Self-Funded Health Benefit Administration

Experience the Distinction

Our strong network savings, best‑in‑class administration, and flexible plan design options give employers the power to build benefits that truly fit their needs.

We combine comprehensive vendor partnerships with integrated, seamless solutions to enhance plan manageability and member experiences. Through in‑depth analytics and data interpretation, we help clients identify opportunities to control costs, improve total cost of care, and exceed performance expectations. With stewardship focused on fund retention and strategic program monitoring, PAI supports smarter decision‑making and stronger outcomes for both employers and their employees. Contact us to learn how our approach can elevate your benefits strategy.

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Effective Administration

We help employers implement and monitor programs that meet their needs and support employees where they are, ensuring no opportunities for cost control or improved member outcomes are missed. 

Our advanced analytics and reporting help employers understand where their benefit dollars are being spent and where improvements can be made. These insights inform smarter resource allocation and more effective plan design. Integrated services — ranging from best‑in‑class pharmacy benefit management to personalized health coaching and wellness programs — work together to improve care quality while controlling costs.
 

Effective administration is rooted in oversight, insight, and proactive management—and PAI delivers all three.

Smarter Benefits Start Here

Powerful enhancements that deliver savings, convenience, and support.

PAI MemberConnect

PAI Analytics®

Direct Primary Care (DPC)

Health Coaching

Virtual Health

Wellness Programs

Á La Carte Program Offerings

Plan Perks + Discounts

Measured Performance + Proven Administrative Value Leveraging DPC

Year‑over‑year DPC results demonstrate a 10% decrease in medical costs and an almost 12% reduction in pharmacy spend, driven by improved care navigation, stronger network management, and targeted utilization strategies. 

Against commercial benchmarks, outpatient costs are $163 PMPM lower, professional office visit costs are $44 lower, and pharmacy costs are $97 lower, reflecting both pricing efficiency and smarter utilization patterns across all major cost categories.

Looking at a longer trend, the impact becomes even more significant: from CY 2022 (pre‑implementation) through CY 2025, paid medical and pharmacy PMPM increased only 3.21% over three years—compared to a 24% national increase during the same period.

This demonstrates the stability and predictability that employers can achieve when cost management, member engagement, and data‑driven oversight are aligned.

Cost Savings Data

Our Alternative Solutions

Reimagine self‑funded benefits with customizable designs, powerful analytics, and hands‑on support.

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Level Funded

Gain predictable costs and greater plan flexibility with a funding approach that protects your budget while still giving you the control and customization your organization needs to thrive. 
 
 
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Reference Based Pricing

Take charge of your healthcare spend with a transparent pricing model that cuts out network markups, anchors payments to true market value, and unlocks meaningful savings without compromising quality. 
 
 

Trusted Partners

We collaborate with some of the most respected names in the industry to deliver unmatched value and comprehensive solutions for our clients and members.

PCHS
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Unity Preferred
FAIROS
MEDWATCH
OCCUNET
The Alliance
HPS
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How PAI Supports Coverage for Cell & Gene Therapies (CGT)

 PAI helps employers manage the financial and clinical complexity of cell and gene therapies by leveraging specialized coverage solutions designed to protect health plans from catastrophic risk. Rather than absorbing the full, unpredictable cost of a single high‑dollar claim, employers participate in a cost‑effective funding model that spreads risk across a broader pool while maintaining access to life‑changing treatments. This approach provides first‑dollar coverage for eligible therapies and their administration, helps stabilize stop‑loss exposure, and ensures members receive care through credentialed Centers of Excellence with dedicated patient navigation. The result is predictable budgeting for employers and timely, high‑quality access to breakthrough therapies for employees—without compromising financial sustainability.