Case Study · Individuals & Families
The Rodriguez Family
Carlos (41), independent contractor. Maria (38), part-time worker. Two kids, ages 8 and 11. Buying ACA marketplace coverage on their own.
Before OptimalMD — Annual Healthcare Reality
ACA Silver plan premium (after subsidy)$13,680/yr
Family deductible — paid most care out-of-pocket$6,000
Carlos's urgent care — 2x sinus infections$580
Maria's thyroid medication (generic)$564/yr
Kids' annual physicals through insurance$380
Maria's therapy — 3 sessions before stopping due to cost$450
Total annual spend (before)
$15,654
After OptimalMD Prime — Same Family
OptimalMD Prime Family — all 4 covered$1,788/yr
Carlos's urgent care — unlimited virtual$0
Maria's thyroid medication — on $0 generic list$0
Kids' annual physicals — virtual primary care$0
Maria resumes weekly therapy — unlimited included$0
GLP-1 for Carlos (lost 30 lbs) — no pre-diabetic codeIncluded
Total annual spend (after)
$1,788
Annual savings
saved in year one · $69,330+ over 5 years
$13,866
Case Study · Individuals & Families
The Williams Family
David (55) has high blood pressure and high cholesterol. Linda (52) manages type 2 diabetes with metformin. Family HDHP through David's employer at $1,800/month.
Their Annual Healthcare Reality
Family HDHP premium$21,600/yr
David's lisinopril + atorvastatin$888/yr
Linda's metformin + insulin + supplies$2,640/yr
4 primary care visits for medication management$800
Annual labs (out-of-pocket)$480
Total annual spend (before)
$26,408
After OptimalMD Prime + Impact Health Sharing
OptimalMD Prime Family$1,788/yr
Lisinopril + atorvastatin — on $0 generic list$0 (saves $888)
Metformin — on $0 generic list$0
Insulin + supplies — dramatically reduced via OptimalRxReduced
All doctor visits and labs$0
Impact Health Sharing for major medical~$650/mo vs. $1,800
Total annual spend (after)
~$9,588
Annual savings
estimated annual savings
$16,820
Case Study · Individuals & Families
Jennifer M.
Single professional, 34, marketing at $72,000/year. Employer-sponsored HDHP with $2,500 deductible — paying $487/month out of her own paycheck.
Her Annual Healthcare Reality
Monthly premium (employee share)$5,844/yr
Two doctor visits — $185 each out-of-pocket$370
Antidepressant (generic) at $28/month$336/yr
Dermatology visit (mole check)$320
Therapy — wanted but could not afford $150/sessionSkipped
GLP-1 — doctor requires a pre-diabetic codeAvoided
Total annual spend (before)
$6,870
After Adding OptimalMD at $99/Month
Keeps employer plan for catastrophic coverage onlyRetained
All routine visits through OptimalMD$0
Therapy — going weekly, fully private$0
Antidepressant through OptimalMD$0
GLP-1 — NO pre-diabetic code, NO MIB report$0 code risk
Lost 24 lbs · blood pressure normalized✓ Health outcome
Life insurance — standard rate, no metabolic flags-$340/yr saved
Total annual spend (after)
$1,188
Annual savings
annual avoided costs + life insurance savings
$2,400+
The GLP-1 privacy protection alone — by avoiding a pre-diabetic code — saves Jennifer up to $10,750 in excess life insurance premiums over a 25-year term policy.
Employer · Logistics
Regional Logistics Company — 45 Employees
45-employee owner-operated trucking company. Annual renewal arrived — 11% increase
on top of $206,400/year. Owner was weeks from dropping coverage entirely.
