Start Here: What's the one outcome we can't miss?

• In one sentence, what single outcome from this renewal would make the board and your executive team breathe easier?
• Who on your team will judge whether this engagement was successful? Options: CHRO, VP Total Rewards, CFO, Head of Benefits Operations, Board/Comp Committee Liaison, Other
• What specific deadline or renewal date is driving that urgency? Options: < 1 month, 1–2 months, 2–3 months, 3–6 months, 6+ months
• Right now, how confident are you that the renewal will produce a defensible recommendation to the board? Options: Very confident, Somewhat confident, Unsure, Not confident at all
• What’s the one question you expect your CFO or board to ask after we present?

Is your advisor actually representing your interests—or someone else’s?

• If your broker recommended last year’s carrier because it paid the highest commission, how would you discover that now?
• Which of these best describes your current broker compensation understanding? Options: Fee-only disclosed, Commission-based with partial disclosure, Unknown/no disclosure, Hybrid — unclear split
• How worried are you that carrier relationships are influencing recommendation quality? Options: Very worried, Somewhat worried, A little worried, Not worried
• Tell me about a time you suspected a recommendation was driven by the broker’s incentives rather than your needs. What tipped you off?
• What proof would you need to feel confident your advisor is uncompromised? Options: Fee-only contract, Full commission disclosures, References from similar employers, Commitment that senior consultant will lead, Audit of past renewals

When costs keep climbing, who and what feel the pain?

• What happens inside the company when medical renewals increase 8–12% year over year—who feels pressure first? Options: CFO/finance pressure, HR hiring freezes, Benefit plan cuts, Employee dissatisfaction, Board intervention
• How has repeated high growth in premiums affected recruiting, retention, or morale in the last 12–24 months?
• How long have you been seeing consecutive above-market renewal increases? Options: < 1 year, 1–2 years, 2–3 years, 3+ years
• When you think about the last renewal negotiation, what part felt like the biggest missed opportunity (pricing, clinical strategy, vendor choice, transparency, other)? Options: Pricing, Clinical strategy, Vendor choice, Transparency, Other
• Describe an example where a recommendation reduced cost but later created negative downstream effects (employee complaints, network issues, billing disputes).

What would a convincing win actually feel like to your executive team?

• If you could deliver one measurable win to the board next quarter, what would it be (dollar savings, reduced trend, better networks, governance clarity)? Options: Immediate premium savings ($), Lower medical trend (%), Improved network/clinical outcomes, Clear governance & reporting, Better employee experience
• What range of savings or trend improvement would be considered meaningful for your CFO? Options: < 3%, 3–6%, 6–10%, 10%+
• How important is maintaining benefit competitiveness (for hiring) versus maximizing near-term cost savings? Options: Benefit competitiveness is top priority, Balanced — both matter equally, Cost savings are top priority
• Which evidence will convince the board that savings are sustainable (select all that apply)? Options: Granular benchmarking vs peers, Client references with documented savings, Actuarial modeling of scenarios, Clear fiduciary and fee disclosures, Governance cadence and KPIs
• Imagine we present a recommendation your team loves but HR worries will harm recruiting—how would you want us to pursue alignment?

Reality Check: What data and evidence do we actually have?

• How soon can you provide the last 24 months of claims and enrollment data? Options: Immediately, Within 2 weeks, 2–4 weeks, Not available/needs work
• Which of these datasets are accessible today (select all that apply)? Options: Medical claims (paid), Pharmacy claims, Enrollment files (ACA/eligibility), Provider invoices/stop-loss, Broker renewal submission, None of the above
• What quality issues do you anticipate in your data (missing TINs, lag, carve-outs, vendor formatting)?
• How granular do you need benchmarking to be for the board to accept it? (industry, region, size, employee demographics) Options: Industry+region+size, Industry+size, Region+size, Any credible national benchmark
• If we can run a scenario comparing your current renewal, self-funding, RBP, and pharmacy carve-out, which outcomes matter most to you? Options: Cost savings, Net cost after risk transfer, Provider network impact, Clinical quality outcomes, Employee out-of-pocket impact

What tradeoffs are you truly willing to accept?

