When claims pay wrong, vendors underdeliver, or the parties stop talking to each other, I find the root cause, quantify what it cost, and build the plan that fixes it.
No vendor commissions — No referral fees — No contingency
Self-funded plans are assembled from parts. A TPA. A network. A PBM. Cost containment. Stop-loss. Care management. Each vendor is accountable for their piece, and each contract is written to define that piece narrowly.
So when claims pay against the wrong fee schedule for four months, or eligibility files quietly stop reconciling, or two vendors each insist the other owns the problem, the plan absorbs it. The broker gets the call. And every vendor in that conversation has a commercial interest in where the blame lands.
That's the gap I fill.
I've sat on the vendor side for nearly twenty years. I know when a vendor has genuinely made a mistake — and I know when they're managing you.
Every vendor sells a demo. Few get asked whether the system does that today, for a plan structured like yours, without custom development.
I evaluate vendors before implementation — capability against claims, references that aren't hand-picked, contract terms that create real obligations rather than aspirations. I also review vendors you've already implemented, against what they committed to when you signed.
Pre-signature diligence · Post-implementation reviewYour TPA sends eligibility to your PBM. Your cost containment vendor reprices claims your TPA adjudicates. Your stop-loss carrier needs documentation from three sources. Each connection is a failure point, and each failure point sits between two contracts.
I map how work actually moves between your vendors, find where it's stalling, and establish who owns each handoff. When two parties disagree about whose problem it is, I'm the one who determines the answer and says it plainly.
Process mapping · Ownership & escalation designClaims paying against a stale fee schedule. Repricing that doesn't match the direct contract. Systematic adjudication errors that pass every individual audit because the error is in the configuration, not the claim.
I drill into the data, isolate the root cause, quantify what it has cost the plan, and build the correction plan. Then I set the accountability structure — who fixes it, by when, verified how, and what happens if the deadline passes.
Root cause · Exposure quantification · Remediation termsI've built, deployed, and maintained community-owned health plans — shared network, aligned fee schedules, common benefit design across dozens or hundreds of independent employers. They're among the most complex structures in the self-funded market and among the most powerful when they work.
They're also where problems compound fastest. A single misconfiguration replicates across every participating employer at once. I know where these arrangements break because I've been the one building them.
Design · Deployment · Ongoing integrityMost operational problems don't announce themselves in advance, and by the time they're visible they've been running for months. Hiring a consultant at that point means paying someone to spend three weeks learning your plan.
I work on retainer instead. A modest monthly fee keeps me current on your plan — your vendors, your contracts, your fee schedules, your history. When something breaks, I'm already up to speed and I engage immediately.
I am not an outsourced account manager. I don't run enrollment, handle day-to-day service, or sit between your members and your TPA.
I'm also not the one who executes the remediation. When we find that six hundred claims paid wrong, I identify the root cause, quantify the exposure, build the correction plan, and establish who owns it with what deadline and what consequence.
The responsible party does the work — because they're the ones who should, and because that's what accountability means.
When a plan has a real operational problem, the broker gets the call — regardless of whether you caused it, and regardless of whether resolving it is inside what your service agreement covers or what your team is staffed to handle.
I don't place coverage, hold appointments, or take commissions. I won't sell your client anything other than the advisory engagement you brought me into, and I'm not building toward becoming their broker.
You decide whether I'm client-facing or behind the scenes. Findings come to you first. You choose how they're delivered and by whom. If you'd rather present the analysis yourself, that's fine — I'm not attached to being in the room.
My model is designed for privately held and family-owned brokerages serving small and mid-sized plans — firms with deep client relationships and no in-house operational SME bench. The national houses have internal teams for this. You shouldn't have to build one to compete with them.
Some firms put me on retainer across a book of business. Others engage me client by client. Some bring me into finals presentations as evidence of the operational depth behind their service model.
Every vendor serving your plan, in one room, for one day, chaired by someone with no stake in where it lands and nothing to sell you.
On a status call, each vendor reports to you separately and nobody hears what anyone else said. Problems that live between two vendors stay between two vendors, and the version you get is the version each of them wants you to have.
A room changes that. Commitments made in front of the other parties are commitments people keep. Constraints that get vaguely gestured at on email get explained properly when the person who has to work around them is sitting across the table.
I build the agenda from your actual data — open escalations, claims patterns, contract obligations, service levels against what was promised. Not a roundtable of updates. A working session against a list of real things.
Open issues worked through to resolution or to a plan with a name and a date on it. Handoffs mapped in the room, so every party sees where their piece ends and the next one begins.
Action items with a named owner, an agreed deadline, and a defined consequence — all of it accepted by every party before anyone leaves. Documented, distributed, and verified against at the next session.
Your team learns how the machinery actually works — what each vendor can and can't do, where the real constraints sit, and which questions get useful answers. So you're asking better questions in month seven, not waiting for the next summit.
I review your contracts, service levels, claims patterns, and open escalations, then interview each vendor individually. The agenda comes out of what I find, and every party gets it in advance so nobody arrives unprepared or ambushed.
A written record of every decision, owner, and deadline, distributed to all parties within a week. Thirty and ninety day check-ins against the commitments. If something slips, the consequence was agreed by everyone in advance.
Most plans have never had all their vendors in the same room. It shows.
