Benefits cost is not only premiums. It is also the fee stack:
- broker compensation
- admin fees and pass-through charges
- PBM pricing and spread models
- stop-loss admin and contract terms
- COBRA admin and extras
This kit gives you a beginner-safe way to make fees visible and negotiable.
Not legal advice.
What you will produce
- Vendor inventory (who touches benefits and why)
- Fee schedule extraction checklist
- Invoice audit worksheet
- Negotiation target list
- Fee transparency memo format
Step-by-step audit process
Step 1: Build a complete vendor inventory
Include:
- broker
- medical carrier or TPA
- PBM
- stop-loss carrier and admin
- COBRA admin
- wellness vendors
- benefits admin platform
If it touches benefits cost, it belongs in the inventory.
For each vendor, capture:
- fee type
- unit basis (PEPM, percent, fixed)
- billing frequency
- escalation terms
- what is included and excluded
Step 3: Audit invoices
Pick a sample:
- last 3 months (or one quarter)
Check:
- does invoice match the fee schedule
- are there pass-through charges without explanation
- are escalators applied correctly
- are there “miscellaneous” admin lines
Step 4: Build negotiation targets
Targets can include:
- removing or capping escalators
- eliminating pass-throughs
- fixing billing errors
- clarifying what is included
- switching pricing model where appropriate
Templates
A) Vendor fee inventory (copy/paste)
Copyable template (TEXT)
Benefits Vendor Fee Inventory
Vendor:
Role:
Contract term:
Renewal date:
Pricing basis:
Fees (list each):
- Fee name:
- Amount:
- Unit (PEPM, %, fixed):
- Escalator:
Invoice evidence location:
Notes:
B) Invoice audit worksheet (copy/paste)
Copyable template (TEXT)
Benefits Invoice Audit Worksheet
Vendor:
Invoice period:
Expected fees per schedule:
Actual fees billed:
Variance:
Explanation received:
Resolution:
Next action:
Owner: