Independent analysis on self-funded health plans, pharmacy benefits, compliance, and employer strategy — no vendor spin.
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.
Employers are heading into another difficult health plan renewal cycle, and the pressure is becoming harder to ignore.
Over the last decade, level-funded health plans have become one of the fastest-growing segments of the employer-sponsored health insurance market.
Most employees have spent their entire careers assuming employer-sponsored health insurance is the best coverage available.
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.
