• Experts in Employer Healthplan Design and Competitive Strategy

Latest News Posts

Read More

You have the right to know where your benefit dollars are going.


Unfortunately, most health plan vendors do not want you to understand how the expenses are really allocated. Founded by a licensed private investigator and ex-healthcare company executive, we know how to analyze your vendor and install a transparent and effective risk management platform.


Value Proposition
We assist our clients in obtaining the highest possible value for the benefits budget. We do this by balancing a unique blend of proven risk management techniques, leveraged buying power, and creative financing.


Risk Management in Employer Healthcare Plans


Some employers want to have very rich benefits and some want to have only the bare essentials. Covered medical expenses are defined in the Plan Document. The Plan Document, under ERISA may be modified by the Plan Sponsor (employer). A Plan Sponsor may make a deviation from default plan language offered by the administrator to improve or limit the benefits or expand the definition of a covered medical expense. Not all modifications are good ideas and not all modifications will be acceptable to the administrator and stop-loss vendor, but some ideas may be supported after a frank discussion of the potential consequences of the change. Once the language is designed or added to the Plan Document then that expense will be considered covered.

Download our Knowledge Flyers Here:

Health Plan Benefits Design

PEO Consulting

Understanding ERISA Plans

Health and Wellness Plans

Understanding Self Funded Contract Type

Designing Aroud the Family Budget

Health Plan Custom Modifications

Data Needed to Obtain a Competitive Quote (Full Version)

The Value of Good Information

Understanding House Bill 2015

House Bill 2015 - Sample Letter (PDF Click Here)

Ten questions you should be asking about your corporate health plan

1. Cash Pricing – By design, your health plan isn’t paying the cash price. Medical Providers will accept cash for their services, the cash price is usually about half of what the PPO negotiated. The question is “How does my health plan get the cash price instead of the “contract price”? 2. Contingent Compensation Arrangements […]


Individual Coverage HRA and Excepted Benefit HRA FAQs

FAQs on New Health Coverage Options for Employers and Employees Individual Coverage and Excepted Benefit Health Reimbursement Arrangements June 13, 2019 Health reimbursement arrangements (HRAs) are a type of account-based health plan that employers can use to reimburse employees for their medical care expenses. New rules released by the Departments of Labor, Health and Human […]


DOL Issues 2020 Adjusted Penalty Amounts

The DOL released the 2020 annual adjustments to the civil monetary penalties for benefit-related violations. The adjustments are effective for penalties assessed after January 15, 2020, with respect to violations occurring after November 2, 2015. Form 5500 – The maximum penalty for failing to file Form 5500 (which must be filed annually for most ERISA plans) […]


Executive Order on Improving Price and Quality Transparency in American Healthcare to Put Patients First

By the authority vested in me as President by the Constitution and the laws of the United States of America, it is hereby ordered as follows: Section 1.  Purpose.  My Administration seeks to enhance the ability of patients to choose the healthcare that is best for them.  To make fully informed decisions about their healthcare, patients must […]


Copyright 2019 Houston Benefits Services