Start the Plan HEALTHcheck by Alera Group
Do employees have affordable, no-barrier access to primary care?
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No, they pay standard copays and face long wait times
Some employees have easier access (e.g., a pilot program or telehealth)
Yes, all employees have low/no-cost, same- or next-day primary care
Do employees receive ongoing benefits education beyond open enrollment?
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No, education is limited to enrollment season
Some occasional reminders or emails are sent
Yes, there’s a structured, ongoing education program
Does your advisor fully disclose all compensation, bonuses, and overrides?
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No disclosure
Some disclosure, but not all fees are transparent
Yes, full fee and incentive disclosure provided regularly
Are pharmacy rebates passed through 100% with audit rights?
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No rebate pass-through or audit rights
Some pass-through, but not fully transparent
Yes, all rebates passed through with full audit rights
Are your plan documents and disclosures (SPD, SBC, 5500, fee disclosures) current and provided as required?
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No, missing or outdated
Some are compliant, but gaps remain
Yes, all documents are accurate and distributed on time
Do you have a structured process for managing catastrophic or high-cost claims?
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No structured process
Some informal efforts (case-by-case)
Yes, formal process with navigation and second opinions
Do you use stop-loss or risk protections aligned with your plan’s actual risk?
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No, renewal terms are accepted as presented
Some negotiation, but limited alignment to plan risk
Yes, stop-loss coverage is regularly benchmarked and tailored
Does your advisor/administrator ensure your plan complies with newer rules (e.g., CAA fee transparency, gag clause removal, MHPAEA testing)?
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No compliance process in place
Some compliance steps taken, but not comprehensive
Yes, compliance is actively monitored and documented annually
Does your plan steer employees toward high-value providers (bundles, centers of excellence)?
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No incentives or steerage in place
Some voluntary programs exist, but underused
Yes, strong incentives and formal steerage programs in place
Do you receive regular reporting on plan performance (costs, utilization, outcomes)?
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No reporting beyond renewal quotes
Some reporting provided, but inconsistent or incomplete
Yes, detailed reporting provided at least quarterly
Do employees have access to a benefits concierge or advocacy service?
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No support services available
Limited support (e.g., HR tries to help but no dedicated resource)
Yes, employees have a 24/7 concierge or advocacy team
Does your plan cover preventive and wellness visits at 100%?
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No, most preventive visits still require cost-sharing
Some preventive visits are covered, but not consistently
Yes, all recommended preventive and wellness visits are fully covered
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