MGA Homecare is a leading provider of community-focused care that empowers individuals and their support systems to thrive independently in their homes. Its team of nurses, therapists, and caregivers serve over 5,000 patients per day across Arizona, Colorado, North Carolina, Tennessee, Texas, and Washington.
The Challenge
MGA Homecare faced a dual crisis with its self-funded group health plan. The financial pressure was mounting year after year, while simultaneously failing to meet the diverse needs of its geographically dispersed workforce.
From 2023 to 2024, MGA had to increase its benefits budget by 8%. Looking ahead to 2025, their consultant at Marsh McLennan Agency (MMA) projected another 10% increase based on claims experience.
"The cost increases were not sustainable for us to continue to absorb, let alone pass on to our employees," says Britta Emenecker, MGA’s Vice President of People Experience. “Every dollar diverted to insurance increases also meant fewer resources for patient care and service expansion, which threatened our core mission.”
Beyond the cost crisis, participation hovered around 23%, and many enrolled employees weren't satisfied.
For Dan Burton, consultant at MMA, the situation was clear: "They were facing unsustainable increases. The traditional model was breaking down both financially and in terms of employee satisfaction."
The Solution
In summer 2024, MGA Homecare decided to implement an ICHRA with SureCo for the 2025 plan year. Several competitors had switched, and back-of-the-napkin math showed a 20% savings, says Burton.
"It started out as a mechanism to explore financial gains so we could reinvest into our benefits," Emenecker explains. "However, the power of choice ICHRA offers quickly took the front seat."
Michael Vuoto, account executive at MMA, emphasizes that success requires total alignment. "For an ICHRA rollout to be successful, the broker, the administrator, and the client all need to be in lockstep communicating, cooperating, getting along," he says. "Truly everyone needs to buy into this."
The implementation had a learning curve. The compressed timeline and unique nature of home healthcare workers made traditional communication methods less effective. To address this, SureCo and MMA partnered to provide recorded trainings during Open Enrollment, and MGA conducted a "roadshow" for continued ICHRA education.
"What a dream team," says Emenecker. "I tell employees to look at SureCo like an extension of our benefits team because they are the experts for your medical insurance."
Burton adds: "You need all three—a good broker, a good administrator like SureCo, and a committed client. When one of those is a challenge, it creates a ripple effect."
The Employee Support
The Results
MGA saved $1.27M—an 11.7% reduction in medical spend versus current, and nearly $2.5M versus renewal. Enrollment also increased by over 30%, bringing MGA 's total participation rate to ~40% .
Success continued in year two. Enrollment increased 6%, and MGA's PEPY remained 17-26% below what it would have faced on group.
"The second year is easier," Emenecker confirms. "Employees learned year over year. Some of it was lived experience—employees who had poor experiences with certain carriers simply chose different options."
For Burton, the migration has been a success story worth replicating. "I love the concept of ICHRA," he says. “A lot of people think it's a small group play, but it works for large companies with the right partner like SureCo and the right advisor."
Vuoto adds, "The SureCo team has been incredibly responsive and dedicated. They've been doing anything they can to work with the MGA team to solve problems."
Looking forward, Emenecker sees ICHRA as the future of employee benefits. "ICHRA gives employees options, and they get to be their own advocate when it comes to the providers, facilities, and coverages that matter to them and their families," she says. "They can be an active, educated consumer. That's a better way to live."
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