Patrick Ansara Partner and Director of Client Operations
Patrick Ansara is a partner and Director of Client Operations at Ethos Benefits. He leads client strategy, plan financials and carrier relationships for a book of large employers: renewal strategy, contribution and premium equivalent modeling, monthly funding reports, stop-loss and underwriting review, and pharmacy cost control. His core work is turning a plan's claims data into a multi-year cost strategy.
Patrick believes employers should own their claims data and know exactly what drives their costs. He builds the tools that make that possible: claims dashboards, vendor scorecards, benefits committees and PBM contract reviews. He joined Ethos in 2023 because the firm looks for ways to solve the underlying cost problem instead of managing around it.
Patrick has worked in employee benefits since 2013, after earning a degree in health policy studies during the national debate over the Affordable Care Act. He spent about four years at a benefits consultancy, a year in health insurance in Australia, and then worked on the carrier side at Sun Life and Cigna. He is based in Boca Raton, Florida.
Written or reviewed by Patrick
- Form 1095-A vs. 1095-C.Form 1095-A vs. 1095-C: who sends each form, why only the 1095-A is needed to file a tax return, and how 1095-C codes affect premium tax credits.
- Form 1095-B vs. 1095-C.Form 1095-B vs. 1095-C: who files each ACA form, what each one reports, the deadlines for tax years 2025 and 2026, and how employees receive them.
- The ACA affordability safe harbor.The ACA affordability percentage by year (9.96% for 2026, 10.22% for 2027), how the W-2, rate of pay and FPL safe harbors work, and the 4980H penalties.
- ACA reporting requirements.ACA reporting for employers: which form you file, deadlines for tax years 2025 and 2026, the December 2024 law changes, and penalties for late or wrong returns.
- ACA reporting software.What ACA reporting software must do for an applicable large employer, the three ways to buy it, the questions to ask a vendor, and what stays your job.
- What is aggregate stop-loss insurance?Aggregate stop-loss caps a self-funded plan's total claims for the year. How the aggregate attachment point is set, monthly vs. annual aggregate, and the ASD.
- Broker compensation disclosure.What the CAA's broker compensation disclosure rule requires, which brokers and consultants must disclose, the deadlines, and what to ask your broker.
- Broker of record letter.What a broker of record letter is, who signs it, what goes in it, how the waiting period works, and what employers should check before switching brokers.
- The employee benefit plan audit.Which employee benefit plans need an independent audit with Form 5500, why most insured and self-funded health plans are exempt, and what the audit covers.
- Employee benefits administration.What employee benefits administration covers, from enrollment, eligibility and 834 files to payroll, invoices, life events, COBRA and ACA tracking.
- Employee benefits management.What employee benefits management covers, how it differs from strategy and administration, and a month-by-month calendar for overseeing your plan.
- The employee benefits strategy.What an employee benefits strategy is, the data it is built on, how to build a three to five year plan with a committee, and how to measure it.
- Employee benefits survey questions.A free benefits survey template with 33 employee benefits survey questions by section, each with its answer format, plus how to run the survey and read it.
- The employee wellness program.How employee wellness programs work, the HIPAA, ADA and GINA rules on rewards and tobacco surcharges, and what randomized studies found about ROI.
- ERISA bond requirements.ERISA bond requirements, including who must be bonded, the 10% rule, when health plans need a bond, what it covers, and how it differs from a fidelity bond.
- ERISA bond cost.What drives ERISA fidelity bond cost, how to calculate the required bond amount under ERISA section 412, and when a health plan needs a bond at all.
- The ERISA compliance checklist.An ERISA compliance checklist for employer health and welfare plans, with each document, notice and filing, who it applies to, and when it is due.
- ERISA vs. non-ERISA.How ERISA and non-ERISA health and welfare plans differ: which plans are exempt, and how reporting, fiduciary duties, claims rules and legal remedies compare.
- ERISA wrap documents.What an ERISA wrap document is, what it must include, how it differs from an SPD, the disclosure deadlines, and the 2026 penalties for missing them.
- What is Form 1095-B?What Form 1095-B is, who issues it, the line 8 coverage codes, who receives it, state mandates, the furnish-upon-request option and 2026 and 2027 deadlines.
- What is Form 1095-C?What Form 1095-C is, who gets one, what Parts I, II and III show, what the line 14 and line 16 codes mean, and what employers and employees need to do.
- The Form 5500 deadline and extension.When Form 5500 is due for calendar-year and non-calendar plans, how the Form 5558 extension works, who must file, and what late filing costs.
- The gag clause attestation.What the gag clause attestation is, which employer health plans must file it with CMS by December 31 each year, and how to make sure yours is done.
- The health plan fiduciary committee.How to build a health plan fiduciary committee under ERISA: who belongs on it, what the charter covers, what it reviews each quarter and how to record it.
