The Employers This Practice Was Built For
Scott's boutique model is designed for qualified engagements, not volume. This page exists to help the right employers identify themselves — and help others find a better fit before reaching out.
The Right Company Size
— and Why It Matters
The Advanced Benefit Design framework is structured for employers with 50 to 2,500 employees. That range is not arbitrary.
Below 50 employees, actuarial stability is harder to achieve — the claims pool is too small to absorb volatility without stop-loss structures that erode the economic case for self-funding. Above 2,500 employees, organizations typically carry internal benefits staff and are better served by institutional consulting firms with dedicated account teams.
Between 50 and 2,500 employees, the opportunity is real, the actuarial math works, and the employer is almost always underserved by a brokerage model that has no incentive to change the arrangement. A 125-employee group on this framework achieved $771,000 in annual savings at fourth-year renewal. The size question has an answer.
Our People
Our clients value clarity over complexity and discipline over novelty. They seek a thoughtful partner to manage capital with care and perspective.
We Work With Buyers at Every Stage
CFOs and Finance Executives
If healthcare is a line item you renew annually without a fiduciary review of the vendor economics underneath it, it is the least governed major expense on your P&L. Scott's engagement is structured around the CFO's view of the problem: EBITDA protection, forecast accuracy, and fiduciary risk reduction. The Cost Modeling Report uses your actual claims data. The quarterly dashboard tracks documented savings against baseline. Your involvement is strategic approval and the executive review — not vendor negotiations.
CEOs and Business Owners
For the CEO who is the financial decision-maker, healthcare spend is a competitive variable. Employers on the Advanced Benefit Design framework are currently operating at $11,048 per employee per year against a 2026 industry average of $17,000. That differential is a cost structure advantage — in hiring, in compensation, in margin. Scott's engagement replaces broker passivity with a documented fiduciary operating model that produces a number your competitor's broker is not showing them.
HR Directors and Benefits Managers
HR is frequently the first person inside an organization to recognize that the current plan isn't working — and the last to be given analytical support to make the case for changing it. Scott provides the Cost Modeling Report, the Fiduciary Risk Scoring Model™ benchmark, and the transition management that removes the internal administrative burden of moving to a new plan structure. If you are the person who influences the CFO's decision, this practice is built for that role too.
Employers Who Have Been Here Before
Some of Scott's most productive engagements begin with employers who attempted self-funding previously — and experienced poor vendor alignment, inadequate stop-loss structuring, or a PBM arrangement that was opaque from day one. That experience is not a disqualifier. It is precisely the context the Advanced Benefit Design framework was built to correct.
If your organization moved to a level-funded plan through a BUCA-affiliated broker and was told you were "self-funded," the Cost Modeling Report will tell you what that arrangement is actually costing you.
Multi-State Employers
Six states, one plan, one federal framework. ERISA-governed self-funded plans operate under federal law, not state insurance mandates — enabling a single uniform plan design to serve employees consistently across state lines. Scott has structured multi-state plans for employers nationally for over 40 years. The administrative complexity is managed through the TPA, not through your HR team.
Scott serves employers in 37-plus contiguous U.S. states where ERISA preemption applies. Employers in states with regulatory structures that conflict with federal ERISA preemption — including New York, Maryland, Oregon, Washington, and California — fall outside the scope of this practice. That is a principled compliance position, not a capacity limitation.
Is This Engagement Right for Your Organization?
If your organization employs between 50 and 2,500 people, has been on a fully insured or BUCA-administered plan, and has absorbed annual renewal increases without a fiduciary review of your vendor economics — you are precisely the employer this practice was built to serve.
The next step is a Confidential CFO Strategy Session. Scott will tell you within the first conversation whether the Cost Modeling Report is likely to produce a result worth pursuing. If it isn't, he will tell you that too.
Common Questions About Fit
Who is the right employer for Advanced Benefit Design consulting?
Employers with 50 to 2,500 employees who are currently on a fully insured or BUCA-administered plan and have never had a fiduciary review of their vendor economics. The model works best when the employer has 24 months of accessible claims data and a CFO or CEO who is willing to evaluate the Cost Modeling Report before making any plan decisions.
Can a company with 75 employees self-insure?
Yes — with the right stop-loss structure and utilization management in place. The actuarial case for self-funding does not begin at 250 employees, regardless of what a carrier-affiliated broker may suggest. Scott has structured viable self-funded plans for groups well below 100 employees. The Cost Modeling Report determines whether the economics work for your specific group.
What does a CFO healthcare cost reduction advisor actually do?
Applies the same financial governance discipline to healthcare spend that a CFO applies to every other major cost center — vendor selection, performance benchmarking, spend transparency, and documented accountability. Scott manages the analytical and vendor work; the CFO's role is strategic approval and quarterly review.
Can one consultant handle a multi-state employer's healthcare plan?
Under ERISA, yes. A self-funded plan governed by federal law operates consistently across state lines without state-by-state compliance complexity. Scott has served multi-state employers for over 40 years. The administrative structure is managed through the independently selected TPA — not through the employer's internal team.
Is Advanced Benefit Design only for companies that have never tried self-funding?
No. Employers who attempted self-funding previously and experienced poor results — inadequate stop-loss, opaque PBM arrangements, misaligned vendor economics — are a strong fit for this engagement. The Fiduciary Risk Scoring Model™ benchmarks the current structure regardless of funding history and identifies where the previous attempt fell short.
