The Benefits Playbook

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The Benefits Playbook: Season 4

Kirk McConnell, Collective Health — Wed, 4 Mar 2026 18:40:00 +0000

It’s 2026, but the healthcare system still feels like it’s stuck in the past. Costs are soaring, benefits are confusing, and employees are left navigating a system built on pieces that don’t fit together. Employers are exhausted trying to manage it all, while employees struggle to get the care they need. But it doesn’t have to be that way.

Smart employers and their consultants are flipping the script: cutting costs, simplifying the experience, and creating benefits their people actually love. On The Benefits Playbook, we uncover the bold strategies that are rewriting the rules of self-funded health benefits.

In Season 4, host Kirk McConnell speaks with industry leaders about bringing transparency to a system built on confusion, using the right financial levers to deliver real value and impact, and designing benefits that truly work for employees. We’ll talk about better data. Better tools. Better insights. Smarter decisions. And benefits strategy that finally makes sense.

This is The Benefits Playbook, Season 4. Brought to you by Collective Health.

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Links

Connect with Kirk McConnell on LinkedIn

Learn more about Caspian Studios

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Navigating Volatility: Innovative Strategies for Cost-Effective Health Benefits with Christian Moreno, Executive Vice President at Lockton

Christian Moreno, Lockton, Kirk McConnell, Collective Health — Tue, 28 Oct 2025 09:00:00 +0000

This episode features an interview with Christian Moreno, Executive Vice President of Lockton. With more than 20 years of experience, Christian specializes in designing health plans that are fully integrated with wellness solutions, helping employers manage the demand side of healthcare.

In this episode, Kirk and Christian discuss strategies to manage healthcare cost volatility, the efficacy of wellness programs versus high-cost medications, and the potential shift towards narrower networks to contain costs while maintaining quality care.

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“ I don't know that you can make this just an employee decision at the end of the day. It's going to have to happen further upstream if we want to have a seismic or substantial impact on cost. If we're just talking about physician A versus physician B, but I can still choose to go within any hospital system at any time with total freedom. If we are going to leave it up to employees and just make it a broad PPO network, I don't know that they have the information just yet to make those decisions. It's going to have to have come from intelligent data tools in their hand. It's going to have to have assistance from the TPA and it's going to have to have assistance from the ecosystem around the member making those decisions.” – Christian Moreno

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Episode Timestamps:

*(00:51): Christian’s career journey

*(02:31): Volatility in healthcare costs

*(10:12): Wellness programs and GLP-1s

*(20:28): Network design and future strategies

*(27:49): Driving employees to high quality providers

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Links:

Connect with Christian on LinkedIn

Contact Christian

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Employers as Agents of Change: Empowering Healthcare Transformation with Siobhan Nolan Mangini & Bob Kocher, Venrock

Bob Kocher, Siobhan Nolan Mangini, Venrock, Collective Health, Kirk McConnell — Tue, 7 Oct 2025 09:00:00 +0000

This episode features an interview with Siobhan Nolan Mangini and Bob Kocher from Venrock. Siobhan is a Partner at Venrock, where she focuses on investments in healthcare technology and services. Prior to joining Venrock, Siobhan was an operator passionate about transforming healthcare through building and scaling innovative companies at the intersection of healthcare and technology. Also a Partner at Venrock, Bob focuses on health tech and services investments. Before joining the company, Bob served in the Obama Administration as Special Assistant to the President for Healthcare and Economic Policy on the National Economic Council and was a Partner at McKinsey & Company.

In this episode, Kirk, Siobhan, and Bob explore Venrock's philosophy and approach to investing in transformative healthcare companies, the importance of aligning incentives, and the potential impact of AI and technology on healthcare delivery.

