Health Plan Diagnostic
Independent review of plan structure, contracts, claims, pricing, fees, funding, pharmacy arrangements and vendor relationships.
Sorgfalt USA · Independent Health Plan Advisory
Your health plan deserves diligence.
Independent health plan advisory, oversight and fiduciary support for employers who want to know where their healthcare dollars are actually going.
Sorgfalt is the German word for diligence, care and thorough attention.
It is also how an employer-sponsored health plan should be managed.
Sorgfalt USA is a one-person practice. Every engagement is conducted personally by Christine Price.
The problem
The problem is rarely the health plan itself.
It is the arrangements around it. Employers commonly have:
- Brokers advising the employer while receiving compensation from vendors
- Opaque network pricing and excessive hospital reimbursement
- PBM arrangements that cannot be independently verified
- Stop-loss contracts not coordinated with plan administration
- Ancillary products generating fees without demonstrated value
- Claims data that is difficult to obtain or interpret
- Vendors measuring their own performance
- Fiduciary responsibilities delegated in practice but not necessarily in law
Employers are often told their health plan is being managed.
Few are shown enough independent evidence to know whether that is true.
What I do
I investigate the plan from the employer's side of the table.
Claims & Pricing Review
Examination of hospital, physician, pharmacy and other claims against appropriate pricing benchmarks and contractual terms.
Vendor & Contract Review
Review of TPA, PBM, stop-loss, network, broker, ancillary and other health-plan relationships.
Plan Architecture
Design or restructuring of self-funded plans to improve transparency, control, access and accountability.
Governance & Fiduciary Oversight
Documentation, processes, vendor monitoring and decision support designed to strengthen ERISA plan governance.
Ongoing Advisory
Direct, personal access to Christine for employers that want continuing independent oversight rather than another vendor relationship.
Fiduciary responsibility
Advice is different when responsibility comes with it.
ERISA imposes fiduciary duties on those responsible for managing plan assets and administering the plan.
Many consultants provide recommendations while contractually avoiding fiduciary responsibility.
When the engagement calls for it, Sorgfalt USA may serve in a defined fiduciary or co-fiduciary capacity pursuant to the written engagement agreement. Fiduciary responsibilities are never assumed by default: they are defined contractually and depend on the scope of each engagement.
I do not believe an employer should be the only party in the room expected to carry responsibility for decisions influenced by outside advisers.
Principle
Responsibility should follow authority.
When Sorgfalt accepts fiduciary responsibility, the scope is identified in writing. The employer knows what Sorgfalt is responsible for, what remains with the plan sponsor, and how major decisions will be documented.
- Documented decision processes
- Vendor oversight
- Fee review
- Claims analysis
- Contract review
- Conflict identification
- Governance documentation
Disclaimer: Sorgfalt USA provides health plan advisory and review services. Providing advice does not by itself make Sorgfalt USA a fiduciary, and not every engagement includes fiduciary or co-fiduciary status. Information on this website is general in nature and is not legal advice. Legal questions should be addressed with qualified ERISA counsel.
How I am different
Independent means independent.
I do not
- Sell insurance
- Accept broker commissions
- Receive PBM spread
- Receive network compensation
- Sell ancillary products
- Charge a percentage of alleged savings
- Increase our compensation because claims increase
I do
- Work directly for the employer
- Review actual data
- Identify conflicts
- Question pricing
- Examine contracts
- Document findings
- Stay involved after recommendations are made
If I cannot clearly explain how I am paid, I should not be advising you.
Selective by design
Boutique by design.
Sorgfalt USA is a one-person practice, and it stays that way. I work with a limited number of employers at any one time, and every engagement is conducted personally — there is no junior account team to hand the relationship to after the agreement is signed.
I evaluate prospective clients just as carefully as they evaluate me. Good relationships require:
- Executive involvement
- Access to plan data
- Willingness to question existing arrangements
- Transparency
- Mutual trust
- Authority to act on meaningful findings
Not every employer is a fit — and that is intentional.
Who I work with
Diligence is not a matter of geography.
- Privately held U.S. employers
- Family-owned companies
- Manufacturers and industrial companies
- Professional organizations
- Multinational and European-owned U.S. subsidiaries
- Employers with approximately 50–500+ employees
- Self-funded employers, or those seriously considering it
Our clients may be American, German, Swiss, Austrian or from somewhere else entirely. The common denominator is not geography. It is an employer willing to manage its health plan with diligence.
Experience
Experience matters when the numbers stop making sense.
Christine Price · Principal
Christine Price has more than 25 years of experience working inside employer-sponsored health plans, including administration, claims analysis, healthcare pricing, reference-based reimbursement, vendor oversight, stop-loss coordination and ERISA plan operations.
She has worked on the hospital, PPO, physician group, insurance carrier and TPA sides of the industry, and founded and ran her own third-party administrator for 22 years before selling it.
Her perspective comes from managing the work itself — not selling products into the plan.
Client experience
Relationships measured in years, not renewals.
Some of my client relationships have lasted more than 20 years.
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.”
Patricia Darden
Former VP of Human Resources, Queensborough National Bank
“I am so blessed to have had Christine and her company in my life. Her vast knowledge of the Healthcare industry saved our bank employees not just money but gave them the knowledge to navigate the waters in a rapidly changing industry. And now she is able to share that knowledge in expanded ways so that more people can have access. Take advantage of it.”
Fees
Clear fees. No percentage of savings.
Fees are based on the actual scope and complexity of the work, and are agreed before work begins. You should know what your adviser costs before deciding whether the advice is worth it.
01 · Fixed project fee
Independent Health Plan Diagnostic
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 · Fixed project fee based on scope
Plan Architecture / Remediation
Defined correction work may include contract changes, vendor evaluation, plan design, reimbursement strategy, corrective implementation 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 · Fixed monthly retainer
Ongoing Advisory & Fiduciary Oversight
Claims and vendor monitoring, compensation review, contract review, decision documentation, executive reporting and formal governance reviews. Any fiduciary role is defined in the written engagement agreement.
| U.S. employees | Annual fee | Monthly retainer |
|---|---|---|
| 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 |
Sorgfalt USA does not charge PEPM simply because a plan has more members, and does not take a percentage of claimed savings.
Approach
I investigate. I document. I stay involved.
Understand
I determine what the employer wants to know and whether Sorgfalt is the right fit.
Investigate
I obtain and examine the relevant contracts, claims, fees, reports and plan documents.
Explain
Findings are presented in plain language, supported by evidence.
Correct
Where appropriate, I help redesign, renegotiate, replace or restructure what is not working.
Oversee
For ongoing clients, I remain involved and monitor the plan rather than disappearing after implementation.
Contact
Start with a confidential conversation.
If something about your health plan does not make sense, send me a note.
I will determine whether the issue is something Sorgfalt USA can help investigate — and you will hear back from me personally.
Sorgfalt USA
Independent Health Plan Advisory & Fiduciary Oversight