Community-owned health plans
Priced on aggregate covered lives across the whole arrangement rather than employer by employer. Because every participant shares a network, fee schedule, and benefit design, one root cause investigation resolves the issue across all of them — so a forty-employer arrangement pays once for work that would otherwise be scoped forty times. Participating employers are covered by the aggregate rate regardless of individual size.
From $6PEPM, aggregate lives
$7,500Per month
Plans over 150 lives
Per employee per month, stepping down as covered lives grow.
$6–$12PEPM
$3,000Per month
Plans from 25 to 150 lives
Small plans carry the same complexity as large ones with fewer people to handle it. A per-employee rate rarely works at this size, so the fee is usually flat.
From $3,000Per month, flat
—Flat fee
Brokerage book retainer
For firms carrying a number of small groups: one retainer at the brokerage level covering a defined book, rather than a separate arrangement per client. Usually the only structure that makes sense when most of the book sits under 50 lives, and it means the smallest groups get the same operational bench as the largest.
From $4,500Per month, per book
DefinedBook agreed up front
Standalone groups under 25 lives
A monthly retainer doesn't fit at this size, so I don't sell one. Work is priced per engagement instead: a defined problem, diagnosed and root-caused, with a remediation plan and accountability terms. Optional standing access keeps me current on the plan between engagements and carries preferred rates. Groups inside a COHP or a brokerage book are covered under those arrangements — this tier is for genuinely standalone employers only.
From $2,500Per engagement
$2,400Per year, optional
The Stakeholder Summit
In-person facilitated session with all vendors. Preparation, individual vendor interviews, agenda build, one full day onsite, written record, and 30- and 90-day verification.
From $12,500Per session, plus travel
From $9,500Per session, plus travel
Part of what the pricing does is keep this practice small enough to actually work.
The whole arrangement depends on me knowing your plan — your vendors, your contracts, your fee schedules, the history of what has already gone wrong and who was responsible. That isn't knowledge anyone holds across thirty clients. It goes shallow. And shallow attention spread across too many accounts is precisely the failure I get hired to diagnose in other people's vendors.
So I take a deliberately limited number of engagements. If I'm at capacity when you reach out, I'll say so rather than sign the retainer and stretch, and I'll tell you when something opens up. If waiting doesn't work for you, I'd rather point you somewhere useful than become the fourth party on your plan who's too busy to look closely.
Every plan is built differently, so the rate is set case by case — but the variables are about your plan, not about what I think you'll pay. Four things move it:
Whatever the number, it's agreed in writing before any work begins and it doesn't move mid-year.
The fee can be structured as a flat monthly amount or on a per employee per month basis, depending on group size and expected case volume. Larger groups and COHPs generally move to PEPM.
A PEPM fee bills alongside the administrative costs your plan already carries, rather than arriving as a separate consulting invoice that needs its own approval. For many groups that's the difference between a quick yes and a budget conversation.
I'm regularly asked whether I'll work on a share of savings. I don't, and the reason matters.
The moment my compensation depends on finding problems, I have a reason to find them — and a reason to size them generously. Every conclusion I reach becomes suspect, including the correct ones. A vendor I clear looks like a vendor I had no incentive to pursue. A recommendation to stay the course looks like one I wasn't paid to make.
The entire value of an independent third party is that the answer isn't influenced by what the answer earns. Sometimes the honest finding is that your TPA handled it correctly and the problem is upstream. Sometimes it's that the issue is real but not worth the cost of chasing. You need to trust those answers exactly as much as the ones that recover money.
Fixed fees, known in advance, regardless of what I find.
I'm Aly Hollewijn, founder of Patron Health.
I've spent my career on the operating side of the self-funded market — TPA leadership and operations, claims leadership, account management, and executive leadership at a claims repricing and direct provider contracting organization. I've built COHPs, negotiated directly with health systems, run implementations, launched products, and scaled operational teams from early stage through market maturity.
That vantage point is the reason this practice exists. I've been on the side that made the mistake, and I've been the one who caught someone else's. I can read a claims file and tell you whether the problem is configuration, contract, or execution — and tell you which party owns it without needing anyone's permission to say so.
I've contributed to federal rulemaking on the No Surprises Act and the CARES Act, and I serve on the Society of Professional Benefit Administrators Transparency Taskforce, where the administration industry works through how transparency regulation actually gets implemented. I've served on national boards in health plan administration.
This matters for a practical reason: I know the difference between what a regulation requires and what a vendor claims it requires.
Patron Health also maintains a separate practice line advising TPAs, MGUs, and vendors on their own operations and strategy. It is governed by a written conflict policy: I never advise an organization and evaluate that same organization for a plan at the same time, I disclose any vendor relationship from the prior two years before accepting plan-side work, and you decide whether it matters. Any plan-side client may request my vendor-client list at any time. Read the policy →
I maintain a network of senior operators — decades of experience each, in the functions where the hardest cases live. These are practitioners who have run these areas, not generalists.
When a case calls for that depth, I engage them directly through Patron Health. You get the specialist, you keep one point of accountability, and you don't manage another vendor relationship to get there.
If you're mid-problem, describe it and I'll tell you honestly whether it's something I can help with. If you're evaluating whether a retainer makes sense, we can talk through your vendor stack and where the exposure sits.
Bozeman, Montana
LinkedIn →
Patron Health keeps a separate practice line for fractional COO and CSO work with the companies that serve these plans — operating under a published conflict policy.