• If achieving a 7–10% improvement requires modest benefit design changes, would you be willing to proceed? Options: Yes — open to tradeoffs, Maybe — need more detail, No — benefits must remain unchanged
• Which of these tradeoffs would be unacceptable under any circumstance? Options: Higher employee cost-sharing, Reduced provider access, Eliminating popular benefits, Increased administrative complexity, None — open to tradeoffs
• Tell us about any previous change you implemented that backfired—what warning signs should we avoid?
• How important is employee communications and change management to you if changes are recommended? Options: Critical — must be flawless, Important — we need support, Moderate — we can manage, Low priority
• Are there internal stakeholders (unions, execs, benefits committee) who could veto changes? Who and what are their main concerns?

Who decides, and how will decisions be defended to the board?

• If we surface an option that shifts risk to the employer (self-funding or RBP), who must sign off and why? Options: CFO, CHRO, Benefits Committee, General Counsel, CEO/Board Liaison
• What evaluation criteria will you use to compare advisory firms (benchmarks depth, references, fee model, continuity)? Options: Benchmark depth, Evidence of savings, Fee-only disclosure, Client retention & references, Senior consultant continuity
• How important is it that the senior consultant who pitches also leads delivery? Options: Essential — must lead, Very important, Somewhat important, Not important
• What governance cadence do you want post-deal (monthly, quarterly, ad-hoc) to satisfy the board’s oversight? Options: Monthly, Quarterly, Bi-annual, Ad-hoc/on request
• Describe the last time an external advisor failed to provide continuity—how did it affect outcomes?

Picking an Advisor: What would make us earn your trust quickly?

• If we offered immediate access to benchmarking slices for your industry/region/size, would that change your willingness to proceed? Options: Yes — greatly increases willingness, Somewhat — helpful, No — not decisive
• Which proof points matter most up front when selecting an advisor? Options: Comparable client references, Deep benchmarking samples, Transparent fee disclosures, Case studies with measurable savings, Assurance senior consultant will lead
• How would you like fee and commission disclosures presented to your board for easy review? Options: Standardized one-page disclosure, Full transaction history, Third-party audit, Verbal assurance plus doc
• What concerns would stop you from selecting a fee-only advisor even if they show strong benchmarking? Options: Lack of implementation support, No proof senior lead will stay, Insufficient client references, Data quality concerns, None — prefer fee-only
• What timeline and decision checkpoints do you need to feel comfortable moving from discovery to commitment? Options: 2–4 weeks with weekly checkpoints, 4–8 weeks with bi-weekly, 8+ weeks, Unsure — need advisor recommendation

Readiness: If we start now, what could block a 3–6 month turnaround?

• Which of these would be the primary implementation risks for a mid-year change? Options: Vendor integration delays, HRIS/TPA data issues, Employee communication failures, Carrier resistance, Regulatory or compliance hurdles
• Do you have internal change-management owners and communications windows already assigned? Options: Yes — assigned and ready, Partially assigned, No — will need support, Unsure
• What internal resources can we count on for data handoffs and system access? Options: Benefits ops, HRIS team, Finance, Internal vendor managers, External broker
• What would a reasonable next step look like from your perspective after this discovery? Options: Data handoff & kickoff, Benchmark preview, Reference checks, Commercial terms discussion, Other
• On a scale from 1–10, how ready is your organization to commit to a new advisor and potentially a different funding model? Options: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10

A Quick Snapshot: Where Are We on Your Renewal?

• What is your upcoming renewal month and how many months away is it? Options: <1 month, 1–2 months, 3–4 months, 5–6 months, 7+ months
• Who is the primary owner of the renewal decision inside your organization? Options: CHRO/Head of HR, VP Total Rewards/Comp, CFO/Finance, Benefits Manager, Cross-functional committee, Other
• How many covered lives does this renewal affect (including employees + dependents)? Options: <1,000, 1,000–5,000, 5,001–15,000, 15,001–50,000
• Briefly describe the single biggest frustration you have with your current renewal process.
• Do you currently have an internal deadline (procurement, board, or payroll) that constrains the renewal timeline? Options: Yes — board/committee deadline, Yes — procurement deadline, Yes — payroll/benefits admin deadline, No formal deadline, Not sure

Are We About to Repeat the Same Cost Story?

