Case Studies — Employer Healthcare Cost Results

Manufacturing · 340 employees

12% → 4%

Renewal increase

Challenge: Four consecutive double-digit renewals with no explanation beyond trend, and no claims data in the employer's hands.
Recommendation: Full claims decomposition, a level-funded alternative modeled against two years of experience, and a rebuilt stop-loss specification.
Outcome: Renewal increase reduced to the low single digits and a repeatable multiyear cost model finance now owns.

Professional services · 120 employees

18–22%

Pharmacy spend reduction

Challenge: Pharmacy spend growing faster than medical, with rebate terms buried in a contract nobody had read since signing.
Recommendation: Independent PBM contract review, specialty carve-out analysis and a renegotiated definition set.
Outcome: Pharmacy cost reduction in the high teens, with rebate dollars flowing back to the plan instead of the vendor.

Distribution · 620 employees

$310K

Annual cost avoided

Challenge: Eight years in a PEO with no market comparison, and leadership unsure whether the arrangement still made sense.
Recommendation: Certified PEO marketing analysis plus a direct-carrier comparison against the PEO master plan, normalized to total cost of employment.
Outcome: A board-ready side-by-side that settled the question with evidence and removed six figures of annual cost.

Construction · 210 employees

$96K

Claims audit recovery

Challenge: Eligibility and billing errors accumulating across two carriers with no reconciliation process in place.
Recommendation: Retrospective claims and eligibility audit, carrier invoice reconciliation and a monthly control process.
Outcome: Overpayments recovered and a reconciliation routine that keeps the leakage from returning.

Nonprofit · 85 employees

Audit ready

Fiduciary risk

Challenge: No documented fee disclosure, no vendor scorecard and no CAA 2021 governance file.
Recommendation: Fee transparency review, a written broker scope of services and a documented compliance calendar with owners.
Outcome: A defensible fiduciary file the board can produce on request, built in under 60 days.

Technology · 145 employees

3-year model

Funding evaluation

Challenge: Fully insured with strong claims experience and no visibility into whether the premium reflected it.
Recommendation: Alternative funding evaluation across level-funded, self-funded and captive structures, stress-tested against cash flow.
Outcome: A funding decision leadership could defend, with downside modeled before a single dollar moved.

Results are representative of past engagements and are presented without client names. Outcomes depend on plan data, funding structure, workforce demographics and market conditions, and are not a guarantee of future results.

The challenge, the recommendation, and the financial result.

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