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For years, Bonnie C. Sawdey was interested in moving Crawford & Co.'s employees exclusively to high-deductible consumer-driven health plans.
The reason, the senior vice president of human resources said, was basic. “I believe employees will make better purchasing decisions because they are spending their own money until the deductible is met,” she said.
In 2006, Crawford considered a shift to full CDHPs within three years, but backed off amid concern that information employees would need to be more cost-conscious users of health care was not readily available, Ms. Sawdey said.
By 2013, Ms. Sawdey returned to the CDHP drawing board. The impetus: a projected 15% increase in group health care costs for 2014 — a much greater increase than in the previous several years — driven by such factors as an older workforce using more services, plan designs that didn't give employees enough economic incentives to be good consumers and new coverage requirements under the health care reform law.
Also aiding in the move, Ms. Sawdey said, was the increased availability of cost information for medical procedures and prescription drugs, enabling employees to comparison shop.
Ms. Sawdey then moved with lighting speed. While many companies have taken several years to make such a change, Crawford did so in less than a year.
“Our costs were projected to increase by approximately 15% in 2014, so we knew it was time to pull the trigger and make the move to CDHP,” Ms. Sawdey said.
On Jan. 1, 2014, Crawford adopted a full CDHP, with employees choosing from three high-deductible health plan designs.
The financial impact was dramatic: Instead of that projected 15% increase, costs fell 6%, saving Crawford $3.8 million.
The savings were not achieved simply by shifting costs to employees. Indeed, Crawford contributed $500 to $1,000, with the amount depending on the plan chosen by employees, to health savings accounts to help employees pay for uncovered expenses. The company made the full contributions on Jan. 1 — unlike at many firms that spread the contributions throughout the year — giving employees access to the full amount to cover expenses incurred early in the year.
Besides that, employee premium contributions, depending on which plan they previously were in, were cut between 4% and 20%.
“Everyone has a lower premium,” Ms. Sawdey said.
The new plan design worked as planned, helping to fuel a change in how employees use health care services.
“Employees are using lower-cost service options, such as urgent care centers rather than emergency rooms, choosing generic drugs over brand name and filling maintenance medications through mail order over retail pharmacies,” Ms. Sawdey said.
That quick action and the cost savings that came with it, is just one of many of Ms. Sawdey's accomplishments in her more than a quarter century with Crawford.
For this, Ms. Sawdey has been named Business Insurance's 2015 Benefit Manager of the Year®. Other achievements include:
• Enhancing Crawford's wellness program in which employees receive financial incentives to have health assessments and biometric screenings. There is a special satisfaction, she said, in the opportunity to improve employees' health through such programs. “Wellness is something that is pretty important to me. We only get one body. We are not like cats. We do not have nine lives. It is really important that people take care of themselves,” she said.
• Implementing a Teladoc Inc. program last year in which employees can talk on the phone to board-certified physicians and get help for a medical problem, avoiding far more expensive office or emergency room visits.
• Implementing a data warehouse in which years of health care claims will be analyzed to identify cost drivers and find new ways to hold down costs, such as through Crawford's wellness programs.
• Putting in place a pension “buyout” program in which former employees were given the option to convert their annuity to a cash lump sum benefit. A whopping 56% of participants accepted the offer, slashing millions of dollars in liabilities and cutting administrative overhead. It was so successful, the buyout program has been extended to more former employees, a move that will expand Crawford's savings.
Despite her tenure in the benefits field, Ms. Sawdey's passion for resolving employee issues has not waned.
“I feel that I can help people. It is very rewarding when I and my team can help employees understand their benefits,” she said.
And, modestly, she credits her successes to her colleagues. “I have a great team of people that work for me. They are absolutely fabulous. I could not get half of what I have done without them,” she said.
Her colleagues are quick to credit Ms. Sawdey's successes to her instincts, intelligence and work ethic.
Ms. Sawdey “is intelligent, experienced and a quick learner. She has the desire to stay current in her professional field as well as take on new challenges. She can be counted on to do what she says and is viewed as a leader with considerable integrity, as well as organizational insight and experience,” Phyllis Austin, Ms. Sawdey's boss and Crawford's executive vice president of global human resources in Atlanta, said about Ms. Sawdey—.
Those who have worked with Ms. Sawdey cite her open mind and careful and thoughtful analysis of issues.
“She is open to new ideas and suggestions. She carefully weighs the pros and cons before making a decision,” said David Berger, an Atlanta-based pension actuary with Aon Hewitt, which for many years has been Crawford's pension consultant.
While Ms. Sawdey has racked up many accomplishments at Crawford, she is not resting on her laurels. She is working to implement a diabetes management program amid an increase in the disease among Crawford employees and dependents.
“The prevalence of diabetes in our participants is more than 10 percentage points higher than the norm and continues to rise,” she said. “My hope is that by offering a specialized program for diabetes management for our employees and their dependents, we will achieve higher engagement levels.”
And she has taken on the role of senior human resources executive at Broadspire Services Inc., Crawford's third-party administration unit, and joined Broadspire CEO Danielle Lisenby's executive leadership team with responsibilities in the human resources area.
When employers move to high-deductible consumer-driven health care plans, one risk is that employees — because they are footing more of the cost — will delay preventive services that could spot medical problems early, before they develop into conditions that are far more expensive to treat.