Case Study
How a company with a seasonal and dispersed workforce bent the healthcare cost curve with ParetoHealth
$400K
in pharmacy savings
"ParetoHealth helped us defy medical inflation while removing the volatility of our stop-loss premium and high-cost claims. This let us focus on keeping our population healthier instead of just managing costs after the fact."
VP of Benefits and Operations, American Heritage Railways
Based inDurango, Colorado
SectorHospitality & entertainment
Number of employees220
Joined ParetoHealth2017
Plan typeFully insured and self-funded
Savings engine partner solutionsCancer
Care navigation
Chronic kidney disease & dialysis
Medicare guidance
ParetoHealth Rx Consortium PBM
Care navigation
Chronic kidney disease & dialysis
Medicare guidance
ParetoHealth Rx Consortium PBM
Overview
American Heritage Railways is a tourism company headquartered in Durango, Colorado. Known for iconic attractions like the Durango & Silverton Narrow Gauge Railroad, they serve over 2 million guests annually through multiple railroads and historic properties spanning more than 20 locations across the U.S.
With more than 200 employees, including a large population of seasonal and geographically dispersed workers, they needed an employee benefits strategy that could support a complex, mobile workforce.
After experiencing both the volatility of traditional self-funding and the rising costs of the fully insured model, American Heritage Railways joined the ParetoHealth community in 2017.
Since then, they’ve gained protection from catastrophic claims, saved over $400,000 on pharmacy spend, and reinvested those savings to help employees navigate care.
Challenge
The shortcomings of traditional health insurance
American Heritage had tried it all. They left their fully insured plan to pursue savings through traditional self-funding. At first, it seemed like the right move.
But then, one of their employees was diagnosed with cancer. Their stop-loss insurance “lasered” the individual, excluding them from coverage. That meant American Heritage had to cover the full cost of treatment on their own.
It was a hard and expensive lesson.
With no protection from future claims tied to that diagnosis, the financial exposure was unpredictable so they decided to return to a fully insured plan. Fully insured meant giving up claims transparency and control, and returning to year-to-year reactivity without a multi-year strategy.
Traditional self-funding challenges:
- A single high-cost cancer claim put the entire plan at risk.
- There was no buffer against volatility.
Fully insured challenges:
- High fixed costs, offering no return on good performance.
- No claims visibility made it impossible to identify or address top cost drivers.
- The plan was locked into 12-month cycles, preventing multi-year strategic planning.
SOLUTION
The benefits of self funding with ParetoHealth
American Heritage Railways moved from a fully insured plan to self-funding with a captive, joining the ParetoHealth community in 2017.
What is an employee benefits captive?
Captive insurance is a group-self insurance arrangement owned by members. An employee benefits captive is owned by multiple employers to collectively self-fund their employee health benefits.
What makes ParetoHealth different?
ParetoHealth consistently outperforms traditional insurance, empowering small and midsize employers with a long-term solution to eliminate volatility and lower overall healthcare spend.
With more than 3,500 employers and 1.2 million covered lives, ParetoHealth is the largest and fastest-growing community of its kind and three times larger than any competitor. The scale of ParetoHealth’s community gives small and midsize employers access to protections, pricing, and programs they can’t access on their own.
ParetoHealth’s Risk Shield offers the strongest stop-loss protections in the market, including guaranteed no new lasers and caps stop-loss increases, making costs predictable year over year and protecting employers from large-claim volatility.
The ParetoHealth Savings Engine addresses the root causes of high-cost claims. Backed by data, analytics, and in-house clinical experts, it delivers curated programs and multi-year strategies that lower costs over time.
Thousands of midsize employers have already left traditional insurance behind to join the ParetoHealth community and the movement is only growing.
How ParetoHealth helped this midsize business
After the challenges of the traditional self-funded and fully insured plans, American Heritage Railway joined ParetoHealth to gain the scale and protection they couldn’t get on their own.
Through ParetoHealth’s Risk Shield, they eliminated new laser risk, capped stop-loss increases, and gained the ability to finally plan ahead. With access to real-time claims data, they could make faster, more strategic decisions.
They reinvested the savings into care navigation to help employees and families navigate care, understand their options, and access high-quality providers.
- Flat healthcare costs since 2017
- $400,000+ in pharmacy savings
- 10% reduction in stop-loss premiums
- Savings reinvested in new employee care navigation
How a public library ditched the status quo and saved $1M with ParetoHealth
How an environmental services provider escaped rollercoaster renewals
Ready to join the right side of the fight? Let’s talk.