Managing Principal - Prospera Consultants

At Prospera Consultants, our mission is to empower businesses and their owners with strategic, client-centered solutions that drive growth, enhance employee benefits, and safeguard financial stability. Guided by our core principles of integrity, honesty, professionalism, knowledge, and a client-first approach, we provide comprehensive consulting services tailored to meet the unique needs of each organization.

We understand the costs and frustrations that often come with providing effective employee benefits that are truly appreciated by your workforce. That’s why we focus on innovation, leveraging advanced technology to transform healthcare strategies. By integrating data-driven tools, predictive analytics, and automation, we help businesses optimize their employee healthcare programs—reducing costs, improving transparency, and enhancing the employee experience. Through real-time insights, telehealth platforms, and automated solutions, we ensure benefit plans are efficient, seamless, and sustainable.

Led by Leonard Quiroz, CLU®, ChFC®, our team combines expertise in employee benefits consulting, financial planning, risk management, and to bring businesses solutions that:

• Lower healthcare costs by reducing claims utilization.
• Increase visibility into plan performance and cost-saving opportunities.
• Improve access to preventive care and wellness tools for employees.

At Prospera Consultants, we are committed to delivering measurable value and trusted advice. Our results-driven approach aligns with your goals to foster long-term financial health, resilience, and a happier, healthier workforce.

As healthcare costs continue to rise, employers are under increasing pressure to balance affordability with comprehensive coverage. Whether businesses rely on traditional fully insured plans or more flexible level-funded plans, integrating a Healthcare Management System (HMS) provides a transformative solution that controls costs, improves employee health, and enhances overall program efficiency.

What is a Healthcare Management System?

A Healthcare Management System is a technology-driven, proactive solution designed to enhance the efficiency of employer-sponsored healthcare plans. HMS focuses on:

• Reducing High-Frequency, Low-Severity Claims: Services such as primary care visits, urgent care, and generic prescriptions are redirected to the HMS, preventing claims from impacting the primary health plan.
• Addressing Chronic Conditions: Approximately 80% of all healthcare spending in the U.S. that's over $2 trillion annually—is tied to chronic illnesses. HMS helps identify risks early, encourages preventive care, and minimizes long-term costs.
• Improving Transparency: Through advanced analytics, HMS provides real-time visibility into claims trends, cost-saving opportunities, and plan performance.

By acting as a first line of defense, HMS ensures that routine healthcare needs are managed efficiently, keeping the primary plan reserved for major medical expenses. 

Financial Impact on Employers and Employees

For Employers: 

• Cost Savings Through Payroll Taxes: HMS is funded through pre-tax employee contributions under a Section 125 arrangement. Depending on how the HMS is structured, employers will generally realize net payroll savings of approximately $573.60 per employee annually.
• Reduced Claims Utilization: Routine care and preventive services managed through the HMS lower claims on the primary plan, leading to:
  • Lower Premium Increases for traditional plans.
  • Greater Surplus Refunds for level-funded plans.
• Improved Renewal Rates: Reduced claims activity contributes to better renewal terms year over year.

For Employees:

• Tax Savings: Depending on      their individual tax circumstances. Employees save an average of $125 per month, or $1,500 annually, in income taxes through pre-tax contributions. About 90% of participants realize a net increase in take      home pay. 
• Affordable Access to Care: Health Management Systems provide cost-effective access to essential healthcare services, including:
  • Primary care visits
  • Urgent care visits
  • Generic prescriptions
  • Preventive screenings and telemedicine services.
• Healthier Outcomes: By identifying health risks early, employees can proactively address potential chronic conditions, leading to improved well-being.
• Technology-Driven Healthcare Management: Advances in technology, including AI-powered analysis and real-time      health tracking tools, allow employees to take control of their overall healthcare more efficiently. HMS systems provide:
  • Personalized Healthcare Recommendations: AI-driven analytics assess health trends and suggest tailored preventive actions or treatments.
  • Real-Time Tracking: Digital health portals and mobile apps help employees monitor appointments, prescriptions, and overall wellness goals.
  • Proactive Alerts: Automated reminders for preventive screenings, routine care, and prescription refills ensure employees stay engaged in their healthcare.

By leveraging these tools, employees gain increased control, visibility, and convenience in managing their healthcare, resulting in improved outcomes and a healthier lifestyle.

Enhancing Traditional Fully Insured Plans

For employers using traditional fully insured health plans, HMS offers a targeted solution to address rising premiums:

• Cost Containment: HMS redirects high-frequency claims to its program preventing unnecessary claims against the fully insured plan.
• Improved Transparency: Employers gain access to detailed claims data and actionable insights to address cost drivers and improve outcomes.
• Increased Employee Satisfaction: Telehealth platforms, wellness tools, and streamlined care management make it easier for employees to access and engage with their healthcare benefits.

