Contracts
- Administrative services agreements
- Insurance contracts
- PBM contracts
- Stop-loss contracts
- Network agreements or access terms
- Broker and consultant agreements
- Ancillary vendor agreements
Sorgfalt Health Plan Advisory
Take Control of
Your U.S. Health Plan.
Independent health plan review and corrective guidance for German, Austrian and Swiss companies with U.S. operations.
The U.S. healthcare system is complex. Your employer health plan does not have to be. I examine how your plan is structured, how the money moves, what your vendors are being paid, what your contracts require and whether your claims are being administered as expected. Then I show management what should change.
Request an Initial Review
Initial inquiries are handled personally by Christine Price.
The problem
The Problem Is Not Just Healthcare Cost.
German, Austrian and Swiss companies entering the United States inherit a healthcare financing system unlike anything they encounter at home. A single employer health plan may involve:
- Insurance carriers
- Third-party administrators
- Pharmacy benefit managers
- Provider networks
- Brokers and consultants
- Stop-loss carriers
- Specialty vendors
- Claims administrators
Each may have its own contract, compensation arrangement and financial incentives. The employer pays for all of it, yet management may receive only a renewal presentation and a summary of costs.
That means the people financially responsible for the plan may not have a clear view of how the plan operates, where the money goes, whether contracts protect the employer, whether claims are paid correctly, what vendors are really compensated, whether the plan structure makes economic sense or whether fiduciary decisions are documented.
That is the problem I solve.
I examine the system underneath the renewal. I identify what is working, what is not, what is costing the employer unnecessarily and what should be changed.
The goal is not simply to find savings. The goal is to give management control of its U.S. health plan.
One expert / one review
One Specialist.
One Independent Review.
I am Christine Price.
I have spent more than 25 years working directly with U.S. employer health plans. My work is operational: I have administered plans, reviewed medical claims, examined hospital pricing, evaluated pharmacy arrangements, worked with stop-loss, reviewed vendor contracts and dealt directly with the consequences of poorly structured health plans.
- I do not sell insurance.
- I do not sell pharmacy products.
- I do not sell network access.
- I do not accept vendor commissions or referral compensation.
My role is simple: understand how the plan is working, identify what is broken, and show management how to fix it.
How the Review WorksTechnical scope
What I Review
To understand a health plan, I follow both the contracts and the money.
Claims and cost
- Medical claims
- High-cost claims
- Hospital pricing
- Pharmacy claims
- Administrative charges
- Vendor fees
- Direct and indirect compensation
- Benchmark comparisons
Plan governance
- Plan document
- Summary Plan Description
- Named fiduciaries
- Delegations of responsibility
- Fiduciary committee structure
- Decision documentation
- Vendor monitoring
- Compensation disclosures
- Required compliance documentation
The review
A Defined Review Process.
Documents
You provide the core plan documents, contracts, claims information and compensation disclosures.
Examination
I examine the financial arrangements, claims, vendor relationships, plan governance and supporting documentation.
Findings
I identify material issues, quantify financial findings where the data permits, and document areas requiring management attention.
Correct the structure
Management receives a clear explanation of what was found, why it matters, and what should change.
Depending on scope, recommendations may involve:
The review does not end with a list of problems. The purpose is to provide a practical path forward.
- Vendor structure
- Plan administration
- Pharmacy arrangements
- Claims processes
- Provider strategy
- Contract terms
- Compensation arrangements
- Plan governance
- Fiduciary documentation
No percentage-of-savings compensation.No vendor commissions.No compensation tied to products recommended.
Fiduciary responsibility
Financial Control and Fiduciary Responsibility Are Connected.
An employer cannot demonstrate a prudent process if management does not understand how the plan operates, how vendors are selected, what they are paid or how significant decisions are made.
U.S. employer health plans subject to ERISA operate within a fiduciary framework that requires prudence, attention to participants’ interests, adherence to plan documents and reasonable expenses.
A favorable renewal does not, by itself, demonstrate a prudent process.
