A documented reason
the vendor was selected.

Ask your broker or consultant to run one contract through it: the RFP already underway, or the agreement already in force. You get the priced ambiguities, the disadvantageous terms ranked by dollar impact, and a record of how the number was reached.

Vendor selection, as documented
plan year
Vendor selectedon file
Bidders compared on the plan's own claimsnot on file
Contract terms priced, by dollar impactnot on file
Ambiguous terms identified and valuednot on file
Basis for the recommendationnot on file
The renewal projection

The renewal number arrives with no basis on which to challenge it.

Usually it is the incumbent's own projection. Sometimes it is a broker-run comparison of headline terms, which is hard to interrogate without the expertise to read the contract language underneath it. Either way, the number on the notice is the number that gets approved.

Healthcare is a top-three line item, and vendor selection is one of the few levers that does not touch anyone's benefits.

Renewal, as presented
plan year
Pharmacy trend
+9.4%against 6.0% medical

Industry Rx trend, research corpus. Illustrative of the conversation, not a projection.

Which contract terms drove the increaseno basis on file
What the plan actually paid under each oneno basis on file
Whether the terms were priced before signingno basis on file
What a different reading of them would costno basis on file
<15%

of employers have a formal fiduciary committee for health and welfare plans; more than half have taken no steps, are still considering, or are unsure

Assurex Global fiduciary poll (single poll, sample size not stated)

1 in 3

benefits managers fall short of the most basic ERISA fiduciary duties, at minimum

Journal of Law, Medicine & Ethics: 221 benefits managers, 50+ employee firms (fielded 2022)

+17–32 pts

higher net confidence in fiduciary safeguards reported by employers with complete claims-data access

National Alliance, Pulse of the Purchaser. Self-reported and descriptive, not causal.

What your advisor runs

Two inputs, and your advisor runs it.

Benchify is a tool your broker or consultant uses on your behalf. Nothing here needs a project from your team.

01
contracts.pdf
claims.csv

Your advisor sends two files

A claims file and the contract: the agreement in force, or every bidder's contract if an RFP is underway. No system integration on your side.

02
rebate ≥ floor × gen_rate

The contract becomes rules

Definitions, discounts, fees, rebate mechanics and exclusions become executable logic. Terms that do not resolve to a single meaning are flagged rather than assumed.

03
RX-48291$118.40
RX-48302$94.10
RX-48314$212.75
27.4k rows

Your own claims price it

The rules run against your plan's real claims, so the comparison is what you would actually have paid rather than what a rate card implies.

04
−$486K
§4.2(c)
RX-48291 …

You get a record

Findings, dollar impact and the clause behind every number. The reasoning is kept, not just the decision.

What you receive

What ends up in the file.

Concretely, what the artifact contains. That is a different thing from what any rule requires of you.

Vendor selection file
complete
Vendor selectedon file
Bidders compared on the plan's own claimson file
Contract terms priced, by dollar impacton file
Ambiguous terms identified and valuedon file
Basis for the recommendationon file
Every entry dated and attributable to a named source document.

Terms ranked by dollar impact

The disadvantageous terms in your agreement, ordered by what each is worth against your own claims. Every concern carries a magnitude, so you know which three are worth reopening. It is not a legal review.

Ambiguities, priced

Where a term admits more than one reading, you see each reading and the spread between them. That is the list to bring into the next negotiation.

A comparison on one basis

If an RFP is underway, every bidder priced against the same claims. So the recommendation rests on what the plan would have paid, not on whose rate card read best.

The reasoning, traceable

Every figure resolves to the contract line and the claims behind it. A year later, the basis for the decision is still recoverable by someone who was not in the room.

Renewals, attestations and board questions

When this is worth raising.

Most of these are already on your calendar.

  • Renewal

    A trend number that is hard to explain upward, arriving with no basis underneath it.

  • A board or audit committee question

    Healthcare spend deserves a better answer than the carrier's projection.

  • Rx becoming its own agenda item

    Pharmacy spend crosses the threshold where it stops being a line inside the medical conversation.

  • The gag-clause attestation

    Signed annually under the CAA, and worth more when there is underlying visibility behind the signature.

  • A new CFO

    Inherited vendor relationships get audited, and each one needs a documented reason.

  • Fiduciary training

    Or counsel asking how service providers were selected, and on what basis.

Your advisor, the law and prior RFPs

Fair questions.

Good, this is sold to brokers and consultants, not around them. The ask on this page is only that the selection process be documented, whoever runs it. Forwarding this to your advisor is the intended path.

We do not claim that, and you should be skeptical of anyone who does. What we will say is narrower: selecting and renewing a service provider is generally treated as a fiduciary act, and when a plan's payments to a provider are questioned, the documentation of how that provider was selected is what gets examined. This produces that documentation. It is not legal advice and it does not discharge a duty.

Then the single-contract motion applies: priced ambiguities and ranked redlines on the agreement already in force, with no bidders and no RFP in flight. Most agreements also permit an annual market check, which is a contractual hook that needs no RFP at all.

Most plans this size do not, and nothing here assumes one. It starts with one contract and produces a record; whether that becomes a standing process is a separate decision you do not have to make first.

What you send

Send one contract.

The agreement already in force, plus a claims file. You get the priced ambiguities, the terms ranked by dollar impact, and redlines to bring into the next conversation.

Send one file and one contract.

Best run by your broker or consultant. Forward this page to them, or send it yourself and we will work with whoever you name.

Start with one contract