HBL

Securing Over $1 Million in Health Plan Concessions
This case study highlights how strategic health plan negotiations secured over $1 million in vendor concessions, strengthened fiduciary compliance, and significantly reduced litigation risk for a global digital marketing firm.
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Securing Over $1 Million in Health Plan Concessions

Securing Over $1 Million in Health Plan Concessions

Client: Global Digital Marketing Firm

A Global Digital Marketing Firm is a technology leader in e-commerce, advertising, communications, and entertainment with over 1,200 U.S. employees. The company faced heightened risks of fiduciary breach lawsuits due to recent U.S. regulatory changes affecting its group health plan. These included the Consolidated Appropriations Act of 2021, new fee transparency rules, and evolving pharmacy benefits manager (PBM) laws. Hall Benefits Law (HBL) was engaged to negotiate contracts with key service providers—Aetna CVS Health (third-party administrator and PBM), Alliant Insurance Services (broker), and Delta Dental—to strengthen fiduciary protections and secure reasonable fees as required by the Department of Labor (DOL). The outcome: over $1 million in concessions from 2025-2029, reduced legal exposure, and a model for proactive ERISA compliance.

THE CHALLENGE

As an employer sponsoring a U.S. group health plan, Global Digital Marketing Firm was vulnerable to fiduciary breach claims for potentially paying excessive fees to service providers. Providers initially refused concessions, insisting 2025 rates were fixed, despite DOL mandates for reasonable compensation. This impasse risked ongoing overpayments, non-compliance with transparency requirements, and lawsuits, especially amid broader regulatory shifts emphasizing fiduciary duties.

THE TURNING POINT

When direct discussions with providers yielded no progress, Global Digital Marketing Firm recognized the need for specialized ERISA expertise to mitigate risks and leverage competitive alternatives. Without intervention, the company faced sustained high costs and potential breaches, prompting the engagement of HBL for strategic negotiations.

THE SOLUTION

HBL, led by partner Anne Tyler Hall with support from Tim Kennedy, conducted a comprehensive contract review to identify fiduciary vulnerabilities and unreasonable fees. They facilitated multiple dialogues with providers, educating them on Global Digital Marketing Firm’s risks under DOL guidelines. When concessions stalled, HBL interviewed alternative vendors and used the leverage of potential business loss to push for better terms, ensuring alignment with regulatory expectations for fee reasonableness and transparency.

Our Results

$1MM+ in Fee Concessions Secured

$1MM+ Concessions

Achieved over $1 million in total fee reductions spanning 2025-2029, including annual concessions and immediate cuts with future increase caps.

Enhanced Fiduciary Protections

Bolstered protections against breach lawsuits by negotiating contract terms that complied with DOL requirements for reasonable service provider fees.

Precedent-Setting Negotiations

Delivered innovative ERISA strategies, with HBL noting no other known firms handling similar proactive negotiations for plan sponsors.

Long-Term Cost Savings

Enabled Global Digital Marketing Firm to maintain competitive employee benefits while reducing overall plan expenses and legal risks.

WHY IT MATTERS

In an era of increasing ERISA scrutiny, employer group health plans must navigate complex regulations to avoid fiduciary pitfalls. This case highlights how targeted negotiations can turn regulatory challenges into opportunities for savings and compliance, emphasizing the value of specialized counsel in reviewing and renegotiating service provider agreements to protect plan sponsors and fiduciaries.

ABOUT HBL

Hall Benefits Law (HBL) is a boutique ERISA and employee benefits law firm helping employers design and defend retirement and health plans. With offices nationwide, HBL advises on M&A benefits, ESOPs, executive compensation, and compliance, and drives savings and transparency through TPA and PBM negotiations. Firm clients have realized over $400MM+ in penalty abatements and multimillion-dollar annual plan savings.