Early in her career, Allison De Paoli found herself sitting across from a young single mother who had just declined health insurance coverage for herself, even though it would have cost only a few dollars a week. When she asked why, the woman explained that she couldn't afford to put her children on the plan, and she questioned what kind of mother she would be if she covered herself but not her children.
"That was horrifying," says De Paoli. "I remember thinking that is not the way that we, as a society, want to live. I don't know anybody who would think that's OK."
Fortunately, that story had a happy ending: The company's HR team went above and beyond to enroll her children in the Children's Health Insurance Program (CHIP), allowing the entire family to have coverage they could afford. But that moment became a guiding principle for De Paoli's career: employee benefits are not just numbers on a spreadsheet; they shape real people's lives.
It also instilled in her a commitment to go above and beyond for clients, ensuring every employee has access to the care they need while maintaining dignity and choice. That philosophy now defines how she approaches every engagement at her firm, Altiqe Consulting, combining strategic insight with relentless advocacy to solve complex benefits challenges.
Moving along
De Paoli's career began in South Florida, working at her family's benefits firm, where she gained hands-on experience with self-funded plans for mid-sized employers and learned how creative problem-solving and strategic design could produce measurable results. After moving to San Antonio, De Paoli explored voluntary benefits and ran a small enrollment firm before realizing her true impact lay in core employee benefits after she found herself asking, "Why is this problem here? I know how to fix this."
De Paoli decided to tackle the problems she encountered head-on, one employer at a time. She founded Altiqe Consulting in 2012, and by 2018, the firm had evolved into a full-service consulting practice, specializing in fiduciary health plan design, pharmacy reform and care-delivery strategy for employers with 50–1,000 employees.
Challenging the status quo
De Paoli has a clear-eyed view of the challenges in the health insurance industry, particularly the tension between what the system is designed to do and those it actually serves.
"The amount of obfuscation and sometimes outright lying that happens in our business is astounding," De Paoli says. "There are unclear lines of who is actually representing the employer. I firmly believe that if you are showing up with a Blue Cross, a Cigna, a United, and a Blue Cross Blue Shield renewal, you are not acting in the interest of your client."
Over her 25-year career, she has built a portfolio of employers who rely on her expertise to reduce costs while maintaining full coverage and improving employee experience, including her very first client, who remains a client today.
Over the years, De Paoli has delivered measurable results for employers by driving significant cost savings without compromising employee access or care. She helped one organization achieve a 50% reduction in pharmacy spend without raising copays or altering the formulary, and another realized 25% savings on specialty drugs for three consecutive years.
Meanwhile, employers who have integrated on-site or direct primary care clinics under her guidance report annual savings exceeding $1,200 per employee, with even greater reductions when high-cost outliers are excluded. Through these strategies, De Paoli has maintained 100% coverage while lowering total plan costs, demonstrating a rare ability to balance fiscal stewardship with high-quality, accessible health care.
Keeping people well
The core of effective benefits design is simple yet profound, says De Paoli. Keeping people healthy ultimately costs less.
"The oxymoronic solution is to deliver as much care as you can, as inexpensively as you can," she says.
Clinics and direct primary care (DPC) models exemplify this philosophy, providing timely, affordable care that prevents small issues from becoming expensive crises. By focusing on health and access first, her strategies improve employee outcomes while reducing long-term plan costs.
"If we don't educate people on how to navigate through the system, they are going to continue to get sicker and sicker. And when that happens, when they avoid care, they cost more," she says.
And speaking of people, good customer service is no longer just a perk, it's table stakes, she says. But what sets De Paoli apart in this current environment is how far she's willing to go for employees, even if it surprises some clients.
"A lot of brokerages don't talk to employees," she explains. "They say, you call the vendor or you talk to HR, and HR will talk to us. But we'll talk to anybody."
De Paoli recalls a text she received at 6:15 one morning from an employee who had fallen ill and was facing an unexpected bill. She handled it immediately and said it earned her one of the best compliments she's ever received, when the head of HR said, "I think she actually gives a shit about what happens to us."
