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The Higginbotham Difference

Higginbotham's single-source service model provides you with a holistic client experience that goes beyond placement.

From traditional health insurance to everyday administration, our Day Two Services® are delivered by in-house specialists across benefits, compliance, wellness, technology, and more.

No outsourcing. A commitment to flat-fee, transparent pricing.

That is the Higginbotham Difference.

Community Impact

Community Inspired

We are committed to investing in the communities we serve. Upholding our core value of generosity, we believe in enriching the communities that grow our and our clients’ businesses.

Encouraging employees to donate their time and leadership, we coordinate volunteer initiatives with community partners and through internal outreach.

The Higginbotham Difference

Our Day Two Services® leadership team guides Higginbotham in innovative solutions, facilitating world-class services for our clients.

From communications to funding alternatives, these industry experts contribute to your benefits program and remain available for the entirety of your policy term.

Judi Archer

Financial Services Communications and Business Development Vice President

Jenn Wordell-Todd COBRA Administration Director

Jeff Wood Self-Funded Health Solutions Vice President

Francine Tebo

Employee Engagement Director

Jill Sailors, PharmD

HiggRx

Senior Clinical Specialist

Meet Your Team of Experts

Katie Callender

Population Health Management Director

Ross Carmichael, J.D., CEBS Compliance and Day Two Services® Managing Director

Tammy Decker HR Services Managing Director

Maggie Hadden EB/HR Technology Senior Director

Samuel Ritter, MD

Employee Benefits Medical Director

Stephanie Holbert TPA Services Director

Sam McMahan

Financial Analytics Director

Strategic Planning

A successful employee benefits program starts with clear goals that align with your company's objectives.

Discovery Phase

• Deep dive into: culture, cost drivers, pain points

• Align channels with your HR and finance teams

• Detailed contract review: administration, stoploss, pharmacy

Evaluate Alternate Strategies

• Request for Proposal (RFP)

o Independent Third-Party Administrators (TPA)

o Pharmacy Benefit Managers (PBM)

o Centers of Excellence (COE)

o Reference-Based Pricing (RBP)

Strategic Planning

Data Analytics and Technology

Mineral

Real Answers from Real Experts

There's simply no substitute for human experience and knowledge. Enjoy unlimited, immediate access to certified, experienced advisors to help navigate your people risk management issues.

Train Your Staff (and Yourself!)

Whether you train because you have to or because it's just a really good idea, we've got you covered with a full-featured learning management system with the industry's most comprehensive unlimited training catalog.

Content You Can Rely On

Fully integrated content combined with expert analysis or employment laws and regulations and best practice information to help you handle current issues and better understand how to prepare for future issues.

Stay Ahead of the Curve

You have enough on your plate just dealing with today's issues. Our team of attorneys and experts monitor and anticipate future challenges and prepare you through email and CE-accredited webinars.

A Living Handbook

The industry's only wizard-based handbook tool covering all 50 states, complete with policy change alerts to ensure your handbook is always up-to-date, accurate, and protecting your business as effectively as possible.

Tools, Forms, and Templates

Thousands of templates, tools, checklists, and policies to make your job easier. Resources include FLSA classification, performance management, salary benchmarking, interactive audits, job description builder, and more.

Compliance

Guidance

• In-house legal

• Audit support services

• Compliance reviews

• HR/legislative updates

• Compliance and interpretation for ERISA, ACA, HIPAA, COBRA, FMLA, etc.

• Quarterly compliance scorecards and action plans

Tools and Services

• Section 105(h) and Section 125 nondiscrimination testing

• Section 414 controlled group analysis

• ERISA documentation

• 5500 preparation and reporting

• COBRA administration

Higginbotham's Compliance Dashboard and Calendar provide an at-a-glance view of annual compliance tasks, with automatic reminders (federal and state).

The Dashboard is customized with your plan details and serves as a repository for all compliance tasks and required plan documents.

Additional capabilities include retirement plan tracking / 401(k) support, ACA reporting logs, and HIPAA policy attestations.

The best employee benefits programs are those that ensure employees know of and understand how to use their benefits.

Companies with best practice plans report that their participants receive consistent, uniform, and branded communications.

