You own the risk. Do you own the savings?

You keep it. We are not a third-party administrator and we don't want your claims file to live with us. We work alongside whoever administers your plan, and several of our levers are invisible to the member entirely: payment integrity, eligibility audits, pharmacy contract terms.

Reference-based pricing (RBP) prices claims against a defensible benchmark instead of a negotiated network discount, typically 15 to 30% off facility cost. The balance-billing exposure is the real question, and the answer is advocacy: a defense team that handles any provider dispute on the member's behalf, so the employee is never in the middle. For groups not ready for full RBP, cash-pay carve-outs on planned procedures capture much of the benefit with none of the noise.

Almost certainly. Fraud, waste and abuse runs 3 to 10% of spend industry-wide, and dependent eligibility audits typically return 3 to 8% of plan cost even at organizations with mature governance. This is not a comment on your team. It is what happens when millions of claims are adjudicated by systems optimized for speed.

And that's only the benefits side. Indirect expense reduction across 60+ categories sits entirely outside your benefits P&L: supplies, IT, telecom, freight, waste, insurance, print, food service, merchant fees. We habitually find another 10 to 30%+ there even at organizations that have already run a procurement exercise, because nobody has benchmarking data across that many categories. It's worth 2 to 3%+ of net margin on its own.

We give them back hours in their day. We only need a couple of meetings, and they reap the dividends in cost savings and time.

We handle vendor management, implementation and member communication, and report savings realized monthly so finance can check the math against its own statements. Most levers are live in 30 to 45 days; several land faster.