Start here
The tools the book keeps pointing to.
A handful of resources come up again and again across the chapters. If you only open five links, open these. Chapter-specific articles, guides, and FAQ sections follow below, grouped the way the book is.
FAQPlan Sponsor FAQ92 straight answers for CFOs and HR leaders.ToolStop-Loss Risk SimulatorModel your risk tower and worst-year exposure.ToolPBM Litigation TrackerThe lawsuits from Chapter 6, kept current.BlogInside Your Health PlanThe blog: pricing, pharmacy, plan funding.NewsletterBenefits BriefThe monthly newsletter.
Prologue
The Renewal Arrives. Everyone Ages Seven Years.
RECEIPT · PART I2 CHAPTERS
Holding the Bill
01
Chapter 1
Who Put the Employer in Charge?
02
Chapter 2
Who Pays, Who Shifts, Who Manages
RECEIPT · PART II5 CHAPTERS
Behind the Counter
03
Chapter 3
The Renewal Looked Different From This Side of the Table
04
Chapter 4
Then I Went Where the Bills Came From
- Article · insideyourhealthplan.comFollow the Money, Part 1Why a hospital bills $85,000 and earns $21,400.
- Article · insideyourhealthplan.comFollow the Money, Part 2Same surgeon, same room, two prices.
- Article · insideyourhealthplan.comWhen Hospital Pricing Stops Being “High”The “40% discount” off a price someone invented.
05
Chapter 5
Same Waiting Room. Different Owner.
06
Chapter 6
One Prescription. Everybody Gets a Piece.
- ToolPBM Litigation TrackerThe lawsuits in this chapter, kept up to date.
- Article · insideyourhealthplan.comSpread Pricing: The Markup You Can’t See$800 charged. $200 paid. $600 kept.
- Article · insideyourhealthplan.comRebates: The $500K Check That Costs $2MWhy a rebate can be the most expensive line in your contract.
07
Chapter 7
The Plan Was Excellent. Then Someone Tried to Use It.
RECEIPT · PART III6 CHAPTERS
What You Can Actually Change
08
Chapter 8
Who Is Actually Taking the Risk?
09
Chapter 9
Captives: Choose Your Company Carefully
10
Chapter 10
Buying Care Better
- Article · insideyourhealthplan.com“Managed to Contract”: Why Direct Contracting Is BackThe employers winning are writing better contracts.
- Guide · insideyourhealthplan.comThe Price Is Set Before You Walk InBundled and episodic care, explained.
- Article · insideyourhealthplan.comOON Repricing: A Fee on Phantom SavingsWho sets the benchmark for the savings you pay for.
11
Chapter 11
Fixing the Prescription
12
Chapter 12
The Large Claim Has a Name
13
Chapter 13
You Signed It. Now Someone Has to Read It.
RECEIPT · PART IV1 CHAPTER
Your Next Renewal Starts Here
14
Chapter 14
Bring Better Questions
About the author
Tess is an employee benefits consultant at Hotchkiss Insurance. With 13+ years in benefits — including time inside the health system — Tess advises mid-market employers on self-funded arrangements, group captives, and cost-containment strategies. She holds the CEBS® designation and the CSFS® for self-funding expertise.