Maximizing Level-Funded Plans 

Level-funded health plans already provide employers with cost predictability, transparency, and the potential for surplus refunds. Incorporating HMS enhances these benefits by:

• Lowering Claims Costs: By covering routine healthcare services outside the primary plan, HMS minimizes claims utilization, increasing the likelihood of surplus refunds.
• Improving Cost Stability: Lower claims ensure that renewal rates remain favorable, supporting long-term budget predictability. 
• Promoting Preventive Care: HMS encourages early intervention, helping employees manage health risks before they escalate into costly chronic conditions.

 A Win-Win Solution for Businesses

Healthcare Management Systems provide a strategic advantage for businesses, whether they use fully insured or level-funded health plans:

1. Cost Control: HMS reduces claims utilization, lowering costs for both employers and employees.
2. Improved Transparency: Advanced analytics deliver clear insights into claims data and savings opportunities.
3. Enhanced Employee Health: Preventive care and routine services help employees stay healthy, reducing the need for expensive treatments.
4. Technology and AI Integration: HMS uses cutting-edge tools like real-time tracking, AI-based healthcare recommendations, and proactive alerts to empower employees to manage their health more effectively.
5. No Net Cost to Employers or Employees: Payroll tax savings and pre-tax employee contributions fully offset the program’s costs, resulting in a net financial gain for employers of $573.60 per employee and, depending on their specific tax situation, employees will recognize an increase in net take home pay of $125.00 mo. on average  

  Conclusion

Integrating a Healthcare Management System into your benefits program is a smart, sustainable strategy that provides measurable value. By reducing claims costs, improving preventive care, and leveraging tax savings, HMS enhances both traditional fully insured plans and level-funded health plans. The result is a solution that:

• Controls rising healthcare expenses.
• Supports healthier, more engaged employees.
• Delivers financial stability and savings to employers.

With advanced technology, AI-powered tools, and real-time health management capabilities, Healthcare Management Systems represent a clear path for businesses to optimize their healthcare strategies while fostering a healthier, more productive workforce.

The CHAMP Plan: A Smarter Solution for Employee Healthcare

At Prospera Consultants, we recognize the challenges businesses face in providing affordable, meaningful healthcare benefits. That’s why we partner with Champion Health, Inc. and their innovative CHAMP Plan™—a Healthcare Management System (HMS) that integrates seamlessly with any health plan—fully insured, level-funded, or self-funded. Designed to reduce costs, improve health outcomes, and comply with Affordable Care Act (ACA) requirements, the CHAMP Plan™ is trusted by some of the most recognized businesses in America, including Amazon, ADP, Allstate, Harley-Davidson Manufacturing, and more.

Why Choose the CHAMP Plan™?

1. ACA Compliance
   • The CHAMP Plan™ is structured to meet the Affordable Care Act’s Minimal Essential Coverage (MEC) requirements, ensuring compliance while offering meaningful healthcare solutions.

1. Proven Financial Benefits
   • Employers save an average of $573.60 per employee annually in payroll taxes (net of administration costs).
   • Employees save approximately $125 per month, or $1,500 annually, through pre-tax contributions.

1. Lower Healthcare Costs
   • The CHAMP Plan™ reduces claims on the primary health plan by covering routine services like:
     • Primary care and urgent care visits
     • Generic prescriptions
     • Preventive care services
   • This redirection lowers renewal premiums for fully insured plans and increases surplus refunds for level-funded plans.

1. Proactive Health Management
   • By focusing on early detection and preventive care, the CHAMP Plan™ helps reduce the burden of chronic conditions, which account for 80% of U.S. healthcare spending.

1. Technology-Driven Innovation
   • AI-powered tools provide personalized healthcare recommendations.
   • Mobile platforms enable employees to track appointments and manage care seamlessly.
   • Real-time analytics offer employers insights into claims trends and cost-saving opportunities.

o Ease of Implementation - The CHAMP Plan™ is designed for effortless integration with existing health plans. Champion Health handles the heavy lifting, making onboarding simple and seamless. The System is quickly set up with basic employee information provided by the employer.

          o Businesses experience immediate savings and improved employee satisfaction with minimal administrative effort required.

          o At Prospera Consultants, we ensure the transition is smooth, enabling businesses to see results without disruption.

A Trusted Solution for Businesses

The CHAMP Plan™ combines cost savings, proactive health management, ACA compliance, and advanced technology to optimize healthcare strategies. Its trust among leading corporations like Amazon, ADP, and Allstate highlights its credibility and effectiveness. Employers benefit from reduced expenses and improved plan performance, while employees enjoy affordable, accessible care and meaningful tax savings.

By partnering with Champion Health, Prospera Consultants delivers an innovative, flexible, and sustainable solution that empowers businesses and their workforces. Whether enhancing a traditional, level-funded, or self-funded plan, the CHAMP Plan™ provides a smarter, compliant, and cost-effective way forward.