Commission-Free Healthcare Advisory: How We Align Incentives for Enterprise Savings

Table of Contents

• The Hidden Cost of Conflicted Broker Relationships
• Why Traditional Commission Models Undermine Your Savings
• Our Commission-Free Structure and How It Works
• Transparent Fee Alignment with Your EBITDA Goals
• Self-Insured Program Restructuring Without Hidden Conflicts
• Implementing Claims Surplus Rebates in Your Plan Design
• Measuring ROI Through Our Savings Estimation Tools
• Moving Forward: Your Path to Sustainable Healthcare Spend Reduction

The Hidden Cost of Conflicted Broker Relationships

Most enterprise healthcare brokers operate under a commission-based model where they earn revenue based on the plans they recommend and the premiums your company pays. This creates a fundamental misalignment: the broker profits when your healthcare costs rise, not when they fall.

Consider a typical scenario. Your CFO tasks a broker with reducing your $50 million annual healthcare spend. That same broker earns commissions tied to your premium payments. If recommending a self-insured structure would lower premiums by 15 percent, the broker's commission drops accordingly, even though your company saves millions. The financial incentive quietly pushes toward status quo solutions that protect the broker's revenue stream.

This conflict runs deeper than most procurement teams realize. Brokers have relationships with carriers, consultants, and vendors that generate ancillary revenue. A recommendation that disrupts those relationships often gets deprioritized, regardless of its merit for your bottom line. Hidden fees embed themselves across plan design, claims management, and network access in ways that remain obscure until you dig into the details.

Actionable takeaway: Request a full fee disclosure from your current broker, including all commissions, bonuses, and carrier incentive payments. Most enterprises discover they're paying 2-4 percent of premiums in broker compensation without clear visibility.

Why Traditional Commission Models Undermine Your Savings

Commission-based compensation creates structural barriers to legitimate cost reduction. When a broker earns $2 million annually on your current arrangement, recommending a restructure that cuts your spend by 25 percent directly threatens their income. The broker may acknowledge your savings goals in meetings while quietly steering you toward incremental, low-risk options.

This isn't conspiracy. It's economics. Brokers face quota pressure from their firms, compensation tied to gross revenue, and career advancement built on maintaining existing accounts. The system incentivizes preservation over transformation.

The result compounds over time. You receive plan design recommendations that look competitive on the surface but lock you into carrier-dependent models where true transparency remains limited. Claims management stays opaque. Network negotiations happen behind closed doors. Surplus rebates that should flow back to your plan often disappear into undisclosed account arrangements.

Large enterprises typically overpay 20-40 percent on healthcare costs compared to optimized self-insured structures, yet commission-based brokers lack the economic motivation to highlight this gap.

What to do next: Compare your broker's recommendations against recommendations from a commission-free advisor who has no financial stake in your current arrangements. The difference in savings opportunities often becomes immediately apparent.

Our Commission-Free Structure and How It Works

We operate on an entirely different model. RevampHealth charges transparent, fixed fees based on the scope of advisory work, not on the premiums your company pays. If your healthcare spend decreases, our fee remains unchanged. This alignment means we profit when you profit.

Our commission-free approach removes the conflict at every stage:

• Plan design: We recommend self-insured structures because they work for your situation, not because they generate renewal commissions.
• Carrier negotiations: We push for pricing and terms that maximize your savings without worrying about jeopardizing commission relationships.
• Claims management: We structure arrangements that reduce your actual medical costs, not arrangements that generate administrative fees for intermediaries.
• Network access: We negotiate direct relationships with PPO networks that provide superior pricing without markup tiers.

Because we don't earn money when your premiums rise, we have every incentive to implement genuine cost reduction strategies. This structural alignment creates accountability that commission-based models cannot match.

Transparent Fee Alignment with Your EBITDA Goals

When we work with enterprise leadership, we tie our advisory fees directly to EBITDA improvement targets. This means your CFO knows exactly what we charge and what return they should expect from our engagement.

Our fee structure typically works like this: you pay a transparent project fee for comprehensive plan analysis and strategy development, plus an optional performance component if savings exceed an agreed-upon threshold. Unlike commissions that hide within renewal processes, these fees appear as clear line items on your budget.

For a $50 million enterprise health plan, our advisory engagement might cost $150,000 to $300,000, with potential performance fees if we identify and implement savings beyond baseline. Compare this against the $1-2 million in annual broker commissions many enterprises unknowingly pay, and the economic case becomes straightforward.

