Case study: Nonprofit uses cost strategies to improve employee health— and its bottom line
Children’s Friend, a nonprofit, switched to a self-funded plan with the aim of combatting rising costs, gaining flexibility and improving health outcomes.
Based on a case study completed in 2023. Updated in October 2025.
Building healthier together
Caring for employees like family
As Rhode Island’s oldest child welfare organization, Children’s Friend has a long‑standing legacy of supporting the state’s most vulnerable children — those facing abuse, neglect, poverty and instability, which represent 90% of the population they serve. That deep commitment to care extends to their employees, too.
“We believe kids grow and develop best when they’re in a strong and stable family,” says President and CEO David Caprio. “We try to recreate that strong family environment for our employees here at Children’s Friend.”
As a human services nonprofit, Caprio says that people are both its biggest asset and biggest expense: 75% of the Children’s Friend budget goes to salaries and benefits.
Despite economic pressures facing employers, Children’s Friend has remained committed to maintaining the quality of its health benefits without shifting costs to employees. Instead, by partnering with their broker and UnitedHealthcare, they’ve implemented more effective benefit strategies.
Taking a strategic approach
To help control rising health care costs, in 2016, Children’s Friend switched from a fully insured health plan to a UnitedHealthcare-administered self-funded plan built around the primary care provider (PCP) relationship.
Children’s Friend employees and covered family members are incented to build a close relationship with their PCPs through benefits like $0 copays for using quality, cost-efficient providers and 24/7 Virtual Visits. As a result, this group has seen above-average preventive care utilization, with a 99.9% network utilization rate, 4% higher Tier 1 provider usage, 24.6% more wellness visits and 53% more virtual visits, compared to UnitedHealthcare norms.
This approach works to deliver both better health outcomes and lower costs. Members who used providers specifically designated for delivering quality care experienced 38% fewer emergency department visits, 22% fewer inpatient admissions and 23% lower risk‑adjusted per member per month costs.1 Built‑in clinical strategies help identify and engage at-risk employees, like those with type 2 diabetes, in programs designed to improve their health.
Inspiring wellness
“Something that makes our health plan unique is all of the wellness benefits that we’ve added over the years, like a weight-loss program and second-opinion services,” says Benefits and Employee Experience Manager Julie Colangeli.
Wellness incentives also help lower costs for the group. Employees have their deductible waived if they complete 5 healthy activities during a certain timeframe. Children’s Friend also has a wellness committee of about a dozen employee volunteers, who coordinate free wellness activities for their colleagues.
To help staff cope with the stressful kind of work they do, behavioral health benefits include an Employee Assistance Program and 3 no-cost counseling sessions a year.
Working together for better results
A successful health benefits strategy like this one is no accident. At regular meetings, Children’s Friend staff discuss claims trends and employee survey results with their broker and UnitedHealthcare team to fine-tune their plan and benefits.
“They know us, they know our people, they’re on our wellness committee,” Caprio says. “We don’t go into those meetings where they tell us we have to increase our employee copay because that’s not going to happen. Instead, it’s more of a conversation: ‘Here’s an idea, here’s a strategy, here’s a new tool we have.’”
The result of that ongoing collaboration is a benefits package that keeps getting better — one that Children’s Friend is proud to offer to its close-knit family of employees.
“Our benefits package is one of the most important things that Children’s Friend does. It’s really part of our commitment to making Children’s Friend a great place to work,” says Colangeli.
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