The Situation Before OptimalMD
After Implementing OptimalMD Prime + Impact Health Sharing
Group health insurance
$206,400/yr
11% renewal increase proposed
+$22,704/yr
New plan: $5,000 individual deductible — employees furious
Morale crisis
Drivers quit in past year citing benefits frustration
3 drivers lost
Turnover replacement cost per driver
$12–18K each
Total annual spend (before)
$206,400/yr
After Implementing OptimalMD Prime + Impact Health Sharing
OptimalMD Prime Family for all 45 employees
$80,460/yr
Impact Health Sharing for major medical
~$102,000/yr
Total new annual benefit cost
$182,460
Direct annual savings vs. previous plan
$23,940
Avoided 11% renewal increase
+$22,680 saved
Turnover in 12 months post-switch
0 turnover
Avoided 2 potential turnover events
$24–36K saved
Total annual spend (after)
$182,460/yr
First-year total financial impact
direct savings + avoided increase + turnover prevention
$82,620
Employer · Tech
Series A SaaS Company — 18 Employees, Competing for Talent
A Series A SaaS company losing engineering candidates to larger competitors — while
spending $170,400/year on a plan their own team called "bare minimum."
The Competitive Positioning Problem
After Redesigning Benefits Around OptimalMD Prime
Basic group health plan
$170,400/yr
Plan perceived by candidates as "bare minimum"
Talent risk
Engineers citing better benefits elsewhere
Losing deals
Promising hires who declined — citing better benefits
2 lost hires
Engineers with families — can't afford dependent add-on
Excluded
Total annual spend (before)
$170,400/yr
After Redesigning Benefits Around OptimalMD Prime
OptimalMD Prime FAMILY plan — all dependents covered
$32,184/yr
Impact Health Sharing for major medical
~$40,800/yr
Total new benefit cost
$72,984/yr
Annual savings vs. previous plan
$97,416/yr
Candidates who previously declined — now accepted
2 engineers hired
Total annual spend (after)
$72,984/yr
Annual savings + 2 top engineers hired
benefits became a competitive weapon vs. FAANG-adjacent competitors
$97,416
The talent narrative became a competitive weapon. Offering "$0 doctor visits for your whole family"
proved more compelling than the old HDHP — even against FAANG-adjacent competitors.
real stories
Real people. Real Savings.
No projections. No estimates. Just numbers from real members — because the proof is in the savings, not the pitch.
Filter:
Individuals & Families
The Rodriguez Family — Gig Economy Family of Four
Carlos and Maria were paying $13,680/year for ACA coverage they could barely afford to use — plus hundreds more on medications and therapy that stopped due to cost.
$13,866
saved in year one
Read story →
Individuals & Families
Jennifer M. — Single Professional on HDHP
Paying $487/month in premiums but couldn't afford therapy or a GLP-1 — because a pre-diabetic code would follow her for decades.
$2,400+
annual avoided costs + insurance savings
Read story →
Individuals & Families
The Williams Family — Chronic Condition Management
David has high blood pressure and high cholesterol. Linda manages type 2 diabetes. Together they were spending $26,408/year and still paying full price on every medication.
$16,820
estimated annual savings
Read story →
Employee
Marcus — The Employee Who Stopped Avoiding Care
A warehouse supervisor skipping blood pressure follow-ups, canceling his son's ADHD therapy, and hiding anxiety attacks — all because of cost and record concerns.
$4,200+
annual out-of-pocket savings
Read story →
Employee
Priya — The GLP-1 Story That Changes Everything
Wanted a GLP-1 for weight management. Her insurance route required a pre-diabetic code — on a blood sugar of 99. That code would have cost her $10,750 in life insurance premiums.
$10,750
avoided excess life insurance premiums
Read story →
Employer
Regional Logistics Company — 45 Employees
Paying $206,400/year for group insurance. Just received an 11% renewal increase. Three drivers had already quit over benefits. They were weeks from dropping coverage entirely.
$82,620
first-year total financial impact
Read story →
Employer
Growing Tech Startup — 18 Employees, Competing for Talent
A Series A SaaS company losing engineering candidates to larger competitors — while spending $170,400/year on a plan their own team called "bare minimum."
$97,416
annual savings + 2 top engineers hired
Read story →
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