Employers are done being price-takers.
Rising premiums, opaque billing, and employee frustration have turned traditional group insurance into an annual pain ritual. But a few companies in San Antonio are proving there’s another way — one that gives employees real access while restoring financial control to the employer.

The Challenge: A Construction Firm Rebuils Its Benefits

T&D Moravitz, a 140-employee construction company, decided to unbundle its health plan. Instead of paying escalating premiums, they partnered with:

  • Direct Med Clinic for Direct Primary Care (DPC) — unlimited same-day visits, 24/7 text access, and in-house pharmacy at no cost to employees.
  • Altique Consulting to design a self-funded plan using independent TPAs, stop-loss protection, and a single-parent captive.

The company didn’t chase a discount. It rebuilt the system.

Why It Worked

1. Direct Primary Care became the front door

Employees contact Direct Med first — by text or same-day visit — for 80–90% of issues. That one step cut urgent-care visits and ER misuse dramatically.

“Open your phone, send a text 24/7. You get your doctor, not a stranger,” says CEO Bill Roberts from T&D Moravitz.

2. Zero-dollar care for most needs

Every visit routed through DPC costs employees $0. Routine labs and imaging now cost less than old copays, with pricing negotiated at true cost — not insurance markup.

3. Transparent self-funding, not blind risk

Instead of paying a carrier’s pooled premium, T&D Moravitz now sees its own claims data (HIPAA-compliant aggregate reports). Stop-loss coverage and the captive structure protect against high-cost shocks — while removing the insurer’s profit motive.

4. Pharmacy savings unlocked

Through transparent sourcing, prescriptions that once billed at $4,000 now cost about $100 — same drug, same dosage.
Employers nationwide are finding similar savings once they bypass opaque Pharmacy Benefit Manager markups (as discussed in Glasp insights on PBM transparency).

5. Culture shift: from frustration to trust

When employees stopped battling carriers, morale shifted. Healthcare stopped being a complaint category and started being a recruiting advantage.

For Employers: How to Replicate the Model

  1. Anchor care in DPC. Choose a clinic that offers unlimited visits, direct messaging, and same-day appointments.
  2. Unbundle your plan. Work with an independent consultant to combine DPC + stop-loss + TPA + pharmacy vendor into one transparent structure.
  3. Reprice prescriptions first. It’s the fastest win and the biggest hidden cost.
  4. Educate staff. “First call Direct Med” becomes company policy — rewarded with $0 care.
  5. Measure monthly. Use claims dashboards and pharmacy variance reports to track real cost containment.

The Business Case

MetricTraditional InsuranceDirect Primary Care + Self-Funding
Renewal trend+15–20% annuallyFlat or ↓ in year 1
Employee complaintsConstantNear zero
Access to careDelayed / outsourcedSame day / text-based
Data transparencyHiddenFull (aggregate reporting)
Local economic impactDollars leave regionDollars stay in community

Local Impact: Keeping Dollars in San Antonio

By sourcing care and pharmacy locally, these employers keep healthcare dollars circulating in the same community that earned them. That’s not just cost control — it’s local economic leverage.

The Core Lesson

When employers own their benefits, they stop renting someone else’s plan.
Transparency replaces frustration. Access replaces bureaucracy.
And the business becomes a better place to work.

→ Watch the full discussion: Own Your Benefits on YouTube

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