Frequently Asked Questions
Weltrio helps companies take control of healthcare spending without reducing employee benefits. By eliminating wasteful spending, guiding employees to smarter choices, and ensuring fair pricing, Weltrio creates long-term savings while improving healthcare quality. Companies overpay for healthcare due to hidden costs, high prescription drug prices, and inefficient insurance plans. With Weltrio, businesses can lower expenses, improve employee benefits, and take control of their healthcare spending.
The Weltrio Solution
What does Weltrio do?
Weltrio helps businesses reduce healthcare costs by:
Educating employees on smart healthcare choices.
Educating employees on personal health choices that impact long-term health
Offering transparent pharmacy benefit management.
Where applicable: negotiating direct contracts with hospitals and providers.
Analyzing data to eliminate unnecessary expenses.
How can companies work with Weltrio?
Companies can start working with Weltrio immediately, even if they’re already self-insured. Weltrio offers two payment options:
A shared savings model where the company only pays if they save money.
A flat fee per employee per month, providing predictable costs.
Do companies have to wait until open enrollment to switch to Weltrio?
No! Self-funded companies can start immediately and see savings in 1-3 months. Fully funded companies may take longer, but Weltrio helps them transition smoothly.
What makes Weltrio different from insurance companies?
Weltrio is not an insurance company. Instead, they work with a company’s HR team to optimize existing benefits and eliminate unnecessary costs. If needed, they can introduce trusted insurance partners.
Implementation & Transition
How long does it take for Weltrio to start delivering cost savings?
Most companies see savings within 1-3 months. Changes like pharmacy cost reductions can happen almost immediately, while larger shifts, like provider contract negotiations, take a little longer.
What kind of data does Weltrio need to assess our healthcare spending?
Weltrio reviews claims data, pharmacy usage, and provider contracts to understand where costs can be reduced.
Does switching to Weltrio require changing our existing health insurance provider?
No! Weltrio works within your existing insurance plan to reduce costs without requiring a provider change. However, if you are overspending, Weltrio will suggest more cost-effective plans and programs.
Can Weltrio integrate with our current HR benefits system?
Yes! Weltrio’s tools and services integrate smoothly with most HR benefits platforms.
Will employees notice any disruptions or major changes in their healthcare benefits?
No. If the company wants to continue with their current benefit plan, employees will continue receiving the care they need, but at lower costs. Weltrio makes the transition seamless and beneficial for everyone. If there are more cost-effective plans available, Weltrio will recommend the best plan for the company’s population and help each employee understand any new benefits. Weltrio understands that changes to health plans can be disruptive. Weltrio will work directly with employees, educating them on new benefit plans and fielding any questions from employees related to benefit changes, relieving HR of any transition pains.
Weltrio’s Unique Benefits
What is a self-insured company?
A self-insured company pays its employees' healthcare costs directly instead of using a traditional insurance plan. This allows companies to save money but also requires smart cost management.
Why do self-insured companies still overpay for healthcare?
Many companies overpay because:
They lack the expertise to negotiate better rates.
They don’t have transparent pricing data.
They choose generic health plans instead of custom solutions.
Medical costs keep rising without a plan to manage spending.
Their HR teams struggle to keep up with healthcare regulations and claims.
Can you give an example of a company that overpaid for healthcare?
Sure! ABC Manufacturing had 500 employees and thought they were saving money by choosing a low-cost health plan. However:
They paid $2,500 for an MRI, while another company with better-negotiated rates paid $800 for the same scan.
They didn’t know what they were overpaying for because they lacked pricing data.
They were stuck in a generic health plan that didn’t fit their employees’ needs.
Costs rose every year, but they had no strategy to control spending.
HR struggled to manage claims and compliance rules.
How did Weltrio help ABC Manufacturing save money?
It is complex, but here are some highlights
Negotiated better provider rates, lowering MRI costs from $2,500 to $800.
Used data analytics to remove wasteful spending.
Built a custom plan tailored to employee needs.
Managed the entire process so HR could focus on other tasks.
Employee Engagement & Education
How does Weltrio educate employees on making smarter healthcare choices?
Each employee meets individually with a Weltrio coach on a quarterly basis. During these quarterly meetings, the employee sets health objectives (goals) and receives valuable, relevant education, clear guidance, cost-comparison tools, and one-on-one support to help employees choose affordable care options without sacrificing quality.
Can Weltrio provide tools or resources for employees to compare healthcare costs?
