Performance Guarantee Types
| Guarantee Type | Example Metric | Typical At-Risk Amount |
|---|---|---|
| Enrollment/engagement | 40% of eligible employees enrolled within 6 months | 10–15% of fees |
| Clinical outcomes | Average HbA1c reduction of 0.5% for diabetic participants | 15–20% of fees |
| ROI guarantee | 2:1 ROI on program investment within 12 months | 20–30% of fees |
| Satisfaction | Employee NPS of 40+ for program participants | 5–10% of fees |
| Retention | 70% of enrolled members still active at 12 months | 10–15% of fees |
Structuring At-Risk Fees
At-risk fees — a portion of vendor fees contingent on achieving performance targets — align vendor incentives with employer goals. A typical structure: 80% of fees are paid regardless of performance; 20% are at risk and paid only if performance targets are met. Vendors who are confident in their outcomes will accept at-risk fee structures; those who are not will resist.
Contract Term Negotiation
Pro Tip
Negotiate contract terms that protect the employer's interests: data ownership (you own your data, not the vendor), data portability (you can export your data when you leave), termination for cause (you can exit if performance targets are not met), and audit rights (you can verify the vendor's reported outcomes). These terms are standard in well-negotiated contracts but are often absent from vendor-provided templates.