Where benefits meet bottom lines
For employers, that extra mile can translate into significant cost savings. One of De Paoli's clients, with about 100 employees, found that everyday medical needs — from the flu to a broken arm to mysterious rashes — were adding up. In the under $10,000 claims bucket alone, these routine visits totaled $447,000, De Paoli recalls. But after the introduction of a near-site clinic, the cost of that same care was reduced to just $190,000 for the year.
"Allison doesn't mind challenging the system, therefore getting us the best quality of benefits," says Tareka Beasley, executive director, HR & Learning at BioBridge Global, an Altiqe client. "She is always thinking about the person who needs medical care. Always looking for the best options for both the company and employee."
Beasley says De Paoli has worked with BBG to help provide a rich benefit plan while keeping the company's premiums flat for seven years, all without sacrificing the strength of the plan. Beyond traditional advisory work, De Paoli also played a key role in starting BioBridge Global's onsite clinic, which has helped keep the company's costs down while encouraging employees to prioritize health.
Saving money for employers is an important objective, says De Paoli, but she notes that "nobody saves money just to save money. Most of our clients reinvest that money back into their workforce in one way or another."
De Paoli emphasizes that education is a big component of how employers discover and engage with innovative and creative benefits plan design.
"In my experience, the people who tackle this first are the people who work on thin margins – manufacturing guys, construction guys – the people who negotiate down to tenths of cents. They're looking at what's going on in their population and they're looking at what is happening to their costs, and they can't square it."
Building trust
De Paoli believes organizations are desperate for partners who genuinely want to work together. "Employers are looking for people who will help them and who they feel helped by. I think that's an important distinction," she says.
Central to that relationship is trust, a quality that is often lacking in the health insurance space, she says.
"Nobody trusts anybody in this system. Employees don't trust their employers; they don't trust hospitals; they don't trust doctors. They may trust nurses, but they don't understand why they're paying so much for drugs. Nobody understands why any of this is happening," says De Paoli. "I see many people in our industry just papering over the problem. Savvy CEOs and CFOs are seeing not only a fiscal problem, but a human capital problem. Because not only is the cost out of control, the experience is out of control."
De Paoli shares her passion and expertise with the industry in a number of ways, sharing insights and raising standards for how health care is delivered and understood. She was an executive producer on the documentary "It's not personal, It's just Healthcare," which exposes how the health care insurance structure and profit‑driven incentives contribute to rising costs, misaligned priorities and barriers to quality care.
She also contributed a chapter to the book "Breaking Through the Status Quo," which challenges the traditional, transactional way companies have approached employee benefits and health care.
Quiet leadership, lasting impact
De Paoli is the kind of advisor whose impact is most visible through the results she achieves for her clients, not through self-promotion or seeking the spotlight. Colleagues and clients describe her as thoughtful, deliberate and relentlessly curious. She doesn't default to standard solutions or rush to answers; instead, she takes the time to understand people, organizations and systems at a deeper level.
"Allison retains her clients for multiple years," says Barbara Greene, founder and CEO of ICF Master Certified Coach. "She leads her team with vision, heart and boldness in creating innovative solutions in health care."
Greene also emphasizes De Paoli's character and community focus, calling her a quiet philanthropist who gives her time, energy and financial resources to community initiatives and beyond. Greene highlighted De Paoli's support of a Girl Scout project at an elementary school where many children had only one uniform, raising funds to provide two per student for 160 kids in grades K–5.
At first glance, De Paoli may appear reserved or stoic, but that composure is part of her superpower, colleagues say. It allows her to remain grounded and objective when emotions, competing priorities or pressure could cloud judgment. Those who work with De Paoli consistently see that her quiet, deliberate leadership and commitment to meaningful outcomes make her a trusted advisor, a strategic partner and a professional whose work leaves a lasting mark.
As for what's next? De Paoli remains focused on educating employers and helping them gain back control.
"Advisors need to speak frankly about what the problems are, what's fixable, what's not fixable, and how to fix it. For so many years, health insurance was an expense that nobody really understood," she says. "Costs kept increasing and nobody thought they could do anything about it. But I think now you're starting to see people saying, we need to understand what is happening here. We cannot allow it to continue this way."
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