Financial Optimization
Evaluate the economics of the benefits program, including funding, plan design, pharmacy, vendor arrangements, benchmarking, risk transfer and other potential cost opportunities.
The Benefits Optimization Report (BOR)
Is your benefits program actually optimized? Find out before your next renewal.
The Benefits Optimization Report (BOR) gives leadership an objective, data-driven assessment of where your healthcare dollars are going, where risk may be developing, and where meaningful opportunities may exist across your benefits program.
Assessment first. Decision second.
20-minute conversation. No obligation to change brokers.
The Central Question
Do not assume. Measure it.
Employee benefits are often one of an organization’s largest operating expenses, yet leadership may only receive a comprehensive strategic review during renewal.
The BOR provides an objective analysis designed to answer:
- What is working?
- What is costing more than it should?
- Where is risk developing?
- What opportunities may be getting missed?
- What should leadership be thinking about over the next 12 to 36 months?
The Diagnostic
What the Benefits Optimization Report delivers.
Predictive Health & Risk Intelligence
Use available data and analytics to help identify population health trends, emerging risk, high-cost claim exposure, preventive-care opportunities and potential future cost drivers.
Multi-Year Benefits Strategy
Translate findings into an executive-level roadmap so leadership can evaluate immediate opportunities while making better long-term benefits decisions.
A Note From Brian
Brian PintoEmployee Benefits Consultant
Why it's worth a conversation.
I work with CFOs and leadership teams who are spending significant dollars on employee benefits but often haven't had an objective, data-driven look at where the program may be leaking money, carrying unnecessary risk, or missing opportunities.
I use the Benefits Optimization Report to identify those opportunities before asking you to consider changing anything.
If the analysis confirms your program is well optimized, that's valuable validation. If it identifies meaningful opportunities, then we have something worth discussing.
Brian Pinto
Let's determine whether a BOR makes sense for your organization.
You stay in control
If the BOR validates your current strategy, you will have objective confirmation. If it identifies meaningful opportunities, we can discuss what implementing them could look like. There is no obligation to make a change.
A Benefits Optimization Report represents approximately $2,500 to $5,000 of consulting analysis. For qualified employers introduced through participating strategic partners, the consulting fee may be waived.
The Process
Five steps. About 90 minutes of your time.
- Step 01Discovery
A 20-minute conversation about your objectives, concerns and timing.
- Step 02Data Collection
Relevant plan, claims, pharmacy, financial, vendor and contract information, under an NDA.
- Step 03Analysis
Financial optimization, benchmarking, funding, pharmacy, compliance and predictive population health analysis where applicable.
- Step 04Executive Findings
A 60-minute executive presentation accompanied by the written Benefits Optimization Report.
- Step 05Strategic Roadmap
Prioritized recommendations and a multi-year strategy. You receive the written report and decide what happens next.
What the BOR Analyzes
Everything that drives the number on your renewal letter.
What is it?
An Objective, executive-level analysis of your entire healthcare and benefits program, delivered as the Benefits Optimization Report (BOR).
What will you learn?
Where your healthcare dollars go, what may be recoverable, how you compare to peers, where clinical risk may be developing, and where your compliance exposure sits.
What is analyzed?
Medical and Rx claims, funding arrangement, stop-loss, PBM contract, plan design, contributions, broker scope of services, compliance file, renewal history and population health indicators.
How long does it take?
About three to four weeks from data delivery, and roughly 90 minutes of your time in total.
What do you get?
A written Benefits Optimization Report, a quantified opportunity list and a multi-year implementation roadmap.
What happens afterward?
You stay in control. If the report validates your current strategy, you have objective confirmation. If it identifies meaningful opportunities, we can discuss what implementing them could look like. There is no obligation to make a change.
Problems This Solves
If any of these sound familiar, the BOR will help.
