Core Specialties
Specialized Support.
Generational Trust.
We don’t try to be everything to everyone. We focus exclusively on the high-stakes complexities of benefits strategy where others struggle, so your most critical plans don't just function, but thrive.
Advocacy for the Next Chapter
We remove the technical and political weight of retiree benefits from your shoulders. Our proven process protects sponsors from liability and provides brokers with the specialized oversight required to maintain plan integrity through every transition.
Plan Design Expertise
Institutional-grade strategies scale from 10,000 people down to groups of two. Through Premier Senior Health Plan, smaller organizations access proprietary Medicare supplements that bypass limitations of the individual market to deliver predictable costs.
Compliance & Operational Oversight
Our commitment to GASB standards and shifting regulations is why our client partnerships far outlast the national average. By keeping integrity and quality assurance at the top of our priority list, we provide long-term plan stability so you have what you need to lead.
Custom Client Solutions
We pride ourselves on being a partner who is there when you need us, providing the direct, name-knowing support of a family friend. Our tailored strategies protect your specific relationships and ensure goals are met with accountability and precision.
Contractual Integrity
Most pharmacy plans fail because they are built on PBM terms. We flip that dynamic, using international sourcing and direct-care strategies to protect the plan sponsor from misaligned incentives.
International Sourcing
By leveraging direct sourcing from Canada and other international markets, we identify the specific drug-level savings that traditional PBMs often overlook. Our sourcing discipline delivers a consistent, defensible reduction in annual pharmacy.
Clinical Utilization & Hospital Integration
Cost control starts with clinical appropriateness and direct-care access. We implement rigorous specialty drug strategies and hospital-based pharmacy care that reduce targeted claims
Direct Contracting
We manage the direct contracting process to ensure the provider is accountable to the plan sponsor—not the middleman. By removing the spread, we ensure the price you’re quoted is the price you actually pay, every time.
Risk Insulation
A poorly structured stop-loss policy is just a secondary liability. We apply a granular analysis strategy to the attachment points and contract language so your reinsurance functions as a predictable financial backstop.
Adversarial Risk Assessment
We don’t rely on carrier-standard formulas. We analyze historical claims and emerging clinical trends to identify the precise attachment points required to insulate the plan from volatility.
Technical Carrier Negotiation
Leverage is built on data. We manage the negotiation to secure stringent terms on lasers, aggregators, and terminal liability, stripping out the padded premiums that carriers use to hedge their own risk.
Claims Resolution & Recovery
When a catastrophic claim hits, we handle the heavy lifting. We actively manage the reimbursement process and push back on carrier denials to ensure the contract performs as promised, protecting your capital from seven-figure shocks.
The Mirror Image Strategy
We help healthcare systems bridge the gap between being a provider and being a plan sponsor. We ensure your internal employee benefits reflect the same high-performance, direct-care strategies you offer the community—turning healthcare spend into a strategic asset.
Internal Ecosystem Alignment
We transform your healthcare spend from a cost center into a strategic asset by prioritizing your own facilities and providers. By designing a plan that incentivizes employees to use the system they work for, we eliminate external leakage.
Specialized Pharmacy Stewardship
Health systems have unique pharmacy assets—like 340B programs and internal specialty labs—that national PBMs often fail to optimize. We provide the technical oversight to integrate these internal assets directly into your benefit design.
Direct Provider-to-Payer Connectivity
We specialize in cutting through the layers of national insurance carriers to create a straight line between the payer and the care. Our direct-contracting models remove the hidden markups and administrative spread of middleman vendors.
Built for Stakeholders
Think of our team as the connective tissue between those who design the plan, those who pay for it, and those who rely on it.
Technical Back-Office
We don’t compete for your clients, we protect your relationships. We handle the specialized audits and transitions helping you win and retain complex groups.
Fiduciary Oversight
We act as your contractual enforcer, ensuring your PBM and carriers are held to a clinical and financial standard that protects your budget.
Scalable Support
We focus on $0 copay sourcing and seamless transitions so that the people behind the plan receive the benefits they were promised.
"Health Insurance Services has been an indispensable group benefits resource to me, our agency, and our clients for many years. Their unique knowledge and product expertise in Medicare, retiree health, and partial self-funding are excellent for groups of all sizes, as is their assistance in sales, implementation, and customer service."
Request a Strategy Audit
Move your plan from projections to performance. We'd love to help.