The Health Plan Score™

See the plan behind the renewal.

Answer ten executive-level questions to generate a directional view of current health-plan performance. Your answers highlight where greater visibility, accountability or strategy may be needed.

81–100

High performing

A deliberate operating system is in place; focus on refinement and durable measurement.

61–80

Building momentum

Important management disciplines are established, with clear opportunities to strengthen execution.

41–60

Needs attention

The plan has meaningful gaps in visibility, purchasing strategy or accountability.

0–40

Reactive renewal

Start with a clearer baseline, defined governance and access to the underlying economics.

01Plan Financing & Risk Strategy

Our funding and risk strategy is deliberately aligned with our objectives, cash flow and risk tolerance.

02Data, Analytics & Transparency

We have timely access to the data needed to understand cost, utilization and vendor performance.

03Medical Network & Provider Economics

We evaluate actual provider prices, quality and access—not network discounts alone.

04Pharmacy & Specialty Drug Management

We understand pharmacy pricing, rebates, specialty-drug spend and PBM contract performance.

05Stop-Loss & Catastrophic Risk

We actively manage catastrophic risk and review stop-loss terms as part of our overall funding strategy.

06Primary Care & Early Intervention

Employees can access high-quality primary care and early support before needs become costly.

07High-Cost Care & Clinical Strategy

We have intentional pathways for complex, high-cost care decisions.

08Navigation & Employee Experience

Employees have practical support to understand benefits and find high-value care.

09Fiduciary Governance, Contracts & Accountability

We use a documented governance process with clear accountability for plan decisions and contracts.

10Employee Engagement, Communication & Measurement

We measure whether employees understand, use and benefit from the plan as intended.