Administration is the part nobody quotes on.
A renewal compares premiums and plan designs. It does not compare what happens when an eligibility file is wrong, when a terminated employee is never reported to the carrier, or when an auditor asks for a plan document that does not exist. These costs arrive later, and they are why an apparently cheaper plan is sometimes the expensive one. Our benefits administration and technology page covers the systems side.
The work behind the plan.
The Eligibility File
The list of who is covered, sent from payroll or HR to the carrier. Errors become claims paid for people who are no longer eligible, or coverage denied to people who are. We check how the file is produced, how often it is sent and who reconciles it.
The Audit Trail
Carriers and regulators can ask for proof of enrollment, qualifying events and notices. We check whether those records exist and whether anyone can find them.
The Plan Documents
A benefits guide is not a plan document. We check that the documents that govern the plan exist and are current, and read more on that in our guide to plan documents.
The Calendar
Notices, filings and deadlines recur on a schedule. We check who owns each one, so none depends on someone remembering.
Find the gaps before someone else does.
Reconcile the File to the Invoice
Comparing who the carrier bills for against who is actually employed and enrolled is the fastest way to find errors, and it finds them in both directions.
Close the Document Gap
Where governing documents are missing or out of date, we say what is needed and who should prepare it.
Name an Owner for Every Task
Each recurring obligation gets one named person, a date and a backup. Our compliance calendar is the starting list.
A short list of what to fix, in order.
A plain list of gaps, ranked by how much each could cost if it surfaced in an audit or a claim dispute, with a recommendation for who should own the fix. It starts from the same four documents as any renewal review.
Start with your renewal · If you are an HR team of one
The other three lenses: Cost · Plan Performance · Risk
Three questions about administration.
The ones that surface after the renewal is signed.
What is an eligibility file?
It is the regular list of covered employees and dependents sent to the carrier from your HR or payroll system. If it is wrong, claims and premiums follow the error.
Is a benefits guide the same as a plan document?
No. A guide summarizes the benefits for employees. The plan document is the legal description of the plan. Having one does not satisfy the need for the other.
Who is responsible when the carrier’s records are wrong?
It depends on the contract and the plan, which is why we begin by reading what each party has agreed to produce and by when. Plan-specific questions go to ERISA counsel, and we bring them in.
Ready? Upload your renewal, or talk it through with someone first. No cost, no obligation.
General information, not legal advice. Plan-specific questions belong with ERISA counsel, and we will bring them in.
Send us your renewal.
We’ll tell you whether it looks competitive, where we see opportunity, and the five questions we’d put to your carrier. No cost, and no obligation to move anything.
The renewal letter
Your current plan summary
Contribution split by tier
Enrolled counts by tier
Four documents, two more if your group is 50 or more. Nothing else; every extra one is a reason to postpone.
An independent employee benefits consulting firm. We look at the entire benefits program — cost, plan performance, risk and administration.
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