Danielle Boyle, senior vice president at Brown & Brown Insurance Services, introduced Claimdoc’s proposal to the St. Cloud City Council on Thursday, saying the approach could lower the city’s medical-claims spending without reducing employee benefits.

Omar Arif, senior vice president of growth for Claimdoc, described the company’s reference-based pricing model as an alternative to traditional managed-care networks. “The only way we can audit and reprice hospital claims is if you remove the managed care network that you use today,” Arif said, explaining Claimdoc’s method of setting allowed amounts using Medicare-plus-a-markup or facility-reported cost plus a markup. He and other presenters estimated typical plan savings in the 25–35% range and said their September analysis projected roughly $2,100,000 in first-year savings for St. Cloud.

Michelle Heneman, who handles member implementation and retention at Claimdoc, told council members the vendor assigns a dedicated member advocate to help employees nominate providers, coordinate outreach to physician offices and perform bill review and balance-bill defense. Heneman said the member-advocate process resolves most provider questions before an appointment and that the company opens a portal where employees can check whether their providers already accept Claimdoc.

Council members asked about implementation burdens, provider acceptance (particularly for specialty and women’s health care), and how the city would protect employees during any transition. Deputy Mayor Gilbert and others pressed for concrete, itemized comparisons of current costs versus projected savings. Omar Arif acknowledged implementation would require heavy outreach and education and said vendors would provide more detailed financial modeling if the council directed staff to proceed.

After discussion about dual-option mechanics (keeping a PPO choice for employees who need it) and the scale of vendor support, council members signaled consensus to move to the next procurement step. City staff was directed to prepare an RFP or include reference-based pricing as a procurement option so the council can review detailed proposals and financial analyses before any contract decision.

Next steps: staff will draft procurement language and return to council with modeled savings, implementation timelines and recommended plan design options ahead of any final commitment.