From a 32% Renewal to 3.4% Over Three Years
How Pittsburgh Pipe & Supply broke the renewal cycle by owning its plan structure — not renegotiating it.
Client Snapshot
| Company | Pittsburgh Pipe & Supply Corp |
| Industry | Industrial distribution / manufacturing (pipe & supply) |
| Employees | 77 total • ~49 enrolled in medical |
| Location | St. Louis, MO & Litchfield, IL |
| Annual Healthcare Spend | ≈ $429,000 |
| Previous Plan Type | Fully Insured (Anthem BCBS) |
| Previous Broker | Marsh & McLennan Agency (MMA) |
| Renewal Date | October 1 (annual) |
The Challenge
A renewal cycle the employer didn’t control — and couldn’t see into.
As a fully insured Anthem BCBS group, Pittsburgh Pipe was handed a rate increase every October and given no claims data to explain it. The structure was the problem: a fully insured employer rents its plan from a carrier whose incentive is to raise the rent. There was no visibility, no leverage, and no path to break the pattern.
In the fall of 2023, the pattern hit its breaking point. Anthem returned a 32% renewal — a roughly $148,000 jump in a single year that would have pushed the plan past $600,000. Left unchecked, that is the compounding math that quietly doubles a benefits budget in just a few years.
The Approach
Phases: Prepare → Architect → Steward
Prepare — Unlock the data
- Replaced the incumbent broker (MMA) and rejected the 32% Anthem renewal outright.
- Moved the group off fully insured Anthem into a UHC level-funded structure to expose claims data and stop paying for pooled risk Pittsburgh Pipe wasn’t generating.
- Established a baseline of actual claims experience — the first time leadership could see what was driving cost.
Architect — Own the structure
- Re-engineered the plan into an independent, non-carrier level-funded model through Crumdale Integrated Health — decoupling cost from any single carrier’s renewal cycle.
- Layered in a transparent PBM with 100% of rebates returned, a $25,000 specific stop-loss, and member advocacy — so plan spend tracks real cost, not a carrier’s trend assumption.
- Preserved member plan designs and broad provider access on the Cigna network platform.
Steward — Defend the result every year
- Treated each renewal as a decision, not a notice. When the UHC level-funded renewal later came in at 11%, BeneSmart moved the group to Crumdale at a 2% increase — an immediate $39,000 saving.
- Drove ongoing savings through claims oversight, out-of-network negotiation, Rx strategy, telemedicine, and advocacy — captured and reported quarterly.
The Results
A 32% shock refused — then two renewals of just +0.55% and +2.8%: about 3.4% in total across three years.
| Plan Year | Structure & Action | Renewal Outcome |
|---|---|---|
| 2023–24 | Rejected the Anthem fully-insured renewal; moved to UHC Level-Funded | Anthem demanded +32% |
| 2024–25 | Rejected UHC’s +11% renewal; moved to Crumdale independent level-funded | Held to +0.55% |
| 2025–26 | Crumdale renewal (Cigna network) — $25K stop-loss, 100% surplus returned, transparent fees | Held to +2.8% |
| Net effect | Two renewals on BeneSmart’s structure totaled ~3.4% — vs. the 32% the carrier first demanded | 32% → 3.4% (3-yr) |
And in a single stewardship year (Oct 2024 – Jun 2025), the structure didn’t just hold the line — it actively recaptured cost:
- $226,678 captured through Crumdale cost-savings measures — including $218,421 in out-of-network negotiation that prevented member balance bills, plus Rx rebates and telemedicine.
- 93.6% generic dispensing rate (vs. an 87% book-of-business standard) and a 100% satisfaction score across member advocacy cases.
- Full claims-level visibility — leadership moved from an annual surprise to a managed line item, reviewed quarterly.
In Their Words
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Key Insight
The renewal is not a force of nature. A fully insured employer rents its health plan from a carrier whose business model depends on raising the rent — and a 32% increase is what that looks like when there’s no leverage. By owning the structure — not renegotiating the rate — Pittsburgh Pipe turned the annual renewal from an event that happened to them into a decision they control. Holding three years of renewals to about 3.4% in total — after a 32% demand — is not luck. It is what happens when incentives are aligned and the employer owns the supply chain.
The Road Ahead: Self-Funded Blueprint™
Level-funding was the on-ramp, not the destination. BeneSmart’s Self-Funded Blueprint™ maps Pittsburgh Pipe’s path to full plan ownership over the next five years — capturing 100% of claims surplus, owning the data outright, and turning health spend from an annual expense into a managed asset.
| Years 1–2 | Level-funded foundation — claims data, transparency, stop-loss, aligned vendors (complete) |
| Years 3–4 | Optimize stop-loss and pharmacy; evaluate direct-contract opportunities to lower the unit cost of care |
| Year 5 | Full self-funded plan ownership — Pittsburgh Pipe owns its plan, its data, and its surplus |
As Pittsburgh Pipe approaches its next renewal, the question has flipped — no longer “how much will it rise,” but “how much more can we optimize.”