Self-funded health plan specialists
Self-funded plan documents, reviewed before gaps become problems.
We review plan documents, vendor agreements, and compliance obligations for employers — and serve as an outsourced compliance department for benefits brokers.
The review delivers
- Written findings
- Prioritized concerns
- Document discrepancies
- Recommended corrections
- Findings review meeting
Documents compared across vendors
Findings organized by priority
Responsible parties identified
Corrections coordinated before renewal
The documents should agree. The responsibilities should be clear.
A self-funded plan can involve a plan document, SPD, TPA agreement, stop-loss policy, amendments, and multiple vendor arrangements.
We review how those pieces work together, identify gaps, and help the responsible parties coordinate practical next steps.
We examine the documents governing the plan and compare their terms with vendor obligations and intended administration. The result is a clear, prioritized assessment — not another generic checklist.
- Plan document
- The governing instrument and its amendments.
- Summary Plan Description
- Participant-facing descriptions that should align with the plan.
- TPA and vendor agreements
- Responsibilities allocated to administrators and vendors.
- Stop-loss policy
- Coverage terms that affect plan risk and cash flow.
- Amendments and notices
- Historical changes and required disclosures.
How we work together
Two ways to engage.
Employers engage us directly for their own plan. Brokers engage us as compliance capacity behind their team.
Direct engagement
Employers and Plan Sponsors
Understand your documents, responsibilities, and priority corrections.
Employer ServicesPartnership
Benefits Brokers
Add specialized compliance depth to your team and client relationships.
Broker PartnershipsHow our review works
From documents to decisions.
- 01
Collect
Gather plan documents, agreements, amendments, and supporting materials.
- 02
Compare
Check how plan terms, vendor duties, and administration align.
- 03
Prioritize
Rank findings by impact and identify the responsible party.
- 04
Resolve
Coordinate corrections with the employer, broker, and vendors.
Plan Document Review — Findings Summary
Plan Year redacted · Prepared for redacted
| Document | Provision | Observation | Priority | Recommended Next Step |
|---|---|---|---|---|
| Plan Document | Eligibility definition | Definition differs from the description used in enrollment materials. | High | Confirm intended terms and align documents. |
| SPD | Claims and appeals timeline | Stated timeframes do not match the administrator's published procedure. | High | Reconcile with TPA and update disclosure. |
| TPA Agreement | Allocation of responsibilities | Certain administrative duties are not clearly assigned to either party. | Medium | Clarify responsibility in writing at renewal. |
Supporting services
Specialized compliance support.
Focused engagements that sit alongside the document review when a plan needs them.
Self-assessment
Surface potential compliance gaps in three minutes.
Answer ten questions to identify areas that may deserve closer review.
Request a Self-Funded Plan Document Review
Tell us about your plan and we'll respond promptly with appropriate next steps.