Independent analysis on self-funded health plans, pharmacy benefits, compliance, and employer strategy — no vendor spin.
Employers spend enormous time evaluating vendors based on presentations, proposals, and projected savings. But none of those things govern the relationship. The contract does — and in employee benefits, it's often the least scrutinized part of the decision.
The DOL just changed how it plans to approach mental health parity enforcement. For self-funded employers, this isn't a reason to relax — it's a clearer picture of exactly where regulators are going to look.
A recap of my session at the United Benefit Advisors Spring 2026 Conference — covering AI in employee benefits, self-funded plan strategy, and what employers need to know right now.
For years, employers have focused on trend percentages, renewal increases, and pharmacy rebates. But the real cost driver hiding in most self-funded plans isn't trend — it's a handful of specialty drugs that can each cost more than a million dollars a year.
With commercial medical trend projected near 9%, employers cannot keep relying on the same cost-shifting playbook and expect a different result.
For years, most employers have treated health insurance as an annual renewal exercise.
Self-Funded Health Plans
Plan design, TPA selection, stop-loss, and ERISA fiduciary obligations.
PBM Consulting
Spread pricing, rebate pass-through, contract audit rights, and PBM negotiation.
ACA Compliance
ALE status, affordability safe harbors, 1094-C/1095-C reporting, and penalty avoidance.
Group Medical Captives
Risk pooling, underwriting requirements, and captive governance.
Stop-Loss Insurance
Specific vs. aggregate coverage, attachment points, lasering, and carrier evaluation.
Benefits Strategy
Benchmarking, vendor ecosystem, open enrollment, and long-term plan strategy.
No fluff. No vendor pitches. Just clear analysis for employers.
