotiating leverage, and a more disciplined understanding of claims trends. While major medical premiums still increased, the rate of increase was lower than prior years, and leadership attributed part of that improvement to better utilization management.
- Administrative efficiency: HR reported that CHAMP’s streamlined enrollment, digital ID delivery, and member support reduced administrative burden and freed up time for strategic benefits planning.
Employee Experience and Satisfaction
- Higher satisfaction scores: Employee feedback collected through post-enrollment surveys showed strong appreciation for easier access to everyday care, reduced out-of-pocket costs, and bilingual support. One employee commented, “I used to avoid going to the doctor because I didn’t know how much it would cost. Now I can get help without worrying about a big bill.”
- Improved retention: While difficult to isolate from other factors, the HR team noted that voluntary turnover rates declined slightly during the first year of CHAMP implementation, and benefits were frequently cited in stay interviews as a reason employees valued working for the company.
- Stronger communication: The structured rollout and ongoing stewardship created a culture of benefits engagement that extended beyond CHAMP, with employees showing greater interest in understanding their full benefits package.
Key Takeaways
The HR director summarized the experience: “CHAMP gave us a way to offer better benefits without dismantling what we already had. Our employees feel more supported, and we finally have the data we need to make smarter decisions at renewal. It’s not just a plan—it’s a strategy.”
For RM Legacy Group, the engagement demonstrated the value of integrating CHAMP as a front-line care layer within a broader benefits architecture, particularly for multi-location employers with diverse, hourly workforces seeking to improve care access, reduce friction, and gain better visibility into long-term cost drivers.