Employees First

Employers moved from fully insured health plans to self-funding—paying medical claims directly—to gain greater control over costs and plan design, which is needed now more than ever. Wouldn’t it make sense to have that same control over supplemental health plans such as critical illness, accident and hospital indemnity? Now, through Employees First’s model, employers can.

Employees First uses a captive structure to bring radical clarity to supplemental health plans— revealing where the dollars are going and the true value of plan designs. These plans, which are predominantly paid for by employees, are intended to reduce out-of-pocket costs during unexpected medical events. Unfortunately, most premium dollars have traditionally fed industry profits instead of paying employees’ claims. Under the Affordable Care Act (ACA), supplemental health plans must remain fully insured, making it difficult for employers to see where the dollars go. This lack of visibility creates a blind spot in both cost control and the plan’s true value to employees.

Employees First’s solution enables fully insured plans to operate with the transparency and control of self-funded plans. Employers can now see where every penny goes. They can also reinvest surplus dollars to enhance benefits or reduce employee contributions, often without changing brokers, plan administrators or disrupting the employee experience.

“Fully insured plans can create a veil of obscurity which reduces employers’ visibility of where the dollars go. Our model guarantees employers will have full transparency of every penny of employee-paid premiums,” says Amy Hollis, founder & CEO.

Employees First also supports employers in meeting their fiduciary obligations across overarching plan management. All costs in the model are capped and disclosed, and employers gain full visibility into the flow of funds, ensuring every dollar not used for claims is accounted for and reinvested back into employee benefits. Clients also gain access to the company’s proprietary plan-modeling tool, which delivers customized, data-driven insights for supplemental health plan design. For the first time, supplemental health plan value can be weighted using actuarial standards—which is an industry first.

The model has already delivered measurable results. Employees First has returned more than $40 million—dollars that would otherwise have gone to high industry profits. Instead, 100 percent of these surplus dollars have been reinvested into enhanced employee benefits, increased paid claims and lower employee contributions.

Looking ahead, the company plans to expand its model to other fully insured benefit categories where similar inefficiencies exist. The long-term goal is to make financial transparency, fiduciary compliance and premium reinvestment a standard across all areas of employee benefits— particularly those paid directly by employees.

This isn’t just a business innovation, it is a mission-driven shift to realign benefit structures around employees. As healthcare costs rise, Employees First delivers more than a workaround; it offers a sustainable blueprint for optimizing plan value and converting hidden profits into tangible workforce value.