Benefits Influencer

In this episode of Benefits Influencer, host Dennis Carlson interviews Steve Santangelo, Chief Revenue Officer at Garner Health, about their unique approach to healthcare cost management through provider quality assessment. The conversation offers benefits brokers and consultants valuable insights into innovative solutions for addressing rising healthcare costs at a time when employers are seeking more effective alternatives to traditional health plans. ------------------------------------------------- Steve Santangelo brings his decade of carrier-side experience to explain how Garner Health uses data analytics to identify high-quality healthcare providers and incentivize employees to choose them, resulting in both better care and lower costs. The discussion explores: Key Takeaways: Provider Quality Focus: Garner Health analyzes physicians on over 500 metrics using data representing 320 million patients to identify high-performing providers. Their approach connects patients to top doctors within existing networks, finding that higher quality care typically costs less, delivering average savings of 27% per healthcare episode. Market Transformation: We've reached a "tipping point" in healthcare where employers are actively seeking alternatives as costs become unsustainable. CFOs are now directly involved in benefits decisions, and previously "too disruptive" solutions like reference-based pricing are gaining traction as companies face higher healthcare cost increases. Broker Strategy: Successful benefits consultants need to develop multi-year strategies for clients rather than temporary solutions. Vendors should work closely with brokers throughout the client lifecycle, focusing on delivering promised results that help brokers demonstrate value when renewals arrive. The episode also covers insights on price transparency developments, how self-funded employers can leverage concentrated membership for direct contracting, and why brokers remain essential partners in implementing innovative healthcare solutions.

In this episode of Benefits Influencer, host Dennis Carlson sits down with Sina Chehrazi, founder and CEO of Nayya. Nayya is an AI-powered platform that unlocks the value of Health & Wealth programs for employees in real time. They discuss how Nayya is transforming employee benefits by connecting disparate data points to create a personalized experience throughout the benefits lifecycle - from enrollment decisions to ongoing usage and claims. Sina shares insights about the fragmented benefits ecosystem, the critical role of employee benefits consultants, and the future of benefits technology integration. Key Takeaways: Personalized data integration is transforming benefits: Nayya connects previously siloed data (prescriptions, HSA, medical claims, financial accounts) to create truly personalized recommendations for employees during enrollment and throughout the year, helping employees make better benefits decisions based on their specific situation. Benefits consultants remain crucial: Far from becoming obsolete, consultants are becoming more important as the benefits ecosystem grows more complex. They serve as trusted advisors to employers navigating point solution fatigue and emerging options like captives that could increase competition in major medical. Integration is the future: The benefits technology market is splitting between closed ecosystems and open integration approaches. Sina predicts that platforms embracing integration will ultimately win, similar to how Salesforce has grown through its integration marketplace, creating value for all stakeholders. More info at www.nayya.com  

In this episode, Dennis Carlson sits down with Kristen Rivers, SVP of Sales at ParetoHealth. They discuss how mission-aligned benefits consultants and employers can access premium healthcare solutions typically reserved for large companies through captive healthcare models, highlighting the limitations of traditional fully-insured and level-funded plans while emphasizing the value of actionable data transparency and stronger contractual protections available through alternative funding approaches. Key Takeaways The healthcare market is at a watershed moment where employers are seeking alternatives to unsustainable cost increases in traditional fully-insured plans, with many consultants becoming catalysts for this change. Contrary to popular belief, level-funded plans are often "fully insured, repackaged with a little more data" but without the ability to meaningfully act on that data to control costs. Pareto Health's model provides stronger contractual protections (no-new laser provision and 30% rate cap for the entire membership duration) while giving employers access to cost-saving levers like alternative drug sourcing and patient assistance programs. Contact Information To connect with Kristen Rivers or learn more about Pareto Health, reach out to her directly on LinkedIn or contact any member of the Pareto team in your market.

In this episode of Benefits Influencer, host Dennis Carlson interviews Rachel Schneider, the CEO and founder of Canary, a company revolutionizing how employers support their workforce during times of crisis. Canary manages employee emergency relief funds, allowing companies to formalize a compassionate and equitable response when employees face unexpected hardships. Schneider, drawing from her extensive experience researching the financial well-being of working Americans, shares her journey of creating Canary and its impact on countless lives. Listeners will gain invaluable insights into: The step-by-step process of establishing and implementing an emergency relief fund, ensuring fairness and transparency for all employees. Real-world examples of how Canary has been utilized, particularly in the aftermath of natural disasters like the recent LA wildfires, underscoring the crucial role of immediate financial support. How Canary seamlessly integrates into an employer's benefits program, complementing existing financial wellness and philanthropic initiatives, and potentially aligning with Secure 2.0 provisions. Canary's strategic approach to partnering with brokers, empowering them to educate employers on the transformative benefits of incorporating this essential safety net into their benefits strategy. Tune in to discover how Canary is changing the landscape of employee support and fostering a culture of care within organizations.

Brandy Burch, CEO and founder of benefitbay, joins Dennis to discuss Individual Coverage Health Reimbursement Arrangements (ICHRAs). Brandy shares her expertise on the evolution of the ICHRA market, strategic considerations for brokers, and the importance of a comprehensive technology platform for successful ICHRA implementation.   Listen in as we discuss how to go from a defensive ICHRA strategy to playing offense to better serve employer clients.   Show Notes (generated using AI)   Brandy's Background and benefitbay (2:00): Brandy discusses her background in accounting and finance and her extensive experience purchasing benefits for businesses. This experience led her to found benefitbay, a SaaS technology platform designed to address the complexities of ICHRAs. benefitbay focuses on partnering with brokers to provide them with the tools they need to be successful in the ICHRA market. ICHRA Overview and Evolution (6:30): Brandy provides an overview of ICHRAs and their evolution since their introduction in 2020 under the Trump administration. She explains how ICHRAs allow employers to offer pre-tax benefits to employees who purchase individual health insurance plans. The discussion also covers the initial slow adoption by brokers and their shift towards more offensive strategies as employers express interest in ICHRAs Broker Strategies and the Role of Technology (10:00): The conversation shifts to the importance of brokers in the ICHRA market and the value they bring to employers. Brandy emphasizes the need for brokers to have comprehensive technology platforms that can help them quote, enroll, and administer ICHRAs efficiently. She also highlights the importance of integrating ancillary and voluntary benefits into the ICHRA platform to provide a holistic benefits solution for employers. Market Trends and Drivers for ICHRA Adoption (18:00): Brandy analyzes market trends in ICHRA adoption, noting the significant growth in the average group size adopting ICHRAs. She discusses the key drivers behind this adoption, including employee choice, cost savings, and the need to address the unique needs of diverse workforces and geographically dispersed employees. She also highlights the impact of M&A activity and the challenges faced by healthcare organizations with limited network plans. Positioning ICHRAs in the Benefits Landscape (26:00): The discussion focuses on where ICHRAs fit within the broader spectrum of employer-sponsored health insurance options. Brandy advises brokers to position ICHRAs as part of a comprehensive benefits strategy that includes fully insured, self-funded, and alternative financing arrangements. She stresses the importance of having the right tools and partners to effectively present ICHRA options to employers. benefitbay's Value Proposition (33:00): Brandy outlines benefitbay's value proposition for brokers, emphasizing their focus on the mid-to-large group market and their commitment to broker partnerships. She encourages brokers to proactively explore ICHRAs and utilize benefitbay's platform to stay ahead of market trends and meet the evolving needs of their clients.