Questions management should be able to answer:
- 01Who is responsible for the plan?
- 02Who selects and monitors the plan’s service providers?
- 03What are those providers being paid?
- 04Can management document how those decisions were made?
Sorgfalt Health Plan Advisory provides health plan advisory and review services. Information on this website is general in nature and is not legal advice. Legal questions should be addressed with qualified ERISA counsel.
About
Christine Price
U.S. Health Plan Specialist
I have worked with employer-sponsored U.S. health plans for more than 25 years. My background is not based on selling health plan products. It comes from operating plans, paying claims, reviewing costs, resolving problems and seeing firsthand where the system fails employers.
I am German American and was raised in the United States. I understand the expectations European management brings and have spent my career working inside the U.S. system.
One of my longest-standing client relationships is with a German-owned U.S. company that I have served for more than two decades.
European management asks reasonable questions about U.S. healthcare. Those questions do not always receive clear answers.
Sorgfalt helps management examine the evidence, understand the answers and take control of the plan.
Based in the United States.
Working with companies across the DACH region and their U.S. operations.
Client experience
What Clients Say
Long-term relationships matter more to me than marketing claims.
Chris Pauly
VP Finance and Administration, Ventana USA
U.S. sister company of Ventana Deutschland GmbH & Co. KG, Vreden, Germany
Client relationship: more than two decades
“Before working with Christine, healthcare was something we largely accepted at face value. She completely changed the way we think about managing our self-funded health plan.”
“Instead of simply renewing every year and hoping for the best, we now understand where costs come from, what questions to ask, and how to challenge the status quo.”
Read full client statement ↓
“The results have been significant. We’ve seen firsthand how the right strategy can reduce claim costs by hundreds of thousands of dollars while still providing quality care for our employees.”
“Over the years, Christine has become not only a trusted advisor, but also a friend. She genuinely cares about helping employers make better decisions and isn’t afraid to challenge conventional thinking when it benefits her clients.”
“I would recommend her to any employer who wants to take control of their healthcare spending instead of letting it control them.”
Fees
Clear Scope. Clear Fee.
You should know what the work costs before it begins. Sorgfalt works on fixed project fees. I do not charge a percentage of savings. I do not receive broker commissions, vendor commissions or referral compensation from services being reviewed. The scope and fee are agreed before work begins.
01
Independent Health Plan Review
Core plan documents, contracts, claims, pricing, compensation disclosures and governance records are examined. Management receives documented findings and a corrective path.
| U.S. employees | Fixed fee |
|---|---|
| Up to 100 | $7,500 |
| 101–250 | $10,000 |
| 251–500 | $15,000 |
| 501–1,000 | $20,000 |
| 1,001+ | Fixed fee quoted in advance |
02
Plan Correction & Implementation
Defined correction work may include contract changes, vendor evaluation, plan design, reimbursement strategy, negotiations and implementation oversight.
| U.S. employees | Fixed fee |
|---|---|
| Up to 100 | $15,000 |
| 101–250 | $20,000 |
| 251–500 | $30,000 |
| 501–1,000 | $40,000 |
| 1,001+ | Fixed fee quoted in advance |
03
Ongoing Governance & Oversight
Annual oversight may include claims and vendor monitoring, compensation review, contract review, decision documentation, executive reporting and formal governance reviews.
| U.S. employees | Annual fee | Monthly billing |
|---|---|---|
| Up to 100 | $50,000 | $4,167/month |
| 101–250 | $75,000 | $6,250/month |
| 251–500 | $125,000 | $10,417/month |
| 501–1,000 | $175,000 | $14,583/month |
| 1,001+ | Fixed annual fee | Billed monthly |
No PEPM pricing.No percentage of savings.No commissions or referral fees.No hidden or surprise fees.
You do not need to become an expert in the U.S. healthcare system. You do need to know that your company understands and controls the health plan it is paying for.
That is where I help.
Contact
Tell Me About Your U.S. Health Plan.
Initial inquiries are handled personally. Please provide a few basic details about your company and U.S. operation. I will respond by email.