There is a structural conflict of interest embedded in every fully insured health plan — and almost no one in the industry will tell you about it. We will. And we'll show you, with your own claims data, exactly how much it's costing you.
Most C-suite leaders who come to us have spent years accepting annual rate increases as a fact of life. They don't know they have a choice. Here's what that assumption is actually costing you.
Traditional fully insured plans legally permit carriers to withhold adjudication-level claims data from you — the plan sponsor. You are funding a health plan for your employees without access to the information needed to manage it. No CFO would accept this arrangement in any other line of their business.
A commission-based broker earns a percentage of your premium. When your costs go up 10%, their income goes up 10%. There is no financial incentive for them to find you a lower-cost solution. This isn't a conspiracy — it's structural. The Consolidated Appropriations Act now requires brokers to disclose this. Most hope you don't ask.
To manage rising premiums, most employers shift costs to employees through higher deductibles — some exceeding $5,000 — and increased co-pays. The result: employees avoid preventive care, conditions worsen, emergency visits spike, and productivity suffers. You're spending more and getting less on both sides of the equation.
Under ERISA, you are the plan fiduciary. The Consolidated Appropriations Act (CAA) now mandates Gag Clause Attestations, compensation transparency, and claims data access requirements. Non-compliance carries personal liability. Most employers — and their brokers — are not fully compliant today.
"A broker who earns a commission on your premium has a financial incentive to keep your costs high. A fiduciary advisor who charges a flat fee has a financial incentive to drive your costs down. These are not the same relationship."
For decades, large employers have accepted the fiction that rising healthcare costs are inevitable. They are not. They are the predictable result of a system that profits from your opacity. The numbers tell the story plainly.
Answer four questions. Our benefits intelligence engine will analyze your situation and deliver a specific, actionable assessment in seconds — no email required.
Every recommendation we make is preceded by a rigorous analysis of your population health data, utilization patterns, and funding mechanics. Then we model it. We quantify the impact on employee behavior and your bottom line before you move a single dollar.
Percentages are illustrative benchmarks based on industry research. Your actual recovery depends on plan structure, employee demographics, and utilization patterns — which we analyze in your complimentary strategy session.
We keep your exact PPO network intact — same doctors, same hospitals. We layer in medical bill review, voluntary concierge services, and claims auditing to eliminate waste immediately, with zero employee friction.
We transition you to a transparent self-funded or level-funded model. You gain access to your own adjudication-level claims data, stop paying carrier profit margins, and fund only actual claims — not projections padded with risk charges.
Maximum optimization. We deploy advanced clinical programs — Green Imaging (imaging cost reductions of up to 80%), Direct Primary Care, captive or non-captive structures, and pharmacy benefit carve-outs — to achieve the full recoverable savings.
Gary Bencivenga said it best: the most powerful word in advertising is not "free" — it's "proof." Here is ours.
No spreadsheet delivered at renewal. No reactive conversations. This is proactive, data-driven stewardship — 365 days a year.
We conduct a no-cost, no-obligation analysis of your current plan, carrier contracts, broker compensation disclosures, and any available claims data. You see the full picture — likely for the first time.
We facilitate in-person planning sessions with your leadership team. We model benefit plan designs in real time, quantify the impact of each variable on employee behavior and cost, and present an executive summary of our findings.
We manage the full transition — carrier negotiations, TPA selection, stop-loss placement, employee communications, and compliance documentation. Your employees experience no disruption. Their doctors don't change.
Monthly reporting. Mid-year clinical and financial audits. 120-day pre-renewal strategic planning. Multi-channel employee education. We are not a broker you call once a year — we are an integrated extension of your leadership team.
Under ERISA, you — the employer — bear personal fiduciary liability for how your health plan is administered. The Consolidated Appropriations Act (CAA) has significantly expanded those requirements. Most employers are not in compliance today, and most brokers are not helping them get there.
We begin every engagement with a full fiduciary compliance audit and ensure your plan meets every CAA requirement — including Gag Clause Attestations, compensation disclosure, and claims data access mandates. We document everything. Your liability is our priority.
Request a Compliance AuditWe ensure your plan documents, administrative procedures, and advisor relationships meet ERISA's fiduciary standards of prudence and loyalty — protecting you from personal liability.
The Consolidated Appropriations Act requires annual attestation that your plan does not contain prohibited gag clauses restricting access to price and quality data. Most employers have not submitted this attestation.
CAA Section 202 requires brokers to disclose all direct and indirect compensation over $1,000. We provide full transparency as a matter of standard practice — and help you demand it from every vendor in your benefits ecosystem.
The Transparency in Coverage rule requires carriers to publish machine-readable files containing in-network rates and out-of-network costs. We help you leverage this data — and ensure you're accessing your own claims data as required by law.
In a 20-minute strategy session, we'll show you — with your own numbers — what your current plan is actually costing versus what a transparent, self-funded alternative would deliver. No commitment required.
Your information is used solely to schedule your complimentary strategy session. We do not sell or share your data. You can opt out at any time.