5 Steps to a Better Health Care Plan


By Donnie Marcontell

Crises remind us of the important purpose those in the trucking industry serve. During COVID-19, it’s delivering personal protective equipment, medical supplies, and hand sanitizer. After 9/11, it was mail when the US Postal Service decided it wanted to ship by ground rather than air.

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In 2001, Bancroft and Sons Transportation LLC, a Fort Worth and Arlington, Texas-based federal motor carrier, answered this call by shifting its entire fleet to carry mail instead of commercial products. Six years later, it had 130 trucks moving mail all across the country, and now nearly 20 years later, Bancroft’s business still booms.

In 2017, the company decided to make bold changes to the health plan they offered employees, which is one of the reasons they’ve been able to navigate changing business conditions. Bancroft and Sons had a higher turnover rate and often struggled to attract and retain qualified drivers. This was partly due to providing a traditional, yet expensive health benefits plan, which rendered minimal control of annual rising costs.

Bancroft and Sons now offers a higher-quality, lower-cost health plan to employees, which has resulted in lower turnover. After the first year, the company lowered costs by $300,000, was able to cut deductibles in half, and slashed their drivers’ premium contributions by 40%.

So, how did Bancroft and Sons do it? And more importantly, how can other trucking companies do the same? It starts with following these five steps from Dave Chase, CEO and co-founder of Health Rosetta, an organization that aims to accelerate the adoption of simple, practical, nonpartisan fixes to the US health care system.


The status quo approach to health benefits is to provide a health plan via a brand name insurance carrier. These are quality carriers with good intentions, but they often have misaligned financial incentives due to market dynamics. A better approach for many employers is to use a self-insured health plan. When properly structured, self-insured plans provide a better opportunity to control costs, while still protecting the employer’s liability. Moving to a self-insured health plan was the first fundamental change Bancroft and Sons made.


The next step was to partner with an experienced benefits advisor. It is critical for leaders to understand that they don’t have to go it alone. There are benefits advisors willing to work transparently, plus partner the client alongside carrier-independent third-party administrators (TPAs) and other vendors with aligned financial interests.


Many pharmacy benefit managers (PBMs) are well known for hidden fees, shell-game pricing, and taking drug manufacturers’ money to promote specific drugs. Business owners can gain more value and savings by partnering with a transparent PBM. A transparent PBM returns 100% of manufacturer rebates to the employer, contractually agrees the employer owns their claims data, and is most effective at managing drug costs and quality.


Primary care providers are the bedrock of the highest-functioning health systems. But, in the current high-volume, fee-for-service reimbursement model, providers are stressed and find it difficult to properly diagnose patients.

Therefore, the best investment an employer can make is to provide employees access to Direct Primary Care (DPC) providers. DPC practices are paid based on their quality of care, have a much lower volume of patients, and are thus able to better diagnose the physical and emotional needs of patients.

For truck drivers who spend long hours sitting down and are often eating at greasy spoons, a value-based primary care model like DPC can reduce downstream costs in the form of fewer long-term medical conditions like heart problems or chronic back pain. Most importantly, it’s better for the health and well-being of employees.


The initial idea behind PPO networks was to trade guaranteed patient volume for lower costs using a smaller network. After many years, that’s no longer the case. Major carrier networks are great at selling their “discounts,” particularly for hospital charges, but these “discounts” are often 250 to 500% higher when benchmarked against what Medicare pays.

Bancroft and Sons decided to rent a PPO network for physicians and ancillary providers only and use reference-based pricing and direct bundled contracts to pay a fair price to hospitals and facilities. Reference-based pricing pays hospitals a fair percentage more than Medicare, but often significantly less than PPO network rates.

Thanks to following these five steps, Bancroft and Sons was able to save money, better recruit and retain talent, and recently reach a monumental step in the family-owned business’ history: Its 50th anniversary. There’s nothing stopping other trucking companies from soon experiencing the same success.


Donnie Marcontell is senior client executive at One Digital where he builds health plans using the principles of Health Rosetta, an open-source blueprint for better benefits. Find out more, visit

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