Yes! Weltrio offers online resources, cost estimators, and direct support to help employees find the best-priced healthcare services.
How does Weltrio encourage employees to use lower-cost, high-quality healthcare providers?
By offering financial incentives, educational programs, and concierge services, Weltrio guides employees toward the best-value care.
What training or support does Weltrio offer HR teams to help implement cost-saving strategies?
Weltrio provides HR teams with training, reporting tools, and ongoing support to ensure cost-saving measures are successfully implemented.
Self-Insured Companies & Cost Savings
What sets Weltrio apart from other healthcare cost management solutions?
Unlike traditional cost-cutting approaches, Weltrio finds savings without reducing benefits. It focuses on transparent pricing, smart provider selection, and eliminating hidden fees.
How does Weltrio ensure its cost-saving recommendations align with our company’s values?
Weltrio creates custom solutions to match each company’s priorities, ensuring cost savings don’t come at the expense of employee health or satisfaction.
Can Weltrio’s strategies work for both large corporations and small businesses?
Yes! Whether a company has 200 employees or 5,000+, Weltrio customizes solutions to fit each organization’s size and needs.
Does Weltrio offer ongoing support, or is it just a one-time setup?
Weltrio provides continuous support by monitoring cost-saving opportunities, adjusting strategies as needed, and offering expert guidance. Additionally, Weltrio meets quarterly with each employee to act as their personal health advocate, helping them set and achieve customized health goals.
How does Weltrio measure success, and what results have other companies seen?
Success is measured by real cost savings and improved employee health. Many Weltrio clients save 50-60% on healthcare costs while improving benefit quality.
Self-Insurance & Risk Management
What are the biggest risks of becoming self-insured, and how does Weltrio help mitigate them?
Self-insurance risks include high claims costs, cash flow issues, and complex administration. Weltrio helps by structuring stop-loss coverage correctly, negotiating provider discounts, and managing claims efficiently.
How does Weltrio support companies that are new to self-insurance?
Weltrio guides businesses through every step, from setting up stop-loss coverage to building a customized plan and then helps the employees with all claims and insurance questions so the HR team does not have to. Companies get expert support to transition smoothly and avoid common mistakes.
What stop-loss insurance options do Weltrio recommend, and how do they protect against big claims?
Stop-loss insurance protects self-insured companies from large, unexpected claims. Weltrio ensures companies have the right coverage, so they don’t overpay while staying protected from high-cost medical cases.
How does Weltrio help HR teams manage self-funded healthcare plans?
HR teams often struggle with complex healthcare regulations and claims. Weltrio handles compliance, claims analysis, and cost management so HR can focus on employee support.
Prescription Drug Cost Management
How does Weltrio identify overpriced prescriptions in my company’s plan?
Weltrio reviews drug pricing across different pharmacies and PBMs to identify costly prescriptions. If a medication is significantly overpriced, Weltrio finds lower-cost alternatives without changing treatment effectiveness.
Can Weltrio help employees find lower-cost prescriptions without changing their medications?
Yes! Sometimes, the same medication costs much less at a different pharmacy. Weltrio helps employees find the most affordable options without switching prescriptions.
How does Weltrio work with doctors to ensure cost-effective prescriptions are prescribed?
Weltrio educates doctors on cost-saving options and provides data on lower-cost alternatives. If a high-cost drug is prescribed, Weltrio can suggest a more affordable option that provides the same benefits.
What strategies does Weltrio use to keep specialty drug costs manageable?
Weltrio ensures specialty drug costs are controlled by requiring lower-cost alternatives to be tried first, negotiating better pharmacy pricing, and preventing copay assistance programs from driving up employer expenses.
Can Weltrio prevent employees from unknowingly choosing overpriced pharmacies?
Yes! Weltrio provides employees with cost comparison tools and pharmacy recommendations to help them choose the lowest-cost option for their medications.
Reducing Prescription Drug Costs
Why do some prescriptions cost much more at different pharmacies?
Prices vary because pharmacies set their own prices, and PBMs negotiate different rates. Employees might pay a fixed copay, but the employer covers the rest, which could be much higher than necessary.
What are ways companies can reduce prescription drug costs?
Companies can save money by:
Encouraging employees to use price-transparent pharmacies.
Promoting generic drugs instead of expensive brand-name medications.
Negotiating direct contracts with transparent pharmacies.
Avoiding “new” brand-name drugs that are just expensive combinations of cheap generics.
Understanding Specialty Drug Costs & Savings Strategies
What are specialty drugs, and why are they so expensive?