• What if your next renewal follows the same pattern—would your board or finance team consider that acceptable? Options: Unacceptable — immediate action required, Concerning — needs explanation, Manageable for now, Unsure
• How many consecutive years have you seen increases in the 8–12% range (or higher)? Options: This is the first year, 2 years, 3 years, 4+ years, Unsure
• When you think about the last renewal negotiation, what felt most broken (pricing, transparency, network selection, clinical outcomes, other)? Options: Pricing, Transparency of fees/commissions, Network quality, Clinical outcomes/data, Negotiation effort, Other
• Describe a concrete consequence if this renewal results in another double-digit increase (e.g., hiring freeze, benefit cuts, budget reallocation, board escalation).
• How emotionally urgent is this to you and your leadership team on a scale from calm to crisis? Options: Crisis — immediate action, Highly urgent, Moderately urgent, Watchful but not urgent, Low priority

What’s Actually in Your Data (and What’s MIA)?

• If I asked for your most recent 12–24 months of data, what exact files would you be able to share within 72 hours? Options: Fully populated claims (medical + Rx), Enrollment files by month, Premium invoices/renewal exhibits, Carrier contracts/SBCs, None/partial
• How confident are you in the quality and cleanliness of your claims data right now? Options: Very confident, Somewhat confident, Questionable — some cleanup needed, Not confident / needs significant work
• Which specific analytics or slices matter most for your benchmarking and why (e.g., age bands, geography, plan tier, ICD clustering, high-cost members)?
• Have you previously received a vendor-side analysis (carrier or broker) of the same data? If so, what did you accept or dispute from that analysis? Options: Yes — accepted most, Yes — disputed conclusions, No — this is first independent review, Not sure
• What internal systems or people will be required to extract and validate data (HRIS, payroll, broker, third‑party admin)? Options: HRIS/Payroll, Benefits/HR team, Current broker, TPA/Carrier, Outside actuarial/vendor, Other

Who’s Actually Steering This Conversation?

• If your current broker were removed from the room, how different would the conversation be about carriers and plan design? Options: Completely different, Somewhat different, Not much different, Unsure
• How long has your incumbent broker/advisor held your account and what makes them hard to replace (relationships, embedded systems, perceived value)?
• Do you have any contractual exclusivity, captive arrangements, or large termination liabilities with your broker or carrier partners? Options: Yes — exclusivity/captive, Yes — termination fees, No material liabilities, Not sure
• Are there other advisors, internal or external, who will need to be engaged in a potential shift (legal, procurement, benefits consultant, union reps)? Options: Legal, Procurement, Internal Finance, Union/employee reps, External consultants, None
• When selecting an advisor, how important is a fee-only model, independent benchmarking depth, and the continuity of the senior consultant who pitches the work? Rank the three in order of priority. Options: Fee-only independence, Benchmarking depth, Senior consultant continuity

Where Could the Renewal Break Down (Before It Even Starts)?

• What single operational or political risk do you fear most derailing this renewal (data delays, internal approvals, carrier pushback, employee backlash, vendor turn-over)? Options: Data delays/quality, Internal approvals, Carrier resistance, Employee dissatisfaction, Vendor/TPA instability, Other
• Have you experienced sudden mid-year cost shocks (large claims, new high-cost Rx, pandemic effects) that should influence how we model the renewal? Options: Yes — major shocks, Yes — moderate, No significant shocks, Unsure
• Are there upcoming organizational events (M&A, divestiture, large hiring/layoff, union negotiations) that could change enrollment or risk profile during the renewal window? Options: M&A or divestiture, Planned large hiring, Planned layoffs, Union negotiations, None anticipated, Unsure
• What mitigation steps have you tried in past renewals when risk surfaced—and which actually moved the needle?
• How flexible are you to implement changes mid-year if early warning signals appear during analysis? Options: Very flexible — will act quickly, Somewhat flexible — needs approvals, Not flexible — only at renewal, Unsure

If You Could Protect One Thing, What Would It Be?