More importantly, our fee aligns your savings goals with ours. When your EBITDA improves by capturing healthcare savings, we demonstrate tangible value. When you save $10 million on your annual healthcare spend, your CFO sees a direct line from advisory engagement to corporate profitability.

Action item: Request a detailed fee proposal that breaks down advisory costs against projected savings. Legitimate commission-free advisors should be comfortable providing this transparency upfront.

Self-Insured Program Restructuring Without Hidden Conflicts

Self-insured plans represent the most significant opportunity for large enterprises to reduce healthcare spend, yet commission-based brokers often recommend them only when forced. Why? Because self-insured structures reduce renewal commissions and require genuine claim management expertise that not all brokers possess.

We specialize in restructuring enterprises from fully-insured to self-insured programs, which typically delivers 15-30 percent savings over three to five years. The transition eliminates carrier profit margins, surplus loading, and commission stacks. You move from paying for insurer overhead to paying only for actual claims plus lean third-party administration.

The restructuring process involves several critical components:

• Carrier agreement termination and financial settlement
• Third-party administrator (TPA) selection and contracting
• Stop-loss insurance procurement at optimal retention levels
• Claims data transition and reporting system setup
• Employee communication and plan education

Without commission conflicts, we recommend the TPA, stop-loss carrier, and network arrangements that deliver the best outcomes for your claims experience and cost profile, not the arrangements that generate the highest ancillary fees.

Our enterprise savings case studies demonstrate how large employers have navigated this transition successfully.

Implementing Claims Surplus Rebates in Your Plan Design

One of the most direct cost-reduction levers available to self-insured employers involves claims surplus rebate structures. When your plan experiences favorable claims outcomes, that surplus belongs to your company, not to a carrier or administrator.

Commission-based brokers often fail to highlight this opportunity because rebates reduce the total premiums from which they earn commissions. We prioritize rebate structures that return excess funds to your plan as quickly as possible.

Here's how this works in practice: if your annual healthcare spend projection is $50 million but actual claims come in at $45 million, the $5 million surplus flows back to your plan rather than being absorbed by carrier or TPA profit. Over multiple years, rebate structures can return millions to your company.

We structure rebate arrangements with your TPA and stop-loss carrier to ensure:

• Surplus calculations remain transparent and auditable
• Rebates process within 90 days of plan year close
• Surplus can be used to reduce the following year's costs or returned to employees through plan enhancements
• Definitions of surplus remain clear and free from administrative manipulation

Measuring ROI Through Our Savings Estimation Tools

Measuring healthcare advisory impact requires more than comparing year-over-year premiums. We use the CFO savings estimator to model your specific situation and project realistic savings across multiple scenarios.

Our estimation process accounts for:

• Current claims experience and cost trends
• Recommended plan design changes and their impact on utilization
• Self-insured versus fully-insured financial models
• Stop-loss pricing at various retention levels
• TPA fees and claims processing costs
• Network optimization savings

Rather than presenting generic industry benchmarks, we analyze your actual claims data, employee demographics, and cost drivers to project returns specific to your organization. This transparency allows your finance team to evaluate advisory engagements against concrete ROI models.

We typically recommend measuring success against baseline metrics established at the start of engagement, tracking actual claims, premiums, and administrative costs through year three. Most clients see positive ROI within the first plan year, with cumulative savings accelerating over subsequent years as program design optimizations mature.

Moving Forward: Your Path to Sustainable Healthcare Spend Reduction

Reducing enterprise healthcare spend by 20-40 percent requires more than incremental plan tweaks. It requires a partner whose economic incentives align perfectly with your savings goals.

The commission-free advisory model removes the structural conflicts that have long constrained healthcare cost reduction. By eliminating commissions, we can focus exclusively on identifying and implementing strategies that improve your bottom line.

Your next step is straightforward: evaluate your current broker's compensation structure and compare it against what commission-free advisory offers. Request a no-obligation consultation with our team to review your claims data and develop a preliminary savings assessment. We'll show you the specific opportunities available in your plan without the conflicts that commission-based relationships create.

Healthcare benefits don't need to be a hidden cost driver masked by opaque broker arrangements. RevampHealth helps enterprise leaders implement transparent, aligned advisory relationships that deliver measurable savings and EBITDA improvement.