HealthPlanIQ blog

What Separates a Benchmark From a Report: Independence

Craig Rosenthal — Tue, 01 Sep 2026 21:29:35 GMT

Federal judges do not cite methodologies they find unconvincing.

Over 18 years at Fiduciary Decisions, our benchmarking reports were used as evidence in retirement plan fee litigation. In at least four cases, federal judges cited our methodology in written decisions. Our approach was tested under adversarial conditions, with opposing counsel challenging every assumption and competing experts offering alternative analyses, and it held up. That happened for one reason: independence.

Reporting can be shaped. Benchmarking cannot.

Our benchmarking method is not customizable by the requestor. The comparison groups, the data sources, and the calculations are set by us, not by the employer, not by the provider, not by anyone with a financial interest in the outcome. That separation is what makes benchmarking benchmarking rather than reporting.
When a client asked us to adjust a comparison group to produce a more favorable result, the answer was no. When a provider challenged our data selection in litigation, we could show exactly why each choice was made, and that no choice had been made to favor either side. That is what judicial credibility looks like in practice.

“Healthcare is different” is true, and it misses the point

The most common objection to applying retirement benchmarking discipline to health insurance is that healthcare is different. It is. The providers are different, the data structures are different, and health insurance is far less transparent today than retirement was when we built Fiduciary Decisions. Anyone who claims they can benchmark health insurance exactly the way retirement plans are benchmarked is not being straight with you.
What transfers is the method, not the data. Benchmarking in any industry requires four things: an independent entity that sets the methodology, comparison groups chosen without input from the requestor, data sources with no financial interest in the outcome, and calculations the client cannot adjust to produce a preferred result. Those four requirements do not change from one industry to the next. They are what separate a benchmark from a report.

HealthPlanIQ applies those same requirements to health insurance, built on all of what the industry currently makes available, and designed to expand as regulation and market pressure push providers toward greater transparency.

One question to ask

Your benchmark is only as credible as the independence of the entity that produced it. That was true in retirement and it is true in healthcare. Before you accept any benchmarking in this space, ask who set the methodology, and whether the answer was you.

Part of the Countdown to Change series.

You Already Benchmark Your 401(k). Your Health Plan Needs the Same Discipline.

Craig Rosenthal — Tue, 01 Sep 2026 21:24:49 GMT

You have an investment committee for your 401(k) plan. You meet regularly. You document the meetings. You benchmark your plan's fees against comparable plans to decide whether what you pay your recordkeeper, investment manager, and TPA is reasonable. If the fees are out of line, you have a process for fixing it. You do all of this because ERISA requires it, and because at some point someone explained what happens to employers who do not.

Now consider your health insurance plan. It is your second largest expense after payroll. It renews every year, often with a steep premium increase and no independent explanation of why. Your broker recommends a carrier. Your TPA tracks the claims. Your pharmacy benefit manager runs the drug spend. Each of them is paid in ways that may not be fully disclosed to you.

Do you have a committee that meets to evaluate your health plan's fees? Do you benchmark those fees against comparable plans? Do you document the process? Most employers do not. Not because they are careless, but because no one ever told them that the same duty they meet for their retirement plan applies equally to their health plan. It does. ERISA says so.

Retirement fixed itself, and it did not do so willingly

Before 2012, fee disclosure in retirement was largely voluntary, and compensation was buried in expense ratios, revenue sharing, and wrap fees built to be hard to trace. Then Section 408(b)(2) required disclosure. Then litigation began in earnest. Then better tools and better-informed advisors started moving money toward lower-cost, higher-value providers. The industry resisted every one of those forces. Then it adapted. Fees came down. Transparency went up. Participants benefited.

Health insurance is where retirement was in 2008, before the regulation, before the litigation, before the market began to move. The differences are real. Some health providers still actively withhold data that retirement providers were eventually compelled to disclose. Revenue sharing is commonplace and often hidden. Almost no one in the health insurance chain acknowledges fiduciary status, even though ERISA's definition applies whether they acknowledge it or not.

The CAA created a standard of proof

Section 408(b)(2) did more than require disclosure. It created a standard of proof. Once providers had to disclose their compensation, employers had to evaluate it, and “we didn't know” stopped being a defensible answer. Employers who benchmarked and documented their process were protected. Those who had not were exposed.

The Consolidated Appropriations Act can do the same thing for health insurance, if employers treat it as the opportunity it is rather than the compliance burden it appears to be. The disclosure requirements are in place. The fiduciary obligation exists. The benchmarking tool that lets you evaluate what you are being told is being built now.

If you already run this process for retirement, you are closer to the starting line for health insurance than you think. The employers who understand what happened in retirement have a real advantage in what comes next.

Are you one of them?

Part of the Countdown to Change series.

Why I Have Spent 18 Years on Benchmarking, and Why Healthcare Is Next

Craig Rosenthal — Tue, 01 Sep 2026 21:14:57 GMT

Fewer than 15 percent of people stay with the same employer for more than 20 years. Fewer than 35 percent stay in the same occupation. I have spent 18 years building benchmarking services for retirement plans, and I am not done. The question worth answering is why.

It is not that benchmarking is glamorous work. It is that the problem it solves is real, the harm from ignoring it is concrete, and the solution, which is independent, rigorous, and grounded in what the law requires, genuinely changes outcomes for employers and the people who work for them.

The tool that did not exist

When I co-founded Fiduciary Decisions in 2008, the retirement plan industry had a structural problem. Employers were paying fees they had no independent way to evaluate. Providers disclosed what they chose to disclose. Employers accepted what they were given. The fiduciary obligation to determine whether fees were reasonable was written into ERISA, but no practical tool existed to meet it. We built that tool.

Over 18 years, Fiduciary Decisions became the industry's leading independent benchmarking service for retirement plans. Our reports were used as evidence in litigation. In at least four cases, federal judges cited our methodology in written decisions. That means our approach held up under adversarial conditions, with opposing experts challenging every assumption. That is the credential that matters in this work.

The same approach, a new industry

Now I am applying that approach to health insurance, and this time I am not building alone.
Joshua Jeffries has founded, funded, and operated multiple healthcare businesses. He understands how health insurance actually works, and where the incentives to keep it opaque are strongest. Babu Sivadasan has taken two companies public and spent his career turning complex data into decisions people can act on. HealthPlanIQ is exactly that: complex industry data made usable for the employers who need it most.

A benchmarking expert, a healthcare insider, and an entrepreneurial technologist. The three things this problem has always required, finally in the same room. The method transfers. The market data does not. Everything else does.

Health insurance has not had its moment yet

One regulation changed retirement. Section 408(b)(2) of ERISA required service providers to disclose their compensation to employers, in writing, in advance, with enough detail that a fiduciary could judge whether it was reasonable. When it took effect in 2012, record-keeping fees dropped, revenue sharing became visible and in many cases disappeared, and litigation exposed the plans that had paid too much without documentation. The industry resisted the change, then adapted, then got better.

Health insurance has not had its 408(b)(2) moment yet. The Consolidated Appropriations Act is beginning to create one. The question for employers is whether you wait for litigation to force the issue, or begin now, while the next step is still manageable.

This is where it started. Over the coming weeks I will lay out what we built, why it matters for healthcare, and what you can do about it.

Part of the Countdown to Change series.