- How to choose a PBM.How employers choose a good pharmacy benefit manager: the PBM contract terms to check, questions to ask, red flags, and the steps of a PBM RFP.
- What is level-funded health insurance?What a level-funded health plan is, how the monthly payment splits into claims, stop-loss and administration, and the real pros and cons for employers.
- Level funded vs. fully insured.Level funded vs fully insured, side by side: monthly cost, who carries claims risk, surplus refunds, run-out liability and compliance, with a comparison table.
- Level funded vs. self-funded.Level funded vs self funded health plans compared: stop-loss, vendor choice, access to claims data, cash flow, surplus refunds and terminal liability.
- Medical vs. pharmacy benefits.What counts as a medical benefit vs. a pharmacy benefit, why the same drug can be billed under either, and how that changes what an employer's health plan pays.
- Medicare Part D creditable coverage.What Medicare Part D creditable coverage means for employer plans, the new 73 percent test for 2027, the October 15 notice and the CMS disclosure deadline.
- NQTLs and mental health parity.What an NQTL is, how it differs from a quantitative limit, which employer plans need a written NQTL comparative analysis, and where the 2024 parity rule stands.
- Medical loss ratio rebates.How employers handle a medical loss ratio rebate, including the employee share, the three-month rule, allocation options, taxes and non-ERISA plans.
- PBM spread pricing.What PBM spread pricing is, a worked example, how to spot it in a pharmacy contract, and what the 2026 federal PBM law changes for employer plans.
- The PCORI fee.What the PCORI fee is, the per-covered-life rate for each plan year, who pays it, how to count covered lives, and how to file Form 720 by July 31.
- Pharmacy benefits administrator.What a pharmacy benefits administrator does, how a PBA differs from a PBM on pay, rebates, networks and data, and what employers should verify in any contract.
- What is reference-based pricing?How reference-based pricing works for self-funded health plans, why balance bills happen, where the No Surprises Act helps, and what employers need in place.
- RxDC reporting.What RxDC reporting is, which group health plans must file, who files the P2 and D1 to D8 files, the June 1 deadline, and how to confirm your vendors filed.
- Section 105(h) nondiscrimination testing.How Section 105(h) testing works for self-insured health plans, HRAs and health FSAs, who counts as highly compensated, and what happens if a plan fails.
- How does self-funded health insurance work?How self-funded health insurance works for employers, from the claims fund, TPA, PBM and stop-loss to ERISA, Form 5500, PCORI and who it fits.
- Self-funded health insurance pros and cons.The pros and cons of self-insured health plans for employers, from claims data and design control to cash flow, large claims, lasering and fiduciary duties.
- Self-funded healthcare trusts.What a healthcare trust does for a self-funded health plan, the main types (VEBA, grantor trust, MEWA), and the bonding, Form 5500 and audit rules that follow.
- Self funded vs. fully insured.Self-funded vs. fully insured health plans, plus level funding and reference-based pricing, compared on risk, cash flow, data, state law and filings.
- Stop-loss captives explained.How a captive health insurance plan works: group vs. single-parent stop-loss captives, risk layers, dividends, collateral, exit terms and risks.
- Stop-loss health insurance examples.Five stop-loss health insurance examples with the math: one large claim, a bad claims year, run-out under 12/12 and 12/15 contracts, a laser and an ASD.
- How does stop-loss insurance work?How stop-loss insurance works for self-funded health plans: specific vs. aggregate coverage, attachment points, contract types, lasering and cost.
- How much does stop-loss insurance cost?Stop-loss insurance has no list price. See what sets the premium, from the deductible and contract basis to claims and lasers, and how employers lower it.
- The summary of benefits and coverage.SBC deadlines for employers. When the summary of benefits and coverage is due, who must provide it, the 60-day notice rule, and the penalties for a miss.
- The summary plan description.What a summary plan description is, what ERISA requires it to include, when it must be delivered, and how it differs from the plan document and the SBC.
- Third party administrator.What a third party administrator does for a self-funded health plan, ASO vs independent TPAs, what to check in a TPA contract, and how a TPA differs from a PBA.
- What are voluntary benefits?What voluntary benefits are, the common types, how payroll deductions and taxes work, portability, commissions, and how employers can judge each product.
- Voluntary benefits and fiduciary duty.When employee-paid voluntary benefits become ERISA plans, what the DOL safe harbor requires, and why new class actions name employers and their brokers.
- Who is subject to ERISA?Private employers' health plans fall under ERISA. See which plans are exempt, including government, church and some voluntary plans, and what the rest must do.
- The year-end health plan compliance checklist.A year-end compliance checklist for employer health plans: the December 31 attestation, testing, notices, new plan limits, ACA reporting and early-year filings.
