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Case Study · Healthcare Staffing · Locum Tenens

A Locum-Staffing Firm Built a Full Benefits Program From Scratch — and Bid the Ancillary Down ~22%

TL;DR
Ancillary RFP
~22%
Dental + vision: $55,307 → $43,302 (Equitable), bid across 5 carriers
Medical
Self-funded
A self-funded group health plan, built new
Structure
W-2 + H&W
1099→W-2 with an hourly health-and-welfare allowance

Company Profile: A multi-state locum-tenens staffing company (roughly 50 benefit-eligible lives) that was moving clinicians from 1099 to W-2 and needed a real employee benefits program built from the ground up. (Client name withheld; the figures below are real, drawn from the carrier proposals and the RFP Benefitra ran.)

The situation: a staffing firm going W-2, with no benefits program to inherit

Converting a contractor workforce to W-2 is the right long-term move for a staffing company — but it means standing up an entire benefits program where there wasn’t one. No incumbent plan to renew, no prior carrier relationships, just a multi-state census of clinicians and a need to offer competitive coverage that helps recruit and retain them without blowing up labor cost.

The firm needed three things at once: a medical plan that fit a growing, claims-unpredictable group; an ancillary suite (dental, vision and more) priced sharply; and a way to fund it that worked with how staffing companies actually pay people — by the hour.

The work: self-funded medical, an hourly H&W allowance, and a competitively-bid ancillary suite

Benefitra built the program in three parts:

  • A self-funded group medical plan — the right structure for a growing staffing group, giving the firm transparency and control instead of a take-it-or-leave-it fully-insured renewal
  • An hourly health-and-welfare (H&W) allowance — an amount set aside per clinician for each hour worked toward benefits, the way staffing firms fund coverage for an hourly workforce
  • A dental & vision suite put out to bid — an RFP across five carriers (the incumbent plus MetLife, Equitable, Reliance Matrix and Guardian) so the ancillary lines were competitively bid, not defaulted. The firm selected Equitable.

The result: the ancillary suite, bid down ~22%

Running dental and vision as a competitive RFP — instead of renewing the incumbent — is where the documented dollars showed up. The firm placed the suite with Equitable:

Incumbent (current) Selected — Equitable
Dental (annual)$48,050$36,869 (~23% lower)
Dental + vision (annual)$55,307$43,302
Annual ancillary saved~$12,005 (~22%)

Figures from the five-carrier ancillary proposal summary; the firm placed the suite with Equitable. The medical plan was built self-funded as a from-scratch program, so it has no prior-carrier savings figure — the documented dollar result here is the competitively-bid ancillary suite.

Why this structure fits locum staffing

Default to a fully-insured package off one carrier

Fast, but it leaves money on the table: ancillary lines get renewed instead of bid, and a fully-insured medical plan gives a growing group no transparency into its own claims.

✗ Convenient, not optimized

Self-funded medical + H&W allowance + bid-out ancillary

A program built around how a staffing firm actually operates:

  • Self-funded medical for transparency and control as the group grows
  • An hourly H&W allowance set aside toward benefits, sized to an hourly workforce
  • Ancillary bid across five carriers, placed with Equitable — ~22% / ~$12K saved vs renewing the incumbent
✓ Selected

The honest trade-offs

Self-funding puts a growing group closer to its own claims — more transparency and upside in good years, more exposure in bad ones, which is why it’s paired with stop-loss protection and suits a firm that wants control rather than a hands-off plan. The hourly H&W model takes more administrative coordination than cutting one premium check. And because this was a brand-new program, the headline dollar result is the ancillary RFP, not a medical “savings vs last year” — there was no last year. What the firm got is a complete, competitively-built program from a standing start, with every line earned rather than defaulted.

Outcome: a complete benefits program, built and bid from zero

The staffing firm went from no benefits program to a full one: a self-funded medical plan sized for a growing group, an hourly H&W allowance to fund coverage for an hourly workforce, and a dental/vision suite placed with Equitable that came in about 22% (~$12K) cheaper than the incumbent because it was put out to bid. For a company converting clinicians to W-2, that’s the difference between “we offer benefits” and “we offer benefits worth leaving your old arrangement for.”

Built from scratch · self-funded medical · ~22% off ancillary, placed with Equitable

The lesson a staffing CFO takes from this: the ancillary lines everyone renews on autopilot are worth bidding — here it was ~$12,000 a year, found simply by making five carriers compete.

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What other employers can take from this

This case shows the value of building a benefits program deliberately and using competition to price it. Starting from scratch, the firm designed a self-funded medical plan and put its ancillary lines out to bid, using an RFP to drive down cost.

Other employers can apply both moves: design the program intentionally rather than inheriting one, and competitively bid the ancillary lines instead of renewing them on autopilot.

When this approach tends to fit:

For broader context on employer benefits, see the IRS rules on Section 125 plans.

To explore the same approach for your own numbers, try the Benefits Savings Strategy Builder or the Benefits ROI Calculator.

Frequently asked questions

Why put ancillary benefits out to RFP?

Because competition tends to lower price. Ancillary lines renewed on autopilot often cost more than a bid process would.

Is self-funding only for large groups?

Not necessarily. With the right structure and stop-loss protection, mid-size employers can self-fund. Modeling shows whether it fits.

Where do I start?

Map your current spend and design, then identify which lines to bid and whether funding changes help.

Reviewed by Sam Newland, CFP, Founder of Benefitra. Last updated June 2026.