ERISA · CAA 2021 · Health Plan Governance
Your organization may spend millions of dollars every year on employee healthcare.
The question is not simply whether you are offering competitive benefits.
Can you demonstrate a prudent process for how plan dollars are spent, vendors are selected, compensation is evaluated and important decisions are made?
Determine whether a Benefits Optimization makes sense for your organization.
Retirement Plan
Health Plan
Healthcare may be one of your company's largest operating expenses. The governance surrounding it deserves the same level of attention.
“Show us your health plan fiduciary process.”
Could your organization quickly demonstrate:
If answering those questions means searching through emails, contracts, renewal presentations and shared drives, there may be an opportunity to strengthen your process.
Why CAA 2021 matters
ERISA fiduciary responsibilities for health and welfare plans existed long before CAA 2021. What changed is the level of transparency, disclosure and data access now expected around employer-sponsored health plans, and the importance of being able to demonstrate prudent oversight.
Employers have greater visibility expectations around healthcare costs, arrangements and plan information.
Plan fiduciaries should understand direct and indirect compensation paid to brokers, consultants and other covered service providers.
Employers increasingly need access to meaningful plan information to evaluate cost, performance and vendor relationships.
Organizations should be able to demonstrate a prudent and repeatable process behind important plan decisions.
Benefits governance is a finance and enterprise-risk issue, not simply an HR renewal exercise.
It is also about how your healthcare dollars are being spent.
Many of the same questions behind good fiduciary oversight tend to uncover financial opportunities.
That is why we start with an Benefits Optimization.
The diagnostic
The Benefits Optimization evaluates your existing benefits program before anyone recommends a change. It is an executive diagnostic, not an insurance quote.
01
A 20-minute executive conversation to understand the current benefits structure and determine whether a Benefits Optimization is appropriate.
02
Review available plan, cost, vendor, compensation and market data.
03
Identify financial, strategic and governance opportunities.
04
If meaningful opportunities exist, develop an implementation path with leadership.
Completing a Benefits Optimization does not mean changing brokers, carriers or vendors. The credibility comes from diagnosing before prescribing.
Determine whether a Benefits Optimization makes sense for your organization.
What are we actually paying?
Including premiums, administrative fees, pharmacy economics, broker and consultant compensation and other material plan expenses.
Are those costs reasonable?
What objective process have we used to determine that?
Can we access the data necessary to evaluate our plan?
Claims, cost, utilization and vendor performance information in a usable form.
Can we demonstrate why we selected and retained our major benefits vendors?
Including the alternatives that were considered at the time.
Can we produce documentation supporting our decision-making process?
Organized, current and available if someone asks for it.
If leadership cannot confidently answer all five, the next step is not necessarily changing anything. It is understanding where you stand.
Benefits governance
Where a Benefits Optimization identifies documentation or oversight gaps, employers can be supported with an organized fiduciary governance process as part of a broader benefits strategy.
This page is provided for general informational purposes and does not constitute legal advice. Employers should consult qualified legal counsel regarding their specific fiduciary and compliance obligations.
You need to know whether there is anything worth fixing.
The Benefits Optimization starts with your current program, your data and your economics.
If the analysis identifies meaningful financial, strategic or fiduciary opportunities, we will show you what they are and what an execution path could look like. If it does not, you will know that too.
No cost. No obligation. Determine whether a Benefits Optimization makes sense for your organization.