- Healthcare costs increasing every year
- Renewal frustration and last-minute decisions
- Pharmacy costs no one can explain
- Unclear broker communication and scope
- Fiduciary and CAA 2021 compliance concerns
- Captive program evaluation
- Self-funding feasibility analysis
- Alternative funding strategies
- Benchmarking against peers
- High-cost claimant risk
- Employee contribution strategy
- Open enrollment improvements
How the Analysis Works
Technology-enabled analysis. Consultant-led recommendations.
The Benefits Optimization Report™ combines employer-provided benefits information, available benchmarking and analytical tools to help identify potential cost, risk and performance opportunities.
Data In
Employer-provided benefits information, available benchmarking and analytical tools are combined to help identify potential cost, risk and performance opportunities.
Technology Applied
Where appropriate, technology and AI-assisted analysis may be used to organize information, identify patterns, model scenarios and support the evaluation process.
Judgment Applied
Findings and recommendations are reviewed and interpreted through an employee benefits consulting lens before being presented to leadership.
Technology supports the analysis. It does not replace professional judgment.
Employer and benefits data should be handled through appropriate approved systems and processes consistent with applicable privacy, confidentiality and organizational requirements.
Questions Employers Ask
Straight answers before you commit time.
When should we evaluate our employee benefits?
Six to nine months before your renewal date. That is enough runway to analyze claims, test funding alternatives and negotiate from a position of information rather than deadline pressure.
Do you only work with companies changing brokers?
No. Most reports begin with no decision made. The point is to measure whether the program is optimized first. If it is, that is useful validation. If it is not, leadership decides how to proceed.
Can you help if we are happy with our current broker?
Yes. A second set of eyes on claims, pharmacy contracts and funding often confirms you are in good shape, which is a useful thing to be able to prove to ownership.
What company size do you work with?
Employers with 20 or more employees, most commonly between 20 and 2,500.
What happens during the Benefits Optimization Report process?
A 20-minute conversation, an NDA and data exchange, two to three weeks of analysis, and a 60-minute executive findings presentation with the written report and a prioritized roadmap.
What does predictive analytics actually tell us?
Historical claims show what happened. Predictive analytics help identify emerging clinical risk and potential future cost drivers within your employee population. It informs strategy. It is not a medical prediction about any individual.
What does the report cost?
A Benefits Optimization Report represents approximately $2,500 to $5,000 of consulting analysis. For qualified employers introduced through participating strategic partners, the consulting fee may be waived.
How are you compensated?
Only if you decide to move forward. Brian is compensated through standard consulting or brokerage compensation paid through the national benefits organization with which he is affiliated, disclosed in writing before you decide. The assessment itself carries no obligation.
Definition
What is employee benefits optimization?
Employee benefits optimization is a structured process for evaluating the financial, clinical, operational and strategic performance of an employer’s benefits program. It examines claims and pharmacy experience, funding structure, plan design, vendor contracts, compliance posture and workforce health patterns, then quantifies which costs are structural and which are simply being accepted.
It is not an insurance product and it is not a quote. It is an assessment and consulting methodology. Brian Pinto is an employee benefits consultant, and his Benefits Optimization approach exists so leadership can understand the current program in financial terms before deciding whether any change is warranted.
Understand the opportunity before deciding whether to make a change. Assessment first. Decision second.
By Industry
How Benefits Optimization applies in specific operating environments
Next Step
You don't need to assume your benefits program is optimized.
The Benefits Optimization Report gives leadership an objective way to find out. If the analysis validates your current strategy, that's useful confirmation. If it identifies meaningful financial, risk or strategic opportunities, then we have something worth discussing. Assessment first. Decision second.
Learn whether a Benefits Optimization Report makes sense for your organization. No cost. No obligation.
Analyses, projections, benchmarks and modeled scenarios are intended to support benefits strategy and decision-making and may rely on assumptions, available data and third-party information. Actual results may vary. The Benefits Optimization Report™ does not constitute legal, tax or medical advice.