Stop Renewing.
Start Governing.
Independent employer healthcare consulting built to eliminate the revenue layers your broker has no incentive to remove.
Scott Hettesheimer works with CFOs and business owners who are done absorbing increases and ready to govern healthcare as a controlled expense.
The Math Your Broker Isn't Showing You
$17,000
2026 U.S. employer healthcare average per employee, per year (per Aon).
$11,048
What a recent Hettesheimer client pays per employee, per year.
$3.4 Million
Savings modeled over 36 months for a 260-employee employer
Fiduciary Independence
No contracts with UnitedHealth, Aetna, BCBS, Cigna, or Humana. No volume bonuses. No hidden compensation.
Proprietary Methodology
The Advanced Benefit Design framework and FiduciaHealth Governance™ model replace legacy carrier structures with plan designs that report to you.
Clean Analysis
Every engagement starts from the open market — vendor selection, stop-loss structuring, and PBM strategy are chosen on merit, not relationship.
Built for C-Suite Executives Who Want Accountability, Not Assurances
The renewal increase your broker presents isn't a market inevitability — it's the output of 8 to 12 embedded revenue layers built into the carrier arrangement your plan is sitting on. Commissions, spread pricing, formulary rebates, administrative overrides, reinsurance margins — each one is legal, each one is hidden, and each one is billable to you every month whether your claims support it or not.
Scott Hettesheimer is an independent employer healthcare cost reduction consultant who operates under no carrier contracts and receives no volume bonuses. His Advanced Benefit Design framework and FiduciaHealth Governance™ model replace renewal management with a structured fiduciary operating system — one that gives CFOs line-item visibility into where every healthcare dollar goes and the authority to redirect it.
Who we serve
Companies with 50 to 2,500 employees carrying healthcare as a line item that grows every year without a clear explanation. CFOs who want to own the number. CEOs who are done treating renewal as an inevitability.
THE GUARANTEE
The $6,000 engagement fee produces a documented Cost Modeling Report identifying specific savings opportunities in your current plan. Find less than $40,000? The fee comes back. Move forward and the ongoing relationship runs at 25% of documented savings over a three-year agreement — no fee owed if savings aren't measured and achieved.
WHERE CFOS OVERPAY
The Cost Leaks FiduciaHealth Governance™ Eliminates
A complete Advanced Benefit Design engagement addresses every cost driver in your plan — not just the renewal line item.
The Fully Insured Illusion™
Learn MoreDesign and transition strategy for employers ready to move beyond fully insured arrangements and take direct control of claims spend.
Stop-Loss Insurance
Learn MoreIndependent stop-loss structuring that limits catastrophic claims exposure — selected from the open market, not from a carrier's preferred list.
Pharmacy Benefit Management
Learn MorePBM audits, contract reform, and cost containment strategies that recover margin currently leaving your plan through opaque drug pricing arrangements.
Claim File Repricing
Learn MoreClaims re-adjudication, overpayment recovery, and fraud, waste, and abuse review for employers who want accountability at the transaction level.
ERISA Fiduciary Consulting
Learn MoreFiduciary risk assessment, compliance guidance, and governance structure for plan sponsors who understand that ERISA liability doesn't disappear with delegation.
Medical Tourism & High-Value Care
Learn MoreHigh-value care steering and medical travel strategy developed in partnership with Dr. Maria Todd, PhD, MHA — internationally recognized in healthcare navigation and medical tourism.
the consulting authority
Scott Hettesheimer Has Served Employers for Over Four Decades
Scott Hettesheimer founded Hettesheimer Insurance Agency, Inc. in Cincinnati, Ohio, and has spent more than 40 years in employer benefits consulting — culminating in the development of the Advanced Benefit Design framework and the FiduciaHealth Governance™ model. He is an Amazon #1 bestselling author of Healthcare's C-Suite Solution, NAHU CDHC Certified, NAHU Self-Funded Plan Certified, BBB Accredited A+, and a HealthCare.gov 2018 Elite Circle of Champions honoree. Employers who want fiduciary-grade healthcare governance — and an advisor who answers the phone directly — reach Scott at 513-661-7581.
Meet the Elite
Advanced Benefit Design Institue — FiduciaHealth Governance™
We are a national collaboration of elite Healthcare Benefit Consultants focused on solving one of the largest unmanaged financial threats to American employers — employee healthcare spending. We are not brokers. We are not a legacy insurance shop. We are the governance alternative built for CFOs who are done treating renewal as an inevitability.
Lead Magnet - Controlled Healthcare Governance Whitepaper
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