Renewal Management
Full carrier marketing at every renewal
Alternate plan design and contribution strategy modeling
Negotiation of rates, contract terms, and rate caps where available
Three-year cost trajectory, so decisions are made against a trend line rather than a single bad year
Funding Strategies
Feasibility analysis across fully insured, level-funded, self-funded, and captive arrangements
Claims and utilization review where data is available; underwriting-based projection where it isn’t
Stop-loss marketing, specific and aggregate attachment point analysis
Group captive evaluation, including the questions most captive presentations skip
Direct primary care and alternative delivery models, assessed on network adequacy and fit for the group
Honest recommendation to stay put if the numbers don’t support a move
Compliance
Support for ACA reporting: 1094-C and 1095-C preparation support, affordability testing, and measurement period tracking. We are happy to work with your payroll department or provider to ensure proper deductions and reporting.
ERISA wrap documents, summary plan descriptions, and summaries of material modifications
Form 5500 filing coordination
Section 125 plan documents and non-discrimination testing
COBRA administration oversight and vendor management
Annual notice distribution calendar — Medicare Part D, CHIP, WHCRA, and Medicare Prescription Surveys
California-specific obligations, including CalSavers coordination and local ordinance exposure – San Francisco HCSO, LA Living Wage Ordinance, etc.
Leave Advisory & Vendor Selection
Benefits continuation and premium collection coordination during leave
Disability and absence carrier contract review
Leave administration vendor search, RFP, and evaluation
Implementation support and ongoing vendor management once a partner is selected
Implementation & Ongoing Administration
Benefits administration platform selection, configuration, and annual build
Carrier EDI setup, testing, and error resolution
Open enrollment planning, materials, and employee meetings — on site, remote, multi-shift, and bilingual as needed
Monthly billing reconciliation and eligibility audits
New hire onboarding support and termination processing oversight
Employee Communications & Collateral
Customized annual benefit guides and open enrollment presentations, new hire and onboarding packets
Benefits content for employee handbooks
Total rewards statements
Plan change, carrier transition, and mid-year update communications
Bilingual materials where the workforce requires them
Employee Advocacy
Direct employee line for claims, billing, and eligibility questions
Claim denial appeals and medical necessity escalation
Prior authorization intervention
Balance billing and provider network disputes
ID card, enrollment, and coverage verification issues
Analytics & Benchmarking
Claims and utilization reporting, with high-cost claimant tracking where data permits
Benchmarking by industry, region, and employer size where available
Contribution strategy modeling and employee cost-share analysis
Board- and CFO-ready reporting, prepared to be read rather than filed
PEO Transitions
Unbundling a PEO is a specialist exercise, and one most brokerages quote for and then subcontract. We coordinate and lead the whole process: sequencing the exit, implementing standalone benefits, payroll, and workers’ compensation, and modeling the true cost comparison rather than the one in the PEO’s renewal deck.