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“ Taking these dials that we're talking about and realizing, oh, I can carve out my PBM, I can put in benefits like Lyra, for example, behavioral health solution for my entire employee population. I can layer on maybe dynamic copays or narrow network designs, high performing networks, and actually have control. That idea that I am an agent of change, of providing better care, but a lower cost for my employees, is actually there and that they have the tools. That much more empowered driver's seat, to me, is where we'd be a decade from now, if not sooner.” – Siobhan Nolan Mangini

“ Changing healthcare is painful. It might be better at the other end, but the change is hard. People will have to change their insurance or change their doctors or change how they access care or it changes. We learned from the ACA and we've learned from everything since that people don't like that. You have to have something that's even stronger than the pain of changing how healthcare works. And then I think there's lots of ways to imagine how it could be better.” – Bob Kocher

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Episode Timestamps:

*(00:43): Siobhan and Bob’s paths to Venrock

*(04:38): The state of US healthcare today

*(15:44): The importance of aligning incentives

*(20:14): Empowering employers as agents of change

*(25:29): AI’s impact on healthcare delivery

*(27:45): Headwinds and tailwinds in the healthcare system

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Links:

Contact Siobhan

Contact Bob

Connect with Scott on LinkedIn

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Employers & Health Systems: Navigating New Healthcare Frontiers with Scott Burton, Commercial Market President, Providence Health Plan

Scott Burton, Providence Health Plan, Collective Health, Kirk McConnell — Wed, 27 Aug 2025 09:00:00 +0000

This episode features an interview with Scott Burton, Commercial Market President at Providence Health Plan. Since joining the organization in 2022, Scott has been influential in the growth of central PHP business and engagement with channel partners. In his current role, Scott is responsible for state and regional commercial sales and growth strategies.

In this episode, Kirk and Scott explore the impact of rising healthcare costs on employers, the shifting role of benefits administrators, and the evolving relationships between health systems and employers.

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“ We're having conversations with many of our employers around, alright, how do we think about benefit design differently? Can we continue to move toward value-based contracting even in today's really challenging world? Employers have a lot of power to impact change, again, large employers and small. I think we're having conversations now that we haven't had in the last decade plus in healthcare and we need to. We need to move to a new paradigm because today's system is clearly broken.” – Scott Burton

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Episode Timestamps:

*(00:55): Scott’s career journey

*(02:41): Why employers should care about the state of health systems

*(08:36): The opportunity health systems have to work with employers

*(12:09): Scott breaks down Providence Health Plan

*(19:24): PHP’s role in community health plans

*(29:47): Scott's advice for employers working with local health systems

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Links:

Connect with Suzanne on LinkedIn

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Thinking Outside the System: Redefining Employee Benefits with Suzanne Usaj, Senior Director of Total Rewards at The Wonderful Company

Suzanne Usaj, The Wonderful Company, Kirk McConnell, Collective Health — Tue, 12 Aug 2025 09:00:00 +0000

This episode features an interview with Suzanne Usaj, Senior Director of Total Rewards at The Wonderful Company. Suzanne leads strategy and execution for the company’s compensation, benefits and wellness suite of programs, delivering value to over 10,000 employees globally.

In this episode, Kirk and Suzanne discuss The Wonderful Company’s unique approach to health benefits, including their focus on preventive care, direct contracting for specialty care, and the important role of their onsite wellness centers.

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“ When someone really needs help, when they're experiencing a situation that they've never experienced before, which is a lot of the complex conditions in our healthcare system, how do we find specialty partners that may or may not be in those broad networks? But we build our own network and incentivize our members to go to that. So you still maintain a little bit of that benefits philosophy where you feel like you need choice, but you're driving people to be able to help make it easy for them to make high quality, low cost decisions for them and for, like I mentioned, the entire healthcare system.” – Suzanne Usaj

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Episode Timestamps:

*(00:57): Suzanne’s career journey

*(04:41): How The Wonderful Company serves their geographically diverse workforce

*(10:16): How Suzanne works within and outside the system

*(16:04): Connecting employees with suitable providers and streamlining the process

*(21:11): How The Wonderful Company uses data to work upstream

*(27:30): Clinics role in The Wonderful Company's strategy

*(32:52): What’s next in Suzanne’s strategy

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Links:

Learn more about The Wonderful Company

Connect with Sara on LinkedIn

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Resist the “Easy Button”: Why Pushing for More Leads to Better Benefits with Sara Richards, Director of Benefits at Red Bull

Kirk McConnell, Sara Richards, Collective Health — Tue, 22 Jul 2025 09:00:00 +0000

This episode features an interview with Sara Richards, Director of Benefits at Red Bull. With experience spanning the consulting, TPA, and in-house side of benefits, Sara’s experience gives her a unique perspective around what’s possible when it comes to developing and