Diligence · Healthcare Services

Healthcare Services ERISA & Benefits Diligence: An Independent Sponsor's Counsel

Securities and M&A counsel for independent sponsors diligencing healthcare services transactions, from LOI to close to the capital markets that open up afterward.

EV range $15M to $120M EV EBITDA $3M to $20M Audience Buy-side / Sponsor
The deal context

Healthcare Services deals in the lower middle market run a specific playbook. ERISA & Benefits Diligence is where the structure either holds or starts to leak.

The typical healthcare services platform sits at $15M to $120M EV with EBITDA in the $3M to $20M range. The thesis runs on roll-up of physician practices and ancillary service lines. Most off-market healthcare deals come through advisors who have seen the structure before. Have one in your call list.

The moves

How ERISA & Benefits Diligence actually gets structured.

  1. Pull the 5500s and audit reports for the last three years.

  2. Identify any controlled-group exposure that follows the seller post-close.

  3. Address multi-employer pension withdrawal liability where applicable.

  4. Plan the benefits transition to the buyer's plans, with a TSA period if needed.

  5. In healthcare services, layer in PC/MSO structuring as part of the ERISA & Benefits Diligence workstream.

The common mistake

Skipping the multi-employer pension review. It can show up as a 7-figure surprise three months post-close.

Jason's take
"ERISA is the silent deal-killer. Treat it like senior debt diligence."
Jason Powell · ERISA & Benefits Diligence
Capital after close

The deal is one thing. The capital that opens up after close is another.

Refinancing, recaps, growth rounds, and the right strategic conversation eighteen months early are all downstream of relationships that take years to build and minutes to use.

MONTH 18
Senior refi
MONTH 24
Dividend recap
MONTH 36
Growth equity
YEAR 4–5
Strategic exit
TALK TO JASON

An LOI on the desk, a healthcare services target, and a ERISA & Benefits Diligence question worth a real conversation.

Twenty minutes of practitioner-grade input from a securities attorney whose first move is to read the deal, not the engagement letter.