Advisory
Broker and consultant of record
Day-to-day advisory for the plan: renewal strategy, plan design, funding, stop-loss, compliance calendar, employee communication, and someone who answers the phone when an employee has a claim problem.
Independent · Fee-first · Indiana only
Benefits built for the people who run your community.
Teachers, deputies, dispatchers, road crews, clerks. The second-largest line in your budget covers them — and in most Indiana units it has never been independently tested against the market. We test it.
46 North Benefit Advisors is an independent public sector employee benefits and pharmacy advisory firm serving Indiana counties, cities, towns, townships and school corporations. We are paid by the unit that hires us, in a number that is disclosed in writing before we start.
The squeeze
Less revenue coming in. A faster-growing plan going out.
Property tax relief is phasing through 2031 while employer health costs compound at the fastest rate in fifteen years. Both trends are outside your control. What sits between them — the contracts, the fees, the pharmacy arrangement — is not.
$18,500average annual cost to cover one employee, 2026Mercer National Survey of Employer-Sponsored Health Plans, 2026 projection
6.7%projected 2026 cost increase — the highest in 15 yearsMercer, 2026 projection (after employer cost-cutting action; ~9% before)
$744Mprojected three-year school revenue loss under SEA 1, from 2026Legislative Services Agency projection, via the Indiana Coalition for Public Education
8thhighest hospital prices in the nation — roughly 3× MedicareRAND Hospital Price Transparency Study, 2024 round
These are published national and state figures, printed with their sources so you can check them. Figures specific to your unit come from your own filings — see Method.
What we do
Five things, done properly, for units of government.
Pharmacy
PBM review and procurement
Pharmacy is the fastest-moving line in the plan and the least visible. We read the actual contract — definitions, rebate pass-through, audit rights, exclusivity — and put it out to market on terms you can enforce.
Benchmarking
Independent benchmarking
Where your spend sits against comparable Indiana units of the same type and size, built from public filings rather than a carrier’s book of business.
Procurement
RFP and market test support
Specification, bid distribution, apples-to-apples scoring, and a written recommendation your board can put in the minutes. We run the process the way your unit already runs a paving contract.
Governance
SEA 3 fiduciary file review
Indiana law now imposes fiduciary duties on your TPA and your PBM. Most files carry nothing that would evidence them. We tell you what is missing and what letter closes the gap.
No charge
A first benchmark, before you hire anyone
We will benchmark your current program against peer Indiana units at no cost and with no obligation. If the answer is that you are already well served, that is a useful thing to be able to prove to a council.
Method
A withheld number beats a wrong one.
Every figure we put in front of an elected official traces to a public filing, an executed document, or a named published source. When a unit’s filed figures will not support a cost per employee, we say so and print nothing.
That rule costs us numbers. Of the Indiana civil units that report any salary at all, roughly seven in ten produce a figure we will not quote. We would rather hand a commissioner four defensible numbers than forty that fall apart in the second meeting.
1,638Indiana units of government in our landscape database46 North landscape master, built from Gateway AFR 2024, DLGF Form 4B 2025, Gateway 100R 2025 and NCES/IDOE
863units with a benefits-to-salary ratio the Pressure Test can compare againstIndiana Gateway AFR 2024 — units filing both a salary line (D101) and a benefits line (D107)
28units where a cost per employee survives every check we runGateway AFR 2024 joined to verified 100R 2025 headcounts
744civil units that reported employee benefits of exactly zeroIndiana Gateway AFR 2024, line D107
Tools
The Pressure Test
Type three figures off your own Annual Financial Report. See where your benefits spend sits against real Indiana units of the same type and size — and, if your filings will not support it, see the tool refuse to compute a cost per employee and tell you why.
What it is not
It is not a savings estimate and it does not quote anything. It is a prioritisation tool: it tells you whether the second-largest line in your budget is worth a closer look this year. It sets no cookies and stores nothing in your browser.
Standard of care
We accept your vendors’ duties, in writing, before the first meeting.
SEA 3 (2025), P.L.69-2025, codified at IC 27-1-25.5, effective July 1, 2025, imposes fiduciary duties on third party administrators and pharmacy benefit managers owed to the plan sponsor. There is no carve-out for local government: your county is a plan sponsor and so is your school corporation.
The statute binds administrators and pharmacy benefit managers — it does not make a broker a fiduciary. So we take the same four duties on voluntarily, in the engagement letter, and publish one total-compensation number every year.
The four duties
- Loyalty and care to the plan sponsor.
- All fees, costs and commissions reasonably and fully disclosed.
- No self-dealing and no undisclosed conflicts of interest.
- Transparency in all financial and contractual arrangements, prescription drug benefits expressly included.
A reading of the public statute, not legal advice. 46 North is not counsel. Confirm the enrolled text and its application to your unit with your attorney.
Insights
What we are reading, and what it means for your budget.
Article
Public Dollars, Private Prices
Two numbers every Indiana public official should be able to recite, three years of renewals in one paragraph, and why the second-largest expense in the budget earned a permanent exemption from the discipline we apply to asphalt.
Research brief · 6 min
The numbers behind the article
A written walk through the renewal record, Indiana’s consolidating carrier map, the questions Aim Medical Trust members should be asking, and the new SEA 3 duties. Full figures table and sources published.
Every premium dollar is a taxpayer dollar.
Pull your contracts. Ask for your data. Get an independent set of eyes on it. The work happens five to seven months before renewal, which for a January 1 plan year means now.