• When you imagine a successful renewal outcome, what single element would make you feel the most relieved (cost savings, benefit competitiveness, vendor transparency, minimal implementation fuss)? Options: Cost savings, Benefit competitiveness, Full transparency (fees/data), Smooth implementation, Senior consultant leadership continuity
• What’s an acceptable tradeoff between immediate premium reduction and benefit richness from both talent and retention perspectives? Options: Reduce cost even if benefits tighten, Maintain benefits even with higher cost, Moderate trade — preserve core benefits, Unsure
• Are there hard minimums or non-negotiables for benefit design (e.g., mental health parity, specific network access, retiree coverage) we must protect? Options: Yes — list specifics, No hard minimums, Some non-negotiables — will list
• How would you define a 'go' decision at the end of discovery—what evidence or metric seals it for your leadership (projected $ savings, % of premium reduction, reference case, benchmark percentile)? Options: Projected $ savings, Percentage reduction vs renewal, Benchmarked percentile improvement, Reference client outcomes, Other

Getting Ready to Move: What Would Help You Say Yes?

• What are the minimal documents and commitments we need to secure to start a discovery (data access, NDA, budget approval, single point of contact)? Options: Data access permission, Signed NDA, Budget/PO, Executive sponsor identified, Single POC, Other
• Who needs to sign off on engaging an independent advisor and which stakeholder is the most likely blocker? Options: CHRO, CFO, Board/Comp Committee, Procurement, Benefits Manager, Other
• What timelines or windows in the next 4–8 weeks would make it realistic to begin data intake and an initial benchmarking readout? Options: Immediately (this week), 1–2 weeks, 3–4 weeks, 4–8 weeks, Longer / not ready
• Would you expect the senior consultant who pitches this engagement to be the named lead on delivery, and how important is that continuity to your willingness to proceed? Options: Absolutely essential, Important but negotiable, Somewhat important, Not important
• Is there anything else about timing, governance, or evidence we should know that would make starting discovery smoother for you?

Quick Read: How Ready Do You Feel?

• On a scale from 'completely ready' to 'not ready', how would you describe your team's deployment readiness right now? Options: Completely ready, Mostly ready, Partially ready, Not ready, Unsure
• What's the single biggest factor that made you choose that readiness level?
• What is the target go-live or effective date we must align to? Options: Specific date (enter below), Start of plan year, Payroll cycle date, Mid-year effective date, TBD
• If that date is fixed, list the immovable milestones or approval deadlines tied to it.
• Which internal groups should be looped into this stage from day one? Options: Total Rewards/Benefits, HR Business Partners, Payroll, IT/Security, Finance, Corporate Communications, Legal/Compliance, Vendor Management, Other

Who Will Actually Move the Needle?

• If something goes wrong during deployment, who is the single person we'd call first—and do they have the authority to solve it? Options: CHRO, VP Total Rewards, Benefits Ops Lead, HRIS/Payroll Lead, IT Security Lead, CFO, No single point of contact, Unsure
• Please list the change-management owners (name and title) we should engage and what each is accountable for.
• How is decision authority structured for go-live changes—who can approve vendor changes, communications, or budget reallocations? Options: VP Total Rewards only, Joint sign-off (HR + Finance), Executive sign-off required, Delegated to Benefits Ops, Escalation to CHRO/CFO, Other
• Do the assigned owners have dedicated capacity for implementation or is this a collateral duty? Options: Dedicated full-time, Part-time dedicated, Collateral duty, No assigned capacity, Unsure
• Share an example of a recent implementation your team owned—what worked and what caused the biggest delays?

Are Your Systems Ready to Talk to Each Other?

• If a carrier or HRIS rejects our files on the first transmission, how long before payroll, enrollment, or benefits administration is materially impacted? Options: Under 24 hours, 1–3 days, Several days, A week or more, Unsure
• Which systems will require data handoffs, file drops, or API integrations for this deployment? Options: HRIS (Workday/ADP/UKG), Payroll system, Benefits administration platform, Carrier portals, TPA/Claims system, PBM/Pharmacy systems, HSA/FSA administrator, Enrollment vendor, Other
• List the primary data elements we must transfer (e.g., member IDs, enrollment elections, effective dates, payroll deductions, demographics).
• How are files currently delivered and authenticated (SFTP, API with tokens, carrier portal upload, manual entry)? Options: SFTP, API (OAuth/API key), Carrier portal upload, Manual file upload by vendor, Email (unsecure), Combination, Unsure
• Are there outstanding IS/security approvals (SOC2, DPIA, vendor contracts) that could block technical onboarding? Please specify.

