October 15, 2025
Louis C. Bernardi, “The Benefits Whisperer”
💥 Certified Healthcare Fiduciary Coach and Health Value Advisor 💥 I work with Business Leaders of mid-sized. Did you know that optimizing your healthcare plan can contribute directly to your company’s survival and growth? ✨ When we compare the benefits of healthcare savings to findings from a recent college essay, “Ten Reasons Why Companies Keep Failing,” the connections are clear. Let’s explore how healthcare optimization addresses these pitfalls:
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Every major business decision follows a process: 🎯 Define the goal 📊 Gather data ⚖️ Evaluate options ✅ Make a decision 🔁 Monitor the results
Except when it comes to health insurance.
For most employers, the annual health plan renewal looks nothing like the disciplined decision-making that drives the rest of the business. And that’s no accident; the system is designed that way.
🎯 Step 1: Identify the Objective or Don’t
In every other department, success is measured by specific outcomes:
“Increase revenue by 10%.” “Reduce production costs by 5%.”
When it comes to benefits, the goal sounds more like:
“Keep employees happy and avoid disruption.”
That’s not strategy, that’s survival.
Without a clear objective, insurers and brokers quietly define one for you: protect their profits.
📊 Step 2: Gather the Right Information
Informed decisions require data, yet most plan sponsors never see their own claims data.
Insurers and PBMs deliberately control access, knowing that the less you see, the less leverage you have.
Imagine approving a seven-figure purchase with no specs, no cost breakdown, and no performance report. It sounds absurd, but that’s how most health plan renewals happen.
Transparency isn’t optional. It’s the foundation of every sound business decision.
⚖️ Step 3: Evaluate Real Alternatives
“Going to market” often means getting quotes from the same three carriers, reshuffling logos, not solving problems.
True alternatives exist when employers take control: ✅ Unbundle the plan (choose your own TPA, PBM, and navigation partner) ✅ Align incentives and audit vendor contracts ✅ Measure value, not discounts
One BritePath client, Oradell Animal Hospital, uncovered over $1 million in savings in their first year, not by switching networks, but by rebuilding their plan around transparency and purpose.
🧩 Step 4: Make the Decision With Accountability
Every other major business decision has ownership and review. Benefits rarely do.
Too often, decisions are delegated to brokers or HR, and no one is truly accountable.
But under ERISA, plan sponsors have a fiduciary duty to make prudent, informed decisions on behalf of their employees.
This isn’t about more work, it’s about smarter governance. When leadership gets back in the game, the conversation shifts from:
“How much did premiums go up?” to “How much value did our plan deliver?”
🔁 Step 5: Implement and Monitor
Smart organizations don’t set and forget, they track KPIs, measure ROI, and refine strategy.
Health insurance? We hit “auto-renew” and hope for better results.
A high-performance health plan isn’t an event, it’s a process. That’s what the PLAN System is built for:
- P: Planning with Purpose
- L: Leveraging Data and Transparency
- A: Aligning Incentives
- N: Navigating the Healthcare System
💬 Questions to Ask Before Your Next Renewal
(and what the answers really tell you)
1️⃣ What’s our measurable goal for this year’s health plan?
Typical Answer: “We just want to keep costs flat.” 🚩 Red Flag: That’s not a goal, that’s survival mode. No measurable outcome means no accountability. ✅ Better Answer: “Reduce total spend by 10% while improving care access and employee satisfaction.”
2️⃣ Have we reviewed the raw claims data and vendor compensation disclosures?
Typical Answer: “Our broker said it’s proprietary.” 🚩 Red Flag: If you don’t have full claims data, you’re making multimillion-dollar decisions blindfolded. ✅ Better Answer: “Yes, we review de-identified claims and use analytics to track cost drivers and outcomes.”
3️⃣ Are we evaluating truly independent options, or just carrier variations?
Typical Answer: “We went to market, same carriers, better discounts.” 🚩 Red Flag: That’s rotation, not competition. Managed care networks all run on the same profit model. ✅ Better Answer: “We compared traditional carriers to an unbundled model using independent partners.”
4️⃣ Who is accountable for this decision, and how will success be measured?
Typical Answer: “Our broker handles that.” 🚩 Red Flag: When everyone owns the decision, no one is accountable, and that’s a fiduciary risk. ✅ Better Answer: “Our CFO and HR director co-lead a fiduciary committee that meets quarterly.”
5️⃣ How do we measure whether employees are getting the right care at the right cost?
Typical Answer: “We rely on the carrier’s discounts.” 🚩 Red Flag: Discounts mean nothing when the starting price is inflated. ✅ Better Answer: “We track steerage to high-value providers and use navigation support to guide members to the best care.”
🚨 If your answers sound like the red flags…
Your business is stuck inside the Decision Trap, reacting to renewals instead of managing them. The good news? Once you start asking better questions, you take back control.
🧭 Next Steps
If you’re ready to rethink how your organization makes one of its biggest financial decisions, join me on the next episode of The Healthcare Heist Podcast.
You’ll walk away with one clear idea: 💡 If you bring the same discipline and transparency to your health plan that you use everywhere else in your business, you’ll finally stop reacting to healthcare, and start outsmarting it.
Contact the author at lcbernardi@britepathbenefits.com
Schedule a call at calendly.com/lcbernardi
Visit our website at www.britepathbenefits.com