The Iceberg Beneath ERISA Reporting
For years, ERISA health plan reporting felt like a dusty annual ritual. Your TPA would drop a Form 5500 on your desk, maybe a Schedule A, and you’d check...
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For years, ERISA health plan reporting felt like a dusty annual ritual. Your TPA would drop a Form 5500 on your desk, maybe a Schedule A, and you’d check...
Out-of-network (OON) charges represent one of the most volatile and poorly controlled cost drivers in employer-sponsored health plans. Unlike in-network...
Pharmacy benefit managers (PBMs) are the often-unseen architects behind your employees’ prescription drug coverage. They sit between employers, health...
Every year, a benefits team somewhere sits around a table, opens a thick actuarial report, and tries to divine the future from claims that are already 18...
Every year, I watch benefits teams chase the latest shiny object-a new point solution, a rebate tweak, a wellness challenge that promises to get people...
Tucked inside every employer health plan’s claims warehouse is a damning report nobody runs. Open a folder of last year’s professional claims, lay it beside...
When most employers think about the soaring cost of healthcare, they focus on big-ticket items: hospital stays, specialty drugs, and rising physician fees....
A 900-life employer I worked with recently learned a lesson the hard way - to the tune of $105,000. An employee's dependent needed a complex spinal fusion....
I sat in a client’s quarterly review not long ago, watching their broker point to a slide that read “58% average network discount-well above benchmark.”...
Everyone loves the idea of a stop loss captive. You grab a handful of sharp employers, pool your stop loss risk, and finally get off the fully insured...
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