- The 2027 maternity billing changes.New CPT maternity codes start January 1, 2027, and Medicare's payment values are still proposed. What changes, what is final, and what employers should do.
- AI in employee benefits.Where AI helps employers run benefits in 2026, where it falls short, and the HIPAA rules, including business associate agreements, that limit its use.
- The benefits dirty dozen.Twelve common health plan practices that quietly raise employer costs, from fee basis swaps to PBM spread pricing, with the question to ask about each.
- A CFO's fiduciary playbook.A health plan fiduciary playbook for CFOs. What to measure, what to ask your advisor and vendors, and how a committee and a 3 to 5 year plan fit in.
- Choosing an employee benefits broker.How to choose an employee benefits broker, what to ask about pay and conflicts, and why a fiduciary standard of care matters for your health plan.
- The Consolidated Appropriations Act of 2021.What the Consolidated Appropriations Act of 2021 requires of employer health plans, from broker pay disclosure to gag clause and RxDC filings, and what to ask.
- The Department of Labor audit.What a Department of Labor (EBSA) health plan investigation reviews, what triggers one, what investigators ask for, and how plan sponsors can prepare now.
- Employee benefits trends for 2027.The employee benefits trends that will shape 2027 health plan decisions, from premium growth and GLP-1 costs to PBM reform, parity and price transparency.
- The employer healthcare coalition.What an employer healthcare coalition is, why vendors listen to employers who ask together, and five plays any mid-market employer can run this year.
- ERISA health plan litigation.ERISA health plan lawsuits over drug prices, PBM contracts, tobacco surcharges and voluntary benefits. What each case alleges, where it stands, and what to do.
- Common invoice issues and evidence of insurability.How evidence of insurability (EOI) for life and disability coverage causes invoice errors and denied claims, and how employers can audit and fix the process.
- GLP-1 coverage decisions for 2027.How employers are deciding GLP-1 coverage for 2027, which benchmarks fit your size, the numbers that should drive the decision, and four plan designs.
- Your health insurance renewal increase.What to do when your health insurance renewal comes in with an increase, and how Axiom Healthcare Services turned a 2.6% increase into a 13% decrease.
- Don't make this one mistake when benchmarking your health plan.Withholding claims data when you benchmark or market your health plan leads to weak bids and bigger increases later. Why full disclosure gets better offers.
- Health plan claims data access.S. 2355 would give employer health plans a legal right to their own claims data and audits. Where the bill stands, what it requires and what to do now.
- When a vendor trains AI on claims data.What HIPAA and ERISA require when a health plan vendor wants to train AI on claims data, and five contract questions to ask before you sign or renew.
- Your health plan renewal timeline.A month-by-month health insurance renewal timeline for employers, from claims review 12 months out to open enrollment and the notices due before January 1.
- How employers can lower healthcare costs.How employers can lower healthcare costs without raising deductibles, from pharmacy and large claims to site of care, and what Kalos Services did.
- How to vet benefits vendors.Four tests employers can run on any benefits vendor before signing, from who carries the liability to whether the fee is reasonable under ERISA 408(b)(2).
- Mark Cuban's call.Mark Cuban says self-funded employers' sickest workers fund their drug rebates. What his Cost Plus Drug Company shows employers about pharmacy pricing.
- The multi-cancer early detection test.An FDA panel backed the Galleri multi-cancer early detection test. What the vote means for employer health plans, cost, coverage and member messaging.
- What OBBBA changed for employer health plans.The One Big Beautiful Bill Act changed HSA rules, the dependent care FSA limit and other benefits. What took effect, when, and what IRS guidance says.
- PBM reform is now law.Federal PBM reform passed in the Consolidated Appropriations Act, 2026. What it requires of PBMs and employer plans, when it starts, and what to do now.
- Tennessee SB 420 and HB 870.Tennessee SB 420 and HB 870 would have widened the state's copay assistance rules. The bills did not pass. What they proposed and what it means for employers.
- Transparency in Coverage final rule.The Transparency in Coverage final rule adds a signed attestation to plan pricing files in March 2027. Key dates, what changes and TPA contract fixes to make.
- The downside of vertical integration in healthcare.Insurers own PBMs, PBMs own pharmacies and hospitals buy practices. What vertical integration in healthcare costs employers and how to protect your plan.
- What happens behind the scenes with your health insurance?Where an employer's health plan premium dollar goes, where costs hide in networks, PBMs and claims, and the plan data federal law says you can get.
- Why is health insurance so expensive?Why employer health insurance costs so much, from hidden prices and commissions to closed plans with no data, and what an employer can change this year.
See what your plan is really costing you.
A Strategic Analysis starts with your plan documents and your broker agreement, then shows you what your plan costs, where the risk sits, and what a committee would decide with the full picture.