Happy with your broker? Bring them.
We work through your broker of record, put them in every meeting and hand them the full analysis.
For employers · CEOs, CFOs & HR leadersYour renewal is an output.
Your renewal is an output.
Start asking about the inputs.
A renewal number is built from claims, trend, pooling, credibility, stop-loss pricing and a handful of judgment calls nobody explains unless you ask. SOTA plans are built so you never have to ask twice.
DWG A-201
Employers · Specification
The specification
Nine things your health plan should be able to answer.
Take this list into your next renewal meeting. If your current plan can't answer these, that's the finding.
Q.01
How was my renewal actually built?
Trend, pooling, demographics, credibility, large-claim add-backs, stop-loss and fees. You should see each factor and how much it moved the number.
SOTA standardEvery rate is built on your data, and we walk you through the build, line by line.
Q.02
Does my plan adjust during the year, or wait for renewal?
A plan priced once and left alone can't respond when costs start moving. By renewal, the money is already spent.
SOTA standardClaims, pharmacy and utilization watched in real time, with fixes applied as issues come up.
Q.03
What is my pharmacy's net cost, and who keeps the rebates?
AWP discounts and copays describe the price. Net cost after rebates, spread and specialty economics describes what you paid.
SOTA standardTransparent pass-through PBM economics, plus pharmacist-led care for high-risk members.
Q.04
Where does my plan steer care, and what does that care cost?
If every provider costs the member the same, nothing moves care to the best value. A bigger discount percentage can still mean a higher allowed amount.
SOTA standardTiered design with the richest benefits, often $0, at high-performance health systems.
Q.05
Who owns the whole architecture?
Six excellent point solutions stacked together can still make a worse plan. Someone has to own how the pieces work as one.
SOTA standardOne team designs, prices, places, administers and services the plan.
Q.06
What happens to a claim before it's paid, and after?
A network discount shouldn't end the review. Bill review, financial-assistance screening and recovery can each apply to the same claim.
SOTA standardEvery claim routed to the right pricing path, reviewed before payment, protected after.
Q.07
Do my plan document and stop-loss policy agree?
If they define eligible expenses or payment methods differently, savings get disputed later, usually on your largest claim.
SOTA standardERISA plan documents, SPDs and stop-loss terms written to match.
Q.08
Can I see my data every month?
Annual renewal meetings are too late to act. A report should produce an owner, an action, or a reason no action is needed.
SOTA standardFull claims and plan data visibility, with analytics that feed plan adjustments.
Q.09
Do I know every dollar my advisors and vendors are paid?
Commissions, bonuses, overrides and vendor fees all come out of the same plan dollars. You're entitled to see them.
SOTA standardDirect and indirect compensation disclosed to you in writing, for us and for your broker.
How we price and build
A fluid system, not a fixed price.
Your plan is built on your organization: its needs, its wants and what it can afford. That's where pricing starts. It's not where our work ends.
From day one we watch claims, pharmacy and utilization as they happen, so problems surface while there's still time to act. Proactive savings are the largest savings you'll ever get. You can't fix a problem you don't know exists.
When we find one, we solve it in real time with the best strategy the market offers. If the right strategy doesn't exist, we build it. That's what makes a bottom-line difference, year after year.
Change the narrative
Retire the old renewal script.
The treadmill isn't a strategy. It's a yearly reaction cycle. Here's what replaces it.
| The script you've heard | The SOTA version |
|---|---|
| “Healthcare costs are up. Your increase is inevitable.” | Trend is a forecast. We show you which factors moved and which ones we can change. |
| “We negotiated you down a few points.” | We change the cost trajectory instead of repricing it. |
| “Look at the size of the network discount.” | We compare allowed cost and plan-paid dollars, not discount percentages. |
| “Raise the deductible to hold the premium.” | Lower the underlying cost of care so employees don't absorb it. |
| “No disruption, same network, same result.” | Clear care pathways, with the best benefits at the best-value providers. |
| “Here's your annual claims report.” | Monthly governance with owners, actions and results. |
Your advisor, your call
Changing your plan and changing your broker are two different decisions.
Most frustration with a broker isn't about the person. It's what happens when an advisor's only tool is a carrier renewal to negotiate. We work with brokers, and we keep the choice with you.
Ready for a change? You're not stuck.
If you've decided you want a new advisor, we can introduce you to independent brokers who know self-funded plans. You choose.
See what everyone is paid.
Our compensation and your broker's are disclosed to you in writing. No surprises in the fine print.
Why employers switch
Top reasons employers move to a SOTA-designed plan.
Renewals they can plan around
Plans engineered to bend the curve, so budget conversations start with a forecast instead of a surprise.
Lower cost without cost-shifting
Savings come from where care happens and what it costs, not from bigger deductibles on payroll.
Benefits employees actually notice
$0 copay options, assigned primary care and a team that answers in 14 seconds on average.
One accountable partner
Design, stop-loss, administration and enrollment under one roof. No finger-pointing between vendors.
Pharmacy they can see into
Pass-through PBM economics, specialty-drug strategies and pharmacists working with high-risk members.
Compliance handled
ERISA plan documents, SPDs, ACA, COBRA, No Surprises Act and HIPAA, aligned with administration and stop-loss.
Proof
What employers are seeing.
Numbers first. Then we'll let our clients speak for themselves.
$10.2MFive-year cost difference in a de-identified case study¹
35.9%Lower cumulative cost than the conventional benchmark¹
95%Member call answer rate, 14-second average wait²
91Member Net Promoter Score²
Approved client quote goes here. Best fit: renewal predictability or total-cost result.
Approved client quote goes here. Best fit: employee experience, service or enrollment.
“I like the flexibility on the plans. [SOTA] can custom design and create, and then on the pharmacy side, the flexibility. I think it gives employers some good options that [employers] just can't get in the normal market.”
¹ De-identified five-year case study (2020–21 to 2024–25), SOTA Employer Health Plan Value Playbook. Includes disclosed modeling assumptions; not a guarantee of future results. ² SOTA call center operations reports, Aug–Sept 2026. Past performance does not guarantee future results.
Employer questions
Straight answers.
Cigna, Aetna, Blue Cross Blue Shield and UnitedHealthcare are trademarks of their respective owners. SOTA Benefits is not affiliated with, endorsed by or sponsored by any of these companies. Network availability varies by plan and location.
Bring your renewal, census and claims reports.
We'll show you how the rate was built and what a SOTA-designed plan would change.