When Will People Hear About It—and Will They Understand?

• If the first employee communication causes confusion, which consequence concerns you most—an overwhelmed HR inbox, enrollment mistakes, or reputational damage? Options: Overwhelmed HR inbox/calls, Widespread enrollment mistakes, Coverage disputes and complaints, Loss of trust with employees, Regulatory/Compliance flags, Other, Unsure
• Which communication channels will we use to reach impacted employees and managers? Options: All-staff email, Intranet/HR portal, Manager toolkit, Live town hall/webinar, Paystub notice, Benefit statements, Text/SMS, Other
• What are the top three messages employees absolutely must understand on day one of go-live?
• Who owns employee-facing communications and approvals for manager scripts and Q&A? Options: Total Rewards/Benefits, Corporate Communications, HR Business Partners, External vendor, Broker/Consultant, Shared
• Are there employee populations (union groups, retirees, contingent workers, global remote) with special timing or translation needs we must plan for?

Where Are the Biggest Mid-Year Landmines?

• What’s the worst mid-year implementation failure you've seen—and how likely is that to happen here? Options: Enrollment mismatch resulting in uncovered members, Payroll deduction failures, Retroactive carrier billing errors, Pharmacy claim disruptions, Regulatory noncompliance, Vendor delivery failure, Unsure
• Which of these risks are highest priority for us to mitigate? Options: Data timing errors, Eligibility mismatches, Payroll deductions, Provider network interruptions, PBM/pharmacy disruptions, Regulatory/COBRA issues, Third-party vendor delays, Other
• Are there carrier/TPA contractual constraints (notice periods, file format mandates, blackout windows) that limit what we can change mid-year? Options: Yes — specific constraints exist, Yes — general constraints, No constraints known, Unsure
• Do you have a documented contingency plan and budget for mid-year rollback or emergency fixes? Options: Comprehensive plan and budget, Plan but no budget, No plan, some ad-hoc options, None, Unsure
• If we needed to stop or reverse a change quickly, what are the fastest operational steps available today?

How Will We Measure a Smooth Launch?

• If leadership asks tomorrow whether the deployment was worth it, which three measurable outcomes would make you comfortable declaring success? Options: Realized cost savings, Enrollment accuracy, No critical service outages, Low HR/Helpdesk volume, Positive employee sentiment, Improved benchmark position, Other
• Which KPIs should we report in the first 30/60/90 days and who should receive each report? Options: Payroll accuracy, Enrollment completion rate, HR/helpdesk call volume, Claims processing errors, Savings vs. renewal, Employee satisfaction/CSAT, Other
• Who within your executive team must sign the go-live acceptance (list names/titles)?
• What thresholds (e.g., % of impacted members, $ amount, SLA breaches) would trigger an immediate escalation to executive leadership?
• How frequently do you want deployment status reviews during the first 90 days (weekly, biweekly, monthly)? Options: Weekly, Biweekly, Monthly, Ad-hoc as issues arise, Other

Who Stays If Things Get Tough?

• You were introduced to a named senior consultant—what would make you confident they will personally lead the deployment through go-live? Options: Contractual assignment, Commitment letter, Named backup included, Weekly leadership check-ins, Unsure
• Which advisor and vendor roles must be present for a clean handoff, and who are their backups? Options: Senior consultant, Engagement manager, Technical/data lead, Benefits operations analyst, Carrier relationship manager, Vendor PM, Other
• Do you have runbooks or handover documentation for the engagement and where are they stored? Options: Complete runbooks exist (link provided), Partial documentation, No documentation, In progress
• If the assigned lead becomes unavailable during the critical window, what escalation and continuity steps would you expect?
• What contractual or practical reassurance (e.g., SLA, named deputy, escalation cadence) would satisfy your executive team about advisor continuity?

