This case study illustrates how fiduciary training empowered a health plan board to initiate a competitive RFP process, resulting in premium increases capped at 3% and securing $7.5 million in projected savings.
Unlocking $7.5 Million in Premium Savings
Client: Board of Directors of a Large Group Health Plan
The Board of Directors of a Large Group Health Plan oversees a multiple employer welfare arrangement (MEWA) facing escalating premiums that threatened its viability for participants. Premiums, negotiated by the plan’s broker, were rising sharply, impacting affordability. Hall Benefits Law (HBL) partners Tim Kennedy and Anne Tyler Hall delivered ERISA-required fiduciary training, empowering the board to initiate a request for proposals (RFP) process for vendors. This led to negotiated 3% premium increases (versus the national average of 8.5%), a 10% rate cap reduction, and extrapolated savings of $7.5 million from 2023 through 2026, with effects extending to 2027.
THE CHALLENGE
As fiduciaries, the board struggled with rising premiums that could force plan discontinuation, lacking the tools to evaluate and challenge vendor proposals effectively. Without enhanced understanding of ERISA duties, they risked non-compliance, higher costs, and failure to meet obligations to participants in a competitive benefits environment.
THE TURNING POINT
Recognizing the need for fiduciary education to fulfill ERISA requirements and optimize operations, the board sought specialized guidance. Unaddressed, the premium hikes would erode participant access and board effectiveness, prompting HBL’s engagement for targeted training and strategic advice.
THE SOLUTION
HBL provided periodic training on ERISA fiduciary responsibilities, encouraging an RFP process for all plan vendors. This equipped the board to solicit, review, and negotiate proposals, resulting in favorable terms that capped increases and delivered substantial savings while maintaining compliance.
Our Results
$7.5MM Extrapolated Savings
Achieved $7.5 million in total savings from 2023, extending through 2026, by negotiating lower premium hikes.
Premium Increases Capped
Secured 3% increases against an 8.5% national average, with a reduced 10% rate cap for stability.
Fiduciary Empowerment
Enhanced board knowledge through ERISA training, enabling proactive vendor management and compliance.
Long-Term Viability
Positioned the plan for sustainability with effects to 2027, improving affordability for participants.
WHY IT MATTERS
Fiduciary boards managing MEWAs often overlook RFP processes amid rising costs, but ERISA training can transform oversight into cost-saving action. This case highlights how education and negotiation empower fiduciaries to reduce expenses, ensure compliance, and sustain benefits, preventing plan erosion in a high-cost healthcare landscape.
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.