Broker Renewal Diagnostic
Stop Losing Renewals to Specialty Claims
Specialty costs are driving employer increases. Most health plans don’t govern how care begins. HealCo helps brokers introduce specialty governance inside existing plans.
SYSTEM ARCHITECTURE
Broker
Governance
Routing
Provider
242
Claims Analyzed
22%
Avg Savings
30d
Deploy time
THE PROBLEM
Why Renewals Are Getting Harder
For many employers the biggest cost increases now come from specialty care escalation.
ESCALATION PATTERN
01
Member reports symptom
Employees enter through hospital emergency or referral networks — the highest-cost access point.
02
Imaging Before Conservative Care
Advanced imaging ordered immediately, locking in facility fees before conservative alternatives are assessed.
03
Surgery Scheduled Pre-Review
Surgical scheduling initiated before non-surgical pathways are reviewed or offered to the patient.
Once hospital specialty care begins, costs compound quickly.
WITHOUT GOVERNANCE
Hospital entry
+$18k
Facility imaging
+$4.2k
Surgical pathway
+$62k
Renewal impact
High
WITHOUT GOVERNANCE
Conservative care
$2.1k
Independent imaging
$800
Non-surgical path
$4.4k
Renewal impact
Stable
PLAN ARCHITECTURE
Carrier
Existing coverage
TPA
Claims administration
Broker
Relationship management
Governance Layer
What HealCo Adds
HealCo introduces a governance layer inside existing health plans.
Diagnostic → Governance
From identifying renewal risk to deploying governance — a clear path forward.
1
Renewal Problem
Specialty escalation identified
2
Diagnostic Review
Claims & pattern analysis
3
Governance Layer
Decision Desk deployed
4
Broker Advantage
Renewal stabilization