Very few organizations in the country have our depth of expertise with the intricacies of member-owned risk pools.
Pooling can be a liberating alternative to the constraints of commercial insurance. Especially if you like to exercise more control, spend less money, reduce claims, and retain surplus funds rather than turn them over to an insurer.
If you’re new to the subject of pools, here’s a quick primer: When like-minded organizations in a common field or industry want to take charge of their risk situation, they join forces, create a membership pool, and directly insure their own risks.
Ashton Tiffany helps organizations start and operate a new pool, or make an existing pool work harder and smarter. We currently manage pools for health benefits, workers’ comp, and property and casualty exposures. We provide services like:
- Budgeting and allocation
- Claims management
- Liaison on regulatory issues
- Safety and loss control reporting
- Service provider management
To start a conversation with us about launching a new pool, or improving the management of an existing one, call John Ashton at 602.222.2105, or send him an email at firstname.lastname@example.org.
When first responders called us
When the Arizona legislature considered expanding workers’ comp benefits for firefighters, it spooked traditional insurers. The biggest one got out of the market altogether. Another major player announced that premiums would more than double.
With renewals just a few months away, firefighters weren’t left with many good options. That’s when they called us.
We helped fire districts set up their own self-insured workers’ compensation pool, just in time for the new policy year. They provided the membership (42 fire departments and districts) and a board of directors, and we provided pool administration services.
Now the firefighters aren’t dependent on the whims of the marketplace. They’ve got their own workers’ comp insurance pool — one they own and control.
Smarter care, lower costs
Employees who suffer on-the-job injuries are entitled to insurance benefits. Depending on the industry, employer costs can add up fast.
We decided to stop the bleeding by establishing a nurse triage program for one of our clients. Under this program, unless there’s an emergency, injured or sick employees call our nurse triage line before seeking treatment. Following a quick consult, the employee receives care advice and then proceeds to the appropriate treatment site.
By avoiding unnecessary claims and unnecessarily costly ones — when, for example, self-care at home is all that’s needed, or when urgent care will work just as well as the ER — the triage program has saved our client loads of cash. The benefits extend well beyond dollars, though: Employees get the peace of mind of an immediate consultation. Employers don’t have to be involved in medical decision-making. And both avoid the hassle of claims paperwork, which is handled by our triage nurses.
In the end, everyone’s happier, and employees are healthier.
Creating the “super pool”
For many years, public employee health care in Arizona was fragmented: Big employers got their health care here; rural employers got their health care over there; school districts in a third place; cities and towns in a fourth. This resulted in limited choices for public entities and a loss of market power.
After conferring with some of our clients, we created a brand new employee benefits pool, open to all public entities. If you were self-insured, you were welcome. If you wanted to share risk with other employers, you were welcome too. Urban? Rural? Mixed? The doormat was out for you. Fire department, school, city, town, special district? Our casa, your casa.
The pool quickly took off, in part because members were tired of the take-it-or-leave-it limitations of their previous arrangements. Working hard for our customers rather than taking them for granted means that we’ve enjoyed 100% member retention, customer service ratings above 90%, and continual growth while other insurers are stagnating. With our pool’s large, diverse employer base, we’ve also gotten the attention of major industry players. This helps us challenge the health care status quo.