Specialty drugs are medications used to treat serious conditions like cancer, autoimmune diseases, and rare disorders. These drugs often require special handling, storage, and administration, which makes them costly. Because they are complex and sometimes newly developed, their prices are much higher than regular medications.
How do specialty drug copay assistance programs work?
These programs are designed to help patients afford expensive specialty drugs. Drug manufacturers offer financial assistance to lower a patient’s out-of-pocket costs. However, while this helps individuals, it shifts costs to employer-sponsored insurance plans, making healthcare more expensive for everyone else.
Can you give an example of how a copay assistance program works?
Sure! Let’s look at Sarah, who needs a specialty drug costing $30,000 per month:
Her insurance requires her to pay a $1,000 deductible and 20% coinsurance until she reaches a $4,000 maximum out-of-pocket (MOOP) limit.
Normally, her first prescription would cost her $4,000, and after that, insurance would cover the full cost.
A copay assistance card from the drug company pays her $4,000 MOOP, so she only pays the copay assistance copay of $20.
The drug company then charges the remaining $26,000 to the employer’s insurance plan.
For the rest of the year, Sarah pays nothing, but her insurance plan covers the $30,000 per month cost.
Why is this a problem for insurance companies and employers?
It is complex, but here are some highlights
Patients don’t see the true cost of their medications.
Insurance companies absorb high costs, leading to increased premiums for everyone.
Lower-cost alternatives often exist, but patients aren’t required to try them first.
How can companies manage these high costs?
Solutions like Weltrio help by:
Preventing copay assistance from counting toward deductibles, ensuring drug manufacturers contribute more.
Requiring patients to try lower-cost options before expensive alternatives.
Finding cost-effective pharmacies to save thousands per prescription.
Understanding PBM Drug Rebate Programs
What is a PBM, and what do they do?
PBM stands for Pharmacy Benefit Manager. PBMs act as middlemen between drug manufacturers, insurance companies, and pharmacies. They negotiate prices and determine which drugs are covered by insurance plans.
How do PBM drug rebate programs work?
Drug manufacturers offer rebates (discounts) to PBMs in exchange for placing their drugs on a preferred list. However, these rebates don’t usually lower costs for patients or employers.
Can you give an example of how a PBM rebate affects drug prices?
Sure! Let’s say a drug company wants its new diabetes medication to be covered by an insurance plan:
The PBM agrees to include it but only if the manufacturer provides a rebate.
The drug costs $500 per month, and the PBM gets a $100 rebate.
Instead of passing the savings to patients or employers, the PBM keeps the rebate.
PBMs prioritize expensive drugs with bigger rebates, even if cheaper alternatives exist.
Why is this a problem?
It is complex, but here are some highlights
Patients and employers don’t see the true cost of medications.
PBMs favor higher-priced drugs to get bigger rebates.
Drug manufacturers increase prices to offset rebate costs, making medications even more expensive.
How can companies avoid unnecessary PBM costs?
Companies can save money by partnering with transparent PBMs recommended by Weltrio, which ensures:
All rebates and kickbacks are returned to the employer sponsored health insurance plan.
Lower-cost medications are prioritized.
Pricing is clear, eliminating hidden fees.
Other Common Questions
How does Weltrio determine where my company is overpaying for healthcare?
Weltrio analyzes claims data, pharmacy costs, and insurance spending to find hidden fees and unnecessary expenses. By comparing what you pay to industry benchmarks, Weltrio identifies areas where you can save money without reducing care quality.
Can Weltrio help reduce hospital and specialist visit costs?
Yes! Weltrio negotiates and finds lower prices with pharmacies and providers, and directs employees to high-quality, lower-cost options. For example, instead of paying $2,500 for an MRI, Weltrio can find a nearby provider that offers the same scan for $800.
How does Weltrio ensure employees still receive quality care while cutting costs?
Weltrio focuses on cost-effective, high-quality healthcare providers. By guiding employees toward the best-value care, they receive the treatment they need without overpaying. Weltrio also promotes early care to prevent expensive complications.
What are common hidden fees in traditional insurance plans, and how does Weltrio avoid them?
Hidden fees include PBM rebates that don't go to employers, excessive administrative costs, and inflated service charges. Weltrio works with transparent partners, ensuring companies only pay for the true cost of care.
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Weltrio helps businesses slash healthcare costs without compromising employee benefits. Our data-driven strategies keep premiums flat, ensuring long-term savings and quality care.
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