Selection and evaluation of benefits administration technology providers covering enrollment, eligibility management, COBRA, direct billing, account-based plans (FSA, HSA, lifestyle), ACA reporting and compliance, reporting and analytics, and the employee experience across web, mobile, and service center channels.
Competitive evaluation and selection of U.S. and global brokers and consultants for strategic, financial, and program management of employee health, life, voluntary, and well-being benefits, including communications strategy and employee communications support.
Evaluation and selection of active and retiree private exchange platforms, including individual coverage HRAs and Medicare supplement marketplace options.
Stand-alone search and benchmarking of pharmacy consultant services, so that a high-cost area of the plan has independent financial oversight.
Assessment of your current H&W broker or consultant’s service delivery, strategic value, market leverage, and fee competitiveness.
Compensation and fee arrangements benchmarked against the market and tested against the scope and value of services delivered, with full transparency on all provider revenue sources.
Review of H&W provider agreements for scope gaps, fee transparency, performance guarantees, and termination provisions.
Support during platform transitions and major upgrades, holding providers to what they proposed and checking that systems are configured to current market practice.
Assessment of ongoing administration quality, error rates, compliance, and participant satisfaction.
Questions plan sponsors ask us most often about this work.
We suggest a formal evaluation every three to five years. The H&W consulting market evolves rapidly, and broker compensation structures can become misaligned with the value delivered over time.
We evaluate technology capabilities, enrollment experience, eligibility management, COBRA administration, account-based plans (FSA, HSA, lifestyle), ACA compliance, reporting, data security, and fees. The process includes development of a fully customized RFP, product demonstrations, a review of total cost of ownership, and reference checks.
We assess pricing guarantees, rebate pass-through rates, specialty pharmacy management, member experience, clinical programs, and overall cost transparency. PBM contracts are among the most complex in the benefits area, and an independent review shows whether the pharmacy consultant is managing them effectively.
Common triggers include declining accuracy or quality, consultant turnover, diminishing engagement of team resources, reduced strategic value, limited market leverage, fee increases without corresponding value, or a change in the consultant’s ownership that introduces conflicts of interest.
Yes. Our H&W discipline works with plan sponsors across the full spectrum of funding arrangements, including self-insured, fully insured, level-funded, and captive programs.