Our internal Employee Benefits Communications team is available to create strategic communications that address your specific benefits needs and inform employees before, during, and after Open Enrollment.

How We Work For You

SMS Text Messaging

Quick and convenient texts send a clear, concise, and cost-effective message when you want to instantly communicate with a select audience.

Webinars

These virtual seminars allow participants to hear what you have to say in a compelling, interactive, real-time event that feels more like a conversation.

Topic-Specific Videos

High-quality video creation increases engagement and connection with your target audience and showcases your knowledge and know-how on a given topic.

Podcast

Get your message across with a one-time digital audio program or a series of episodes that you can download and stream anywhere, anytime.

Digital Media Team

Executes digital technology, interactive PDFs, landing pages, websites, analytic microsites, photography, and videos.

Employee Benefits Team

Develops engaging print and digital tool kits, annual planning calendars, drip campaigns, SMS text messaging, landing pages, videos, Brainsharks, newsletters, onboarding booklet, and custom products for our clients' employees.

AI Decision Assist Tools

Digital, confidential, AI-driven decision tools that create benefits clarity, deeper employee engagement, and smarter plan usage. Built for employers to better help employees and their families make the best choices available.

Comprehensive Annual Communications

When it comes to creating best-in-class resources, we’re a trusted partner for our clients and their employees. They rely on us to create clear, concise, and accurate materials.

SCAN HERE TO LEARN MORE ABOUT WHAT WE CAN DO FOR YOU.

Communications

Full Creative Suite

• Logo and brand development

• Memos, letters, and instructions

• Payroll stuffers and postcards

• Benefits and recruiting summaries

• Company announcements and newsletters

• Enrollment guides

• Wallet cards and envelopes

• Wellness campaigns

• Special mailings and fulfillment

• Promotional materials (magnets, key fobs, etc.)

• Translations

• Electronic interactive PDFs and benefits portal branding

• Social Media—LinkedIn, X, Facebook, and blogs

• Total compensation statements

Employee Response Center (ERC)

Our internal, full-service call and communications center is committed to supporting your employees during Open Enrollment and throughout the year. This team of experts handles a range of inquiries and responsibilities from lost ID cards to complex claims—allowing your HR team to focus on other pressing priorities.

• Average call time exceeds 13 minutes

• Benefits eligibility administration and verification

• U.S.-based team located in Texas and Florida

• Certified ERC professionals

• Roles and responsibilities grid between HR and ERC

• Benefits claims assistance and resolution

• Quarterly customized call reports

• Dedicated toll-free number (group size dependent)

• 140+ languages available with multilingual enrollment support

• System enrollments based on access

Ongoing Support

Your HR & Employee Benefits Service Partner

• Senior Account Manager and Account Coordinator assigned for implementation and ongoing service.

• Benefits check-in meetings (monthly, semi-monthly, etc.) with an Open Items list.

• Full-time resource for daily claim and service needs, escalated issues, and benefit consulting.

• Coordination of all Higginbotham Day Two Services®: Communication, HR Technology, 5500, Wellness / PHM, and more.

February

Service Calendar

March

April

May

Post-Renewal Meeting

Monthly Financial Monitoring Report

RxDC Reporting

June

Monthly Financial Monitoring Report

July

Mid-Year Strategy Meeting

Monthly Financial Monitoring Report

Annual 5500 Reporting

Annual PCORI Fees Due

August

Monthly Financial Monitoring Report

Carrier Renewal Requests

Begin Data Gathering Process

Employee Census

September Marketing Review Meeting

Monthly Financial Monitoring Report

Benefits Marketing Initiatives

Carrier / Renewal Negotiations

Strategic Review

Utilization Analysis

Renewal Decisions / Plan Selections

Contribution Analysis

October Open Enrollment (Late October)

Renewal Support Calls

Monthly Financial Monitoring Report

Carrier Implementation

Ben Admin Updates

Employee Communication Updates

COBRA Updates

November Renewal Support Calls

Monthly Financial Monitoring Report

Finalize Carrier Documents

December

Monthly Financial Monitoring Report

Enrollment files to Carriers – EDI

ID Card confirmation

Annual “Gag Clause” Reporting

January Plan Renewal

Monthly Financial Monitoring Report

Carrier Enrollment Confirmation

Billing Confirmation

Enrollment Audit Reminder

Medicare Part D

CMS Notice Reminder

Compliance Review

Plan Document Creation

Financial Analysis

Offerings Include:

• Self-insured financial plan support

• Pricing and reserve strategy

• Employee contribution strategy

• Long-term disability reserve and IBNR valuations

• Renewal validation

• Projecting renewal and calculating ASO reserves

• Trend modeling and break-even analysis

Self-Funded Center of Excellence

Self-Funded COE

Simplified solutions and customized resources help you mitigate risks associated with today's complex self-funded market.

