How Big Brothers Big Sisters of McHenry County achieved 100% healthcare participation with an HRA

Big Brothers Big Sisters of McHenry County is a nonprofit organization that creates and supports one-to-one mentoring for young people facing adversity. BBBS helps children and young adults grow in confidence, develop life skills, and achieve their full potential.

• Size: >20 employees
• Industry: Nonprofit 
• Location: Chicago suburbs

Key results

• 100% participation amongst BBBS employees
• Four individuals who were previously uninsured now have coverage
• BBBS can better compete with private sector employers to recruit and retain talent

For small nonprofits like Big Brothers Big Sisters, offering traditional healthcare benefits is often out of the question. Expensive group plans are a poor fit for organizations with tight budgets and limited human resources. Unable to offer the same benefits as private sector employers, recruiting and retaining talent is a constant struggle for charities. According to ExactHire, turnover rates for nonprofits are 19% compared with the 12% all-industry average.   

Leslie Blake is the executive director of Big Brothers Big Sisters of McHenry County. With over a decade’s experience in the sector, Blake recognizes the competing demands of small nonprofit organizations. While BBBS is committed to improving the lives of vulnerable people in the community, it must also prioritize its workforce. 

“The realization that many of our own employees could qualify for nonprofit services, because they didn’t have health insurance, was concerning,” recalls Blake. “We’re always very quick to help the families and the kids we serve, but we realized that we also had to support the people that were supporting the mission. That really hit it home.” 

Challenge: Lack of benefits limits recruitment, but group plans are out of reach 

With no healthcare benefits to offer, Big Brothers Big Sisters struggled to retain employees. Many could simply not afford to stay at the organization: despite being passionate about the company’s mission and values, employees were forced to seek opportunities in other sectors that provided coverage. Recruitment was also problematic, because the absence of benefits impacted who could apply for roles at the nonprofit. Applicants tended to be those from higher income levels who could afford to buy their own coverage or rely on their spouse or partner.

We had a diversity issue,” said Blake. “Not offering health benefits was narrowing the pool of applicants that were looking to work with us. It had to be people who were either choosing not to be covered, were choosing to pay 100% out-of-pocket, or, in the majority of cases, were covered under a spouse’s or partner’s plan.

Healthcare benefits are crucial to attracting young jobseekers, too. People entering the workforce today look for employers who will support their physical and mental well-being, not just their professional development. Big Brothers Big Sisters needed to respond to this generational shift in order to access new talent.  

Faced with these challenges, Blake previously looked into group healthcare plans. However, the financial and administrative burdens were too great for an organization operating on limited resources. Every dollar counts for a nonprofit like Big Brothers Big Sisters, and staff are busy juggling multiple roles and responsibilities. 

Unpredictable renewals were another serious obstacle — BBBS needs budget stability to plan effectively, maintain essential services, and invest in long-term growth. With a group plan, one difficult diagnosis could dramatically drive up healthcare costs and send a nonprofit’s budget spiraling out of control. It was time to look for a more affordable, more predictable, alternative. 

We had looked into group plans before, but it’s a high dollar amount to get in, and once you’re in, you’re locked in,” said Blake. “Each year the cost can go up. I know of other nonprofits whose renewal is around 18% year over year. It’s unpredictable.

Solution: Simple QSEHRA implementation with Take Command

Blake set up a staff benefits task force to provide different perspectives on health insurance and select the best option for the organization. The task force found that a qualified small employer HRA (QSEHRA) would allow BBBS to set a fixed monthly allowance for employees to spend on eligible medical expenses.  

Blake now needed approval from the board. She presented the QSEHRA as an opportunity for Big Brothers Big Sisters to demonstrate leadership — no other nonprofits in the area were offering this type of reimbursement. QSEHRA made economic sense, too. By improving retention, BBBS could reduce the time and money spent on replacing employees who left the organization in search of better benefits. However, it was the chance to secure coverage for uninsured individuals that convinced her board of the need to make a change.

“Four staff members or family of staff members weren’t covered at all by health insurance,” said Blake. “By implementing QSEHRA they are now covered. That was a huge thing to tell the board — we would be able to provide coverage for people who otherwise wouldn’t have had it.”

Implementing the QSEHRA was quick and easy with Take Command. Licensed experts provided personalized healthcare advice, so employees could start shopping with confidence. The ongoing support and guidance has been another key to success for the busy nonprofit. With Take Command, BBBS found they could offer healthcare benefits without diverting resources away from their life-changing services. 

“I thought it would be a multi-month process to get to implementation, but it was incredibly simple,” explained Blake. “It took around 20 minutes to enroll our company on the Take Command website, sign the paperwork, set our limits, and put in the employee information. That was pretty much it. When I say it was simple, it was incredibly simple.”

Results: Affordable, customizable healthcare coverage for everyone

Big Brothers Big Sisters of McHenry County have achieved 100% participation in healthcare benefits with the qualified small employer HRA. What’s more, 97% of what the organization has offered employees has been spent, year to date. This is exactly what BBBS had hoped for — they want their staff to get covered so they can take care of themselves and continue to serve the community.

By offering healthcare benefits, Big Brothers Big Sisters are finally able to compete with the private sector to recruit and retain talent. Employees can continue dedicating their professional lives to the BBBS mission, without sacrificing the healthcare benefits they deserve. The organization is also seeing a more diverse workforce, as recruitment is no longer limited to those with alternative healthcare options.

Feedback on QSEHRA and Take Command has been overwhelmingly positive. Employees at Big Brothers Big Sisters appreciate having the freedom to choose their own healthcare, as well as the simplicity of the Take Command platform. 

We’ve sent out staff surveys since implementing the QSEHRA asking whether the program was rolled out the way it was promised, and if there was anything that would have made it easier,” said Blake. “The resounding response was that everything has been quick and easy from the start.