Overview
A global professional services and consulting organization with 5,000 medical-eligible employees was managing a diverse workforce and a complex benefits portfolio. The company offered a strong set of medical, voluntary, and ancillary benefits, but employees still struggled to understand which programs applied to them, when to use them, and how to make financially confident healthcare decisions throughout the year.
Before partnering with Reclaim Health, the organization relied on a static, one-time enrollment support tool. While helpful during open enrollment, the tool did not provide ongoing guidance once employees began using care.
By implementing Reclaim, the company moved from point-in-time benefits education to year-round, claims-driven healthcare financial advocacy. Reclaim helped employees identify better-fit coverage, uncover available reimbursements, and connect with underused employer-sponsored programs when those benefits were most relevant.
The Challenge
Despite offering a robust benefits portfolio, the organization saw several persistent challenges:
Missed savings opportunities
Without personalized, year-round support, employees often used higher-cost care options when lower-cost alternatives such as telehealth or in-network providers were available.
Missed reimbursements
Many employees were unaware when they were eligible for voluntary benefit payouts, leaving meaningful dollars unclaimed.
Low visibility into ancillary benefits
Programs such as telehealth, behavioral health, musculoskeletal support, and maternity care were available, but employees did not always know when or how to use them.
Complex plan decision-making
Employees faced difficult coverage choices with limited personalized context, creating opportunities for overinsurance and unnecessary premium spend.
The HR team recognized that offering strong benefits was not enough. Employees needed timely, personalized guidance to make confident healthcare decisions during enrollment and throughout the year.
A coverage assessment found that nearly one-quarter of employees were potentially overinsured. Among employees eligible for multiple plan designs, 42.9% of those enrolled in the lowest-deductible plan were considered overinsured.
For those employees, Reclaim identified an average annual overspend of $1,460, creating a clear opportunity to help employees migrate to better-fit coverage and reduce unnecessary costs.
The Solution
The organization partnered with Reclaim Health to deliver always-on healthcare financial advocacy powered by claims data, personalized outreach, and actionable benefit recommendations.
Personalized plan guidance
Reclaim used employees’ actual healthcare usage to support plan comparisons, out-of-pocket cost projections, and contribution modeling. This helped employees better understand which plan design was likely to fit their needs and where they may be overspending.
Proactive year-round recommendations
Rather than limiting support to open enrollment, Reclaim delivered claims-driven nudges throughout the year. These recommendations connected employees to relevant voluntary benefits and employer-sponsored programs at the moment they were most likely to need them.
Workforce-level insights for HR leaders
Reclaim surfaced trends across the employee population, helping the organization identify opportunities to optimize plan design, improve benefit engagement, and reduce avoidable healthcare costs while maintaining strict privacy and compliance controls.
Results & Impact
In the first six months of claims data, Reclaim identified significant opportunities to improve benefits utilization and reduce employee financial burden.
Reclaim uncovered voluntary benefit payouts of $470 in savings per qualified family.
Reclaim also connected more than 1,300 families, or approximately half of the enrolled population, to relevant ancillary benefit programs such as telehealth, behavioral health, and musculoskeletal support.
In addition, Reclaim’s coverage analysis found that 24.4% of employees were overinsured, overspending an average of $1,460 annually. This gave the organization a clear path to improve employee plan fit, reduce unnecessary premium spend, and support more confident benefits decisions.
Early plan movement also showed meaningful progress, with a 10 percentage point migration shift to the higher-deductible plan that better aligned with the needs of some employees. The organization also saw $734,000 in HSA contributions that may not have occurred otherwise, creating additional FICA tax savings opportunities for both employees and the employer.
