Company Overview Enstrom Candies is a renowned, family-owned toffee maker based in Grand Junction, Colorado. With over 60 years of tradition and three generations of family leadership, Enstrom Candies has grown to include multiple locations across Colorado while shipping its premium confectionery products nationwide.
Challenge: Managing Rising Healthcare Costs A client since 2014, Enstrom Candies sought an innovative approach to control rising healthcare costs without compromising employee benefits. As a pioneer on the Western Slope, they implemented Reference-Based Pricing (RBP) in their health plan and quickly realized substantial financial savings.
Solution: Reference-Based Pricing & Direct Contracts Due to local physicians’ non-recognition of traditional PPO networks, Enstrom Candies played a key role in establishing direct contracts in Mesa County through a newly formed entity—the Employer Health Alliance (EHA). EHA facilitated direct contracts with physicians and hospitals using a Cost Plus or Medicare Plus pricing model. While physicians readily accepted, hospital contracts proved less favorable for Enstrom Candies and other EHA employers. Consequently, Enstrom Candies continues to utilize RBP for facilities and direct contracts for physician services.
Impact & Employee Benefits The adoption of RBP has significantly benefited Enstrom Candies and its employees. Since 2015, they have:
- Maintained stable employee contributions
- Avoided increases in deductibles and out-of-pocket expenses
- Conducted extensive communication and education on provider charges, balance bills, prescription drug costs, and specialty medications
Additionally, Enstrom Candies introduced Direct Primary Care (DPC) through a local provider five years ago, which has been widely used and highly valued by employees.
Additional Healthcare Initiatives Since 2014:
- Independent Third-Party Administration (TPA)
- Independent Stop Loss Coverage
- Independent Pharmacy Benefit Manager (PBM)
- Accessible, detailed monthly claims data through the TPA and RBP vendor
- Data Analytics
- Specialty Drug Carveout Program
- Comprehensive Wellness Program
- Employee and Employer Portal
- Guidance from a Trusted Advisor 😊
Financial Results: Per Employee Per Year (PEPY) Costs
| Year | PEPY Cost |
| 2018-19 | $6,564 |
| 2019-20 | $4,799 |
| 2020-21 | $9,289 |
| 2021-22 | $9,578 |
| 2022-23 | $7,279 |
| 2023-24 | $6,133 |
| 2024-25 | $6,651 (Annualized YTD) |
Conclusion Enstrom Candies’ forward-thinking approach to healthcare cost management has yielded remarkable results. Through RBP, direct contracting, and strategic benefits management, they have maintained affordable healthcare for employees while achieving significant cost savings. Their success serves as a model for other employers seeking to navigate the evolving healthcare landscape with innovative, employee-focused solutions.
