Plan analyst: reads the claims through the year, not at renewal.
This is the seat most employers have never had. The plan analyst watches the plan as it develops — claims, pharmacy, utilization, high-cost outliers — so that a problem is found while it is still something you can plan around. A large claimant that surfaces in month four is a decision. The same claimant found at renewal is a number you absorb.
A renewal is arithmetic. Somebody has to do the arithmetic.
Carrier reporting answers the question the carrier wants answered. The analyst’s job is to reconstruct the number independently, so your side of the conversation is not built on the other side’s summary.
Claims as they develop
Monthly rather than annually, with large claims tracked and the pattern behind them identified — chronic condition management, a facility being used unnecessarily, a drug category moving fast.
The held-census reprice
Premium change measured on a constant census, so headcount movement does not masquerade as savings or as a spike. One employer, one year, three correct answers: +21 percent total premium, +9.55 percent blended PEPM, +6.80 percent held census. Only the third describes what happened to the cost of covering the same person.
Trend, in three lines
The national line, the local filed line, and your own. They disagree, and the disagreement is the insight a single industry figure hides.
Analysis, not a spreadsheet handed back to you.
The funding comparison
Fully insured, level funded and self funded priced against your own experience, with the assumptions written where you can argue with them.
The outlier flag
High-cost claims and emerging categories raised during the year, in time to affect stop-loss terms and plan decisions rather than to explain them afterwards.
The benchmark cut
Your plan against employers matched on size, region and industry, with the cohort described so you can judge whether the comparison is fair.
Nobody does this work in the week a renewal is due.
It is year-round or it is nothing
Reading claims in month eleven tells you what happened. Reading them monthly tells you what to do. The difference is a dedicated seat.
It is how the argument gets built
Challenging a renewal requires numbers, not an opinion. This seat is where the numbers come from.
Every client gets it
Benchmarking, trend analysis and year-round reading are not reserved for the largest accounts. They are how we run an account.
We are hiring plan analysts.
If you read this page and recognized the job rather than the service, that is worth a conversation. Bloomfield Hills or remote, and pay is based on experience.
There’s no formal mentorship program here — just people who’ve done the job for years, sitting close enough to ask.
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.
Bloomfield Hills, MI 48304
248.370.8853
719.425.2649
281.404.5670
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