From risk financing and pharmacy to clinical oversight and analytics, we bring deep subject matter expertise to better manage costs, improve health care outcomes, and make confident, data-driven decisions.

Risk Financing

Stop-loss, captives, group purchasing

Financial Analytics

Actuarial analysis and modeling, quarterly reporting

Population Health

Address macro cost trends within health plans

Data Analytics

Data warehouse provides actionable insights

Self-Funded Specialty Practice

Strategic Account Management

Strategic total life-cycle for self-funded clients

Point Solution Toolkit

Center of truth for evaluating, validating, and advising on the wide array of point solutions for self-funded employers

Level-Funded Solutions

Expanded access to alternate funding through scalable solution for small groups

Clinical Cost Containment

Dedicated resources to reduce impact of larger, complex claims

PBM Consulting

Transparent pharmacy benefits with independent reviews, negotiations, and audits

Self-Funded COE

Medical & Network Strategy

Benchmark provider pricing, utilization patterns, and in-network leakage

Your medical plan structure is optimized by aligning benefit design and network access with real world cost and provider data.

Identify inefficient or high-cost care settings (e.g., hospital-based infusions, imaging)

Recommend steerage and incentive strategies via plan design

Evaluate tiered, narrow, high-performance, or direct-contracting models

Support carve-outs for targeted services (e.g., surgery, imaging, dialysis)

Every recommendation is backed by claims intelligence not trend reports.

Self-Funded COE

Population Health & Clinical Strategy

Strategic data mining and diagnostic reports help pinpoint macro and micro solutions that define a clear path to cost savings.

This process informs plan design and tactical solutions to achieve favored outcomes.

Macro: Population Health Strategy

• Identify chronic condition trends (e.g., MSK, diabetes, BH, oncology, etc.)

• Recommend targeted wellness, DM, navigation, or advocacy programs

• Align vendor deployment with actual population needs and performance benchmarks

• Focus on impact, not vendor count

Micro: Clinical Cost Containment

Bringing clinical intelligence to the financial side of healthcare.

• Identification & Monitoring

o Continuous tracking of high-dollar and emerging claims

o Clinical review of unusual billing patterns, escalations, and inappropriate care settings

• Benchmarking Cost & Quality

o Compare provider pricing, site-of-care decisions, and billed vs. allowed charges to market norms

• Strategic Cost Containment Review

• Site-of-care redirection

• Medical necessity validation

• Fraud, waste, and abuse flagging

• Pharmacy utilization and sourcing review

• In-network leakage and contract alignment opportunities

Macro supports trend. Micro protects margin.

Self-Funded COE

Crawl

Active Data Mining

Transplant Carve Out

Cost/Quality Navigation/Advocacy

Virtual Care

Population Health Management

Claim Audits/Review/ Alt. Payors

Quality/Cost Transparency

Transparent PBMs

Walk

Utilization Management/Disease Management/Case Management

Direct Contracts/Bundles (Surgery/Imaging) - $0 Deductibles

Virtual Primary Care

Oncology Management

DME

Rx Optimization (Specialty/Biosimilars)

Diabetes Management

Maternity Management

Run

RBP/Cash Pay

Advanced/Direct Primary Care

Centers of Excellence

Medical Tourism

Second Opinion Strategy

Onsite/Near Site Clinic

Dependent Audits

Precision Medicine/ Pharmacogenetics

Self-Funded COE

Data Analytics and Technology

Self-Funded COE

Custom-Built Solutions

Clinical Navigation

Imaging / Surgical Bundles

Virtual / Direct Primary Care

Alternative Payors

Cancer / Infusions

Alternate Rx Sourcing

340B Programs

Specialty Rx Solutions

GLP-1s Strategy International Sourcing

Claim & Contract Audits

Aim to track utilization and ROI of each solution via data analytics, using that data to make active plan decisions for future solutions that increase value and lower spend.

