Your plan members trust you. But who verifies what the TPA is charging?
ERISA Section 404 holds you personally liable for monitoring plan costs. The Consolidated Appropriations Act of 2021 gave you the statutory right to claims data from your TPA — yet most employers don’t know this right exists. We provide independent benchmarking data and court-ready compliance reports — so you have documented evidence you fulfilled your duty to monitor.
Four roles. One shared pressure: personal liability for a system you can't see inside.
You sign the checks but can’t see inside the black box.
Your TPA reports savings, but who verifies the contract rates behind those savings? You’re responsible for millions in healthcare spend with almost no independent visibility into whether those rates are competitive.
You manage the TPA relationship with one hand tied behind your back.
What ERISA requires vs. what most plans actually do.
ERISA Section 404(a)(1) requires fiduciaries to act with the “care, skill, prudence, and diligence” of a prudent person. For healthcare plan costs, that means active monitoring — not passive trust.
Price intelligence designed for fiduciary documentation.
Each tool is purpose-built to create the documentation trail ERISA requires — not just data, but defensible evidence of prudent monitoring.
Contract Benchmarking
Compare your TPA-contracted rates against independent market benchmarks derived exclusively from publicly available federal MRF data. No carrier relationships. No payor data agreements. Covering 147 procedures across 6000 facilities.
You actively monitor market rates with a fully independent benchmark.
TPA Repricing Audit
We audit the contract, not just the claims. Your TPA may show 30% off billed charges while the allowed rate itself is 40% above what the same carrier negotiated at comparable facilities in the same metro. Market data from 50 payer contracts.
From data to documentation in two weeks.
We designed the onboarding to require almost nothing from your team. One hour of setup, then ongoing monitoring that runs itself.
Share claims data
Week 1Secure, HIPAA-compliant data transfer. BAA signed before any data is exchanged. We connect directly with your TPA or accept claims files in standard EDI 835/837 or CSV format.
We benchmark against market
Week 2Every contracted rate compared against 6,000+ hospital Machine-Readable Files mandated by the Hospital Price Transparency Rule. Market percentile positioning for every CPT code in your plan.
From hope-based compliance to documented fiduciary defense.
Questions ERISA counsel and CFOs actually ask us
We built this product by listening to fiduciaries. These are the questions they asked before signing.
Still have questions? Book a callNo. It arms them. Our reports provide the independent data and documentation your counsel needs to demonstrate fiduciary compliance. We generate the evidence — benchmarking data, monitoring logs, methodology disclosure. They provide the legal strategy. Think of it as giving your attorney a loaded briefcase instead of a blank page.
Our methodology disclosure is pre-built for exactly this scenario. Every benchmark is traceable to a CMS-mandated Machine-Readable File source. We disclose our methodology proactively because we built it to withstand scrutiny. When a TPA challenges a finding, you hand them the methodology page — source data, calculation method, quality indicators, and all.
HIPAA compliant with BAA executed before any data exchange. AES-256 encryption at rest, TLS 1.3 in transit. We access claims data — not medical records — through a secure connection with your TPA or via standard file transfer. No PHI is stored longer than analysis requires. We can provide our security documentation and compliance certifications on request.
Self-insured employers with 200+ employees who carry ERISA fiduciary responsibility. If you have a TPA, you’re responsible for monitoring plan costs, and you want independent verification of what you’re paying — this is built for you. We also work with ERISA counsel who advise multiple plan sponsors.
Zero upfront. Shared savings model. We earn a percentage of verified savings from identified overpayments. If we benchmark your contracts and find nothing above market — which happens less than 7% of the time — you pay nothing. Your budget exposure: $0.
Your TPA reports their own performance. We provide independent verification. The difference is structural: we have no payor relationships, no carrier revenue, and no incentive to validate your TPA’s claims. We benchmark against public market data — the same data opposing counsel would use in an ERISA lawsuit.
The question isn't whether you can afford to monitor your plan. It's whether you can afford not to.
Fiduciary lawsuits have tripled since 2020. Settlements average $3.5 million. And the standard of care isn't whether you intended to monitor — it's whether you documented it. Start building your defense today.
Every quarter without documented monitoring is a quarter without fiduciary defense.Fiduciary lawsuits don't ask if you meant well. They ask what you documented. Our first quarterly report can be in your counsel's hands within 30 days.