Hands-On: Logistics, Dates, and Approvals

• If we mapped every approval and data handoff, where are we most likely to miss a deadline? Options: Vendor onboarding, Internal signoffs, Payroll cutoff, Carrier transmission windows, IS/security approvals, Other, Unsure
• Which payroll cutoff schedule or specific payroll runs must we respect for enrollment changes? Options: Monthly (specific date), Semi-monthly, Biweekly, Varies by population, Unsure
• Provide the carrier/TPA transmission windows and typical lead times we must meet (list carrier + deadline).
• Which vendors require formal attestations, security questionnaires, or technical onboarding before file exchanges begin? Options: Carriers, TPA, PBM, HSA/FSA vendor, Enrollment platform, External consultant, Other
• Are there blackout periods (open enrollment, fiscal close, year-end payroll, union negotiations) we must avoid for any go-live activities?

A Quick Renewal Snapshot

• When is your next medical plan renewal window? Options: Within 3 months, 3–6 months, 6–9 months, 9–12 months, More than 12 months
• Give a concise summary of your year-over-year premium trend for the last three renewals (percentages and any one-off drivers).
• How urgent is a change to your benefits strategy right now? Options: Critical — board demands action, High — leadership concerned, Manageable — proactive review, Monitoring — not urgent
• Who is primarily responsible for leading the renewal internally? (select all who will play a leading role) Options: CHRO, VP Total Rewards, CFO, Benefits Manager/Director, HRBP/People Ops, General Counsel, Other
• Which evaluation criteria do your leadership and board care about most when judging advisors? Options: Benchmark depth & relevance, Fee-only proof / disclosure, Advisor continuity (same senior lead), Client retention & references, Negotiation outcomes / realized savings, Clinical impact and quality

Who Really Decides? (and How They Think)

• If a renewal recommendation goes to the board, will board members accept the broker’s numbers or ask for independent validation? Options: They typically accept broker figures, They require independent validation, Depends on CFO/CHRO sign-off, Unsure / varies by issue
• List the individuals (name + role) who must sign off on plan design or financing changes and note their real influence on final decisions.
• Which stakeholder(s) are most likely to block change and why? Options: Board/Comp Committee, CFO/Finance, CHRO/People, Line-of-business leaders, Employee groups/unions, Other
• How important is it that the senior consultant who pitched this engagement remains the engagement lead throughout delivery? Options: Absolutely essential, Very important, Helpful but not deal-breaking, Not important
• When sign-off becomes contentious, what decision path or escalation process do you normally follow?

Is Your Broker Working For You — Or The Carrier?

• What would it mean for your budget and governance if your broker’s carrier relationships have been favoring higher-commission carriers for several renewals? Options: Material budget leakage and board concern, Question broker impartiality, Trigger independent review, Not sure yet
• How is your current broker compensated and what fee or commission disclosures have they provided? Options: Commission-only, Commission + partial fee, Fee-only, No clear disclosure provided
• How often does your broker provide benchmarking, and how specific is that benchmarking to your industry/region/size? Options: Annual high-level benchmarks, Custom industry/region slices, Limited benchmarking from carriers, No benchmarking provided
• Have you observed broker recommendations that aligned more with carrier incentives than plan performance? Tell us one specific example if possible.
• If we proposed moving to a fee-only advisor model, what political or practical resistance would we need to anticipate?

What’s the Financial Pressure Really Like?

• If your current renewal trend continues for another 12–24 months, what concrete operational or strategic impacts would that cause (hiring freezes, benefit cuts, headcount decisions)?
• What is your current annual medical spend (total premium + expected claims)? Options: Under $5M, $5M–$20M, $20M–$50M, $50M–$200M, Over $200M
• What percent or dollar reduction in medical spend would satisfy your CFO and the board? Options: 3–5% / modest, 6–10% / meaningful, 10%+ / transformational, No preset target — must preserve benefits
• Which budget levers are you willing to consider to reach those targets? (select all you would tolerate exploring) Options: Plan design changes (copays, deductibles), Higher employee cost-share, Network narrowing/value-based networks, Self-funding, Reference-based pricing (RBP), Pharmacy carve-out
• What types of financial evidence (benchmarks, actuarial certs, vendor contracts) will convince leadership to move forward? Options: Independent benchmarks, Actuarial model with sensitivity, Signed vendor concessions, Client references with realized savings, Pilot or phased approach

What Are You Willing to Trade For Savings?

