Counties
Ninety-two of them, each a plan sponsor, most with a benefits line that has never been independently tested. Counties sit outside the municipal trust model that serves cities and towns, so the market is genuinely open to them.
What we do
The second-largest line in your budget, run the way you already run everything else.
Indiana units of government put paving out to bid. They put bond counsel out to bid. They put engineering, insurance brokerage for property and casualty, and audit services out to bid. Employee benefits — after salaries, the largest controllable line — routinely go a decade without a rigorous market test. Our whole practice is closing that gap.
The engagement
Read the file before anything else
The current carrier and administrator agreements, the pharmacy contract, the stop-loss policy, the broker service agreement, and whatever compensation disclosure exists. We are looking for definitions, term and renewal mechanics, audit rights, rebate treatment, and every dollar of compensation flowing to every party. This stage produces a written summary of what your unit has actually agreed to, which in our experience is not always what the unit believes it agreed to.
Benchmark against comparable Indiana units
Not against a carrier’s national book. Against the filed figures of Indiana counties, cities, towns and townships of the same type and size, drawn from the Gateway Annual Financial Report and the 100R. Where the filings will not support a per-employee figure, we say so and print nothing — see Method.
Model the funding question honestly
Fully insured, level funded, or self funded with stop-loss. Each is right for some units and wrong for others, and the answer turns on enrolled headcount, claims volatility, reserve position, and the unit’s appetite for a bad year. We show the downside case first, because that is the one that ends up in a newspaper.
Take it to market on enforceable terms
A specification your board can approve, distributed to a real bidder list, scored apples-to-apples, with pharmacy priced separately so it can be compared at all. The output is a written recommendation with the arithmetic attached, suitable for the minutes and for a public records request.
Stay for the boring part
Implementation, enrolment communication in language a road crew will actually read, the compliance calendar, claim escalation, and a quarterly report that shows where the money went. The savings in year one are worth little if year three quietly gives them back.
Pharmacy
Pharmacy is where the money moves and the paperwork does not.
Prescription trend is running in double digits while medical trend runs near nine. It is also the part of the plan where the contract language does the most work: how a generic is defined, whether a rebate is a rebate or an administrative credit, what an audit may and may not examine, and whether the arrangement can be left without a penalty that makes leaving theoretical.
We read the contract, not the summary of the contract. Then we put the pharmacy benefit out to market on its own, priced separately, so the number can be compared to something.
What a PBM review asks
Who is the pharmacy benefit manager, and is that name in a document? What is the full compensation to every party, including spread and retained rebate? Are rebates passed through, and how is that verified? What are the audit rights, and has anyone ever exercised them? What are the term, renewal and exit provisions?
Where a vendor’s identity is not stated in a public document, we report it as unconfirmed rather than inferring it. A name in a benefits file is a fact or it is nothing.
Governance
The SEA 3 file review
SEA 3 (2025), P.L.69-2025, codified at IC 27-1-25.5 took effect July 1, 2025 and imposes fiduciary duties on third party administrators and pharmacy benefit managers, owed to the plan sponsor. The definition of plan sponsor carries no carve-out for local government.
A file review asks a narrow question: if someone requested the documents that would evidence those duties, what would your unit produce? In the files we have examined the answer is usually close to nothing — not because anyone did anything wrong, but because nobody was ever asked. That is a documentation finding, not a compliance finding, and closing it generally costs a letter.
- 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.
This is a reading of a public statute and is not legal advice. 46 North is not counsel and is not a tax adviser. Whether a particular vendor falls inside the statute’s definitions is a question for your attorney.
How we are paid
One number, disclosed in writing, before we start.
Fee-first means the engagement letter names our total compensation from every source before any work begins, and we publish that number annually. Where a commission is unavoidable in a particular market, it is disclosed and credited against the fee rather than added to it.
We would rather explain a fee once than have a public body discover a compensation arrangement it did not know about. That discovery is what ends broker relationships in this state.
A first benchmark costs nothing
Before any engagement, we will benchmark your current program against comparable Indiana units at no charge and with no obligation. If the answer is that your current arrangement is competitive, you now have something you can show a council. If it is not, you have found next year’s budget gap.
Who we serve
Indiana units of government, and only Indiana units of government.
Cities and towns
569 incorporated units. Many are inside a pooled arrangement, which may well be the right answer — but a pool that has never been benchmarked cannot prove it is the right answer, and proving it is worth having.
Townships
Small plans, small staffs, and the least advisory attention of any unit type in the state. Township benefits spend is a rounding error to a carrier and the whole budget to a trustee.
School corporations
Roughly 290 of them, facing a projected multi-year revenue loss under SEA 1 while benefits compound. After salaries this is the largest controllable line in a district budget.
Libraries, utilities and special districts
Separate plan sponsors with the same duties and, usually, a fraction of the administrative capacity. Often the fastest engagements we run.
Not employers we are wrong for
We do not serve private employers, we do not sell individual policies, and we will say so early if a unit is better served by staying exactly where it is. A short honest answer is cheaper for everyone than a long engagement.