PGP/Archon and Budgie Health partner to give employees never-before-seen, real-time access to claims data

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May 07, 2024, 10:48 ET

One of the world's largest General Agencies pilots cutting-edge technology to reduce $150B waste, increase transparency, and matchmake policies

NEW YORK, May 7, 2024 /PRNewswire/ -- Professional Group Plans (PGP), the largest full-service agency in the tri-state area, along with Archon, today announces its strategic partnership with Budgie Health, a revolutionary benefits analytics platform that translates complex healthcare data into simple financial and utilization experiences so that people can get the care they need while saving time and money. This collaboration marks a significant step toward mutual benefits: offering solutions to streamline employer benefits costs while optimizing healthcare choices and enhancing service delivery for patients. On average, employees and their families save $1,200 annually using this tool.

Through this partnership, Budgie Health will be seamlessly integrated into PGP's suite of offerings, instantly bringing potential service availability to more than 60,000 employer groups. Employers within the PGP network have the option to leverage Budgie's unique, budget-friendly technology to empower benefits decision-making by providing real-time access and analysis of individual claims data. With Budgie as their partner, employers within the PGP and Archon network can offer employees personalized recommendations and adjust their utilization and plan choices.

"Health insurance is confusing and difficult to navigate during open enrollment and throughout the year. But, with partners like Budgie, employees can better understand their choices. It helps them decide on the best plan for their needs using their claims history and helps them with providers and prescription choices, which ultimately saves them time and money while keeping costs properly aligned for employers."

Kerry Phelan, CEO of PGP

The Technology Behind Budgie

Budgie Health is an early-stage start-up based out of New York City. Budgie is the first Decision Engine that uses real-time access to health claims data, empowering brokers with data-driven, tailored plan recommendations and offering employees the opportunity to make better enrollment, spending, and utilization decisions. Unlike other solutions that require employees to answer lengthy questionnaires or manually make plan adjustments, Budgie Health utilizes actual claims history to support decision-making during Open Enrollment and beyond.

Budgie is also piloting AI-driven features, LLMs, and machine learning capabilities including complicated scenario modeling and real-time decision support.

"Our mission is to take the financial stress out of healthcare. We do that by providing clarity and confidence to make the right decisions. We're proud that PGP - one of the largest general agents in the world - is an early adopter of this industry-changing technology."

George Spurling, Co-Founder and CEO of Budgie Health

Industry Impact

Each year, $150B is lost in healthcare costs due to selection mismanagement regarding benefits and utilization. This collaboration between PGP, Archon, and Budgie Health represents a pivotal advancement in making healthcare more comprehensible. By partnering, they are pushing the boundaries of the traditional health insurance landscape, offering an innovative solution for healthcare optimization, cost containment, and policy management.

Budgie Health utilizes the capabilities only recently enabled by the CMS Interoperability and Patient Access Final Rule (CMS-9115-F.) By pioneering advanced analysis and real-time access to user-level claims to optimize healthcare decisions, Budgie is setting a new standard for employee benefits programs.

About Budgie Health

Budgie Health guides employees to the right benefits decisions at enrollment and throughout the year, generating savings for employers and employees. Budgie's personalized recommendations are driven by real-time claims analytics, to create more employee trust and less effort for benefits teams. The underlying engine can then help confidently optimize plan designs by assessing the employee-level financial impact of endless scenarios.

https://www.budgie-health.com/

SOURCE Budgie Health Inc.