• Would you accept narrower provider access or modestly higher employee cost-share if it materially reduced long-term trend? Options: Yes — if hiring impact is minimal, Yes — with strong communications, No — benefits must remain competitive, Need to see modeling first
• Which elements of your benefits package are non‑negotiable for recruitment or retention (list top priorities)?
• How sensitive is your employee population to out-of-pocket cost increases or network changes? Options: Highly sensitive — retention/happiness at risk, Moderately sensitive, Relatively insensitive, Unknown / no data
• What communications, support, or financial relief (e.g., HRA, premiums subsidies) would you deploy to reduce employee pushback?
• Do you already have guardrails (minimum plan features) that cannot be compromised? If so, please list them.

How Clear Is Your Data Picture?

• How confident are you that your available claims and enrollment data are complete and accurate enough for rigorous benchmarking and clinical analysis? Options: Very confident, Somewhat confident, Not confident, We don’t know
• Which years of claims and enrollment data are readily available to share for analysis? Options: Last 12 months, Last 24 months, Last 36 months, More than 36 months, We need help extracting data
• What formats and delivery methods can you provide for files (select all that apply)? Options: Excel/CSV, EDI 837/835, TPA or vendor portal extracts, Direct SQL or API access, Other
• Are there privacy, governance, or vendor restrictions (e.g., PHI rules, contracts) we must plan around? Options: HIPAA/PHI controls, Data residency constraints, TPA/Carrier contractual limits, No significant restrictions, Unsure — need to verify
• Who will be the internal data owner/contact and what is their typical availability for clarifications and iterative requests?

Which Alternatives Would You Seriously Consider?

• If a modeled scenario showed 8–15% sustainable savings from self‑funding, RBP, or pharmacy carve‑out, would organizational inertia or complexity likely stop you from acting? Options: We would act, Too risky without pilots, Need further proof and references, Depends on timing and implementation risk
• Select the strategies you are open to exploring in depth (choose all that apply). Options: Self-funding transition, Reference-based pricing (RBP), Pharmacy carve-out / PBM change, Narrow/value networks, Provider-contracting/value-based agreements
• Which outcome requirements are blockers for you when evaluating alternatives? (select all non-negotiables) Options: No increase to employee premiums, Preserve key network providers, CFO-approved financial model, Board sign-off required, Minimal disruption to HR systems
• Have you previously run pilots or proofs of concept for any of these approaches? If yes, what stopped broader adoption?
• What vendor or carrier relationships must be preserved or given priority during any transition?

If We Implemented Change, What Could Break?

• What's the single failure mode that concerns you most when changing carriers, funding structures, or PBMs? Options: Implementation errors/data issues, Employee backlash/higher attrition, Regulatory/compliance failures, Provider network disruptions, Service-level declines
• Describe a recent benefits or HR systems implementation that experienced problems—what happened, timeline to recovery, and lessons learned.
• How capable is your HRIS and benefits admin stack at supporting mid‑year configuration or vendor swaps? Options: Highly capable — minimal impact, Moderately capable — some work required, Fragile — significant effort, Unsure
• Who would own remediation and escalation if issues arise during rollout? Name roles and expected availability.
• What maximum acceptable windows for remediation, service recovery, and executive escalation would you require? Options: 48 hours, 72 hours, 1 week, 2 weeks, Other

What Would Success Look Like — and Who Owns It?

• If we deliver measurable savings while keeping benefits competitive, would you consider permanently replacing the broker, or treat this as a one‑off review? Options: Replace the broker, Periodic independent reviews, Depends on sampled outcomes, Unsure — need board input
• Name the top three success metrics that would convince the board this engagement succeeded (e.g., % savings, time-to-implementation, employee satisfaction, hiring impact).
• How often and in what format does leadership want progress updates (select one)? Options: Weekly written updates, Bi-weekly calls, Monthly executive briefings, Milestone-based only, Ad-hoc as issues emerge
• Which types of evidence would you accept as definitive proof of success? (select all that apply) Options: Benchmarks tied to your cohort, Signed vendor concessions/contract terms, Realized claims trend change after 12 months, Independent audit/attestation, Client references with measurable results
• Even if the project achieves financial targets, what scenario would make you consider it a failure? (operational, cultural, or reputational risks)