GOVERNANCE-FOCUSED EMPLOYER HEALTH PLAN MANAGEMENT

We manage your health plan with structure, discipline, and oversight — not just brokerage.

Vendor Governance & Performance Oversight

We manage all health plan vendors through a formal governance structure that brings clarity, accountability, and financial discipline. Every vendor—TPA, PBM, stop-loss, clinical partners, data platforms, and advocacy programs—is evaluated against documented KPIs, SLAs, and expected outcomes.

  • RFP Strategy, Selection & Contracting
    Independent evaluation and negotiation for TPA, PBM, stop-loss, clinical programs, and point solutions to ensure alignment with plan goals.
  • Performance Scorecards & KPIs
    Quarterly vendor scorecards measuring accuracy, responsiveness, trend impact, member experience, and cost performance.
  • Governance Calendars & Quarterly Reviews
    Structured annual schedule for audits, financial reviews, renewal preparation, compliance checks, and vendor performance meetings.
  • Employee Advocacy & Member Support Oversight
    Ensuring vendor partners provide timely, accurate support while escalating serious issues through a defined resolution pathway.
  • Compliance & Fiduciary Assurance
    Oversight aligned with ERISA and CAA/NSA requirements, including gag clause, Rx DC reporting, and documentation of all governance decisions.

CFO / CEO / CHRO Strategic Support

  • Benchmarking & Plan Performance Evaluation
  • Actuarial & Underwriting Analysis — budget, expected vs. max cost, and stop-loss modeling
  • Plan Design Impact Analysis — financial modeling of all changes
  • KPI Dashboard — predictive claims, specialty drug exposure, stop-loss triggers
  • High-Cost Claimant Oversight — escalation, mitigation, and tracking

HR & Operations Support

  • PEO Evaluation & Implementation
  • Payroll, HCM & BenAdmin Platform Alignment
  • HR Consulting — workflows, policy review, compliance
  • Handbook Development & Employee Communication
Employee Benefit Brokerage Services

Start With a Governance & Risk Diagnostic

A focused 20-minute conversation will quickly show whether your health plan has the governance,
financial controls, and vendor accountability your organization needs — or where the gaps are.

What you’ll receive:

  • A brief review of your current governance structure, pharmacy oversight, and financial monitoring
  • A preliminary assessment of risk, waste, or misalignment in your plan design, vendors, and contracts
  • Clear next steps to strengthen performance, reduce volatility, and protect your organization

No pressure. No obligations. Just clear visibility into how your plan is being run.

→ Schedule a 20-minute Governance Diagnostic call

Prefer email? Contact us at info@allypartners.net