Representative list of point solutions – final point solutions selected based on employer’s needs.

Rx Solutions

Prescription and specialty drugs are a significant cost of your medical plan.

Improper usage, drug intolerance, and brand drug purchases over generics create excess costs.

We contain overall Rx spend and provide real-time oversight through:

• Ingredient cost transparency

• Dispensing fees and AWP discounts

• Aggressive rebate negotiations

• Guaranteed minimum rebates

Based on group needs, we implement:

• Clinical programs

• International sourcing programs

• Patient assistance programs

• Manufacturer copay optimization

Pharmacy Predictive Modeling Tools

Higginbotham's Rx consulting division allows us to be agnostic and objective. This team works to evaluate your current pharmacy solution against potential cost-saving alternatives.

Pharmacy Benefit Intelligence®

Our methodology includes:

• Intent to Bid from vendors with 20+ contract terms

• Executable contracts requested with every RFP

• PBM matching aligned with member needs and risk

• Preferred modeling: pass-through pricing to determine "lowest net cost"

• Carve-in vs. carve-out evaluated case by case

• Cost containment programs like international Rx sourcing, patient assistance programs, copay solutions, manufacturing coupon programs

Population Health Management

Katie Callender MPH, ACSM-EP Director

DJ Clark M.Ed., CSCS, SCCC Consultant

Specialty: Exercise Physiology & Human Performance

Clara Ramirez

MBA, MPH, CPH, CHES Consultant

Specialty: Data Analytics & Health Equity

Margo Bates

MS, SHRM-CP, ACSM-EP, CWWPM Consultant

Specialty: Health Operations & Optimization

Lindsay Ewart MA, CWWPM

Managing Consultant

Specialty: Key Accounts

Andrea Miller MSW, LMSW Senior Consultant

Specialty: Mental Health

Rachel Ellman MS, RD, LD, dipACLM Consultant

Specialty: Nutrition & Dietetics

Day Two Services®

Kelly Aguilar CEAS, 500ERYT, PMA Consultant

Specialty: Ergonomics & Body Mechanics

Kelley Melcher ACSM-EP Consultant

Specialty: Health Strategy & Carrier Solutions

Population Health Management

Wellness programs are tailored to your goals, population, and budget. Our team works with you to design and implement initiatives.

Rely on Our In-House Professionals

• Health Education

• Corporate Wellness

• Exercise and Sports Physiology

• Nutritional Sciences

• Psychology and Mental Health

• Social Work

• Public Health

• Ergonomics and Musculoskeletal Health

Population Health Management

Steps Toward Success

Higginbotham’s population health management consultants focus on five proven principles:

1. Analyze Culture & Claims

A population health management (PHM) program goes from good to great when it takes into account the overall well-being of your employees, their current risks, and their work environment. A strategic and cultural analysis, paired with a claims review, helps identify workforce issues and needs that can be targeted with the right solutions. This assessment provides a solid foundation for program development, implementation, facilitation, and evaluation.

2. Engage Management

Senior leadership support is crucial to the success of a program. Employers who serve as a role model and integrate well-being into the business strategy create a culture where healthy lifestyles are valued, promoted, and incentivized.

3. Create Awareness

A holistic approach to population health considers your employees’ work-life balance, existing resources, and potential solutions and focuses on the specific health risk factors affecting them to create awareness. A comprehensive program may focus on many pillars of well-being, including social, mental, physical, spiritual, occupational, intellectual, environmental, and financial wellness.

4. Provide Education

A careful evaluation of health improvement solutions is important to keep employees informed and engaged. Resources may be provided through our PHM department, the community, a medical carrier, or a vendor partner to encourage employees to make more informed health care decisions, take steps toward sustainable lifestyle changes, and take ownership of their individual well-being.

5. Measure Success

Setting tangible goals and analyzing aggregated data gives us powerful information to see what initiatives are working and what needs attention. Integrate outcomes into renewal strategy through baseline measurements including medical and pharmacy utilization, medical claims costs, employee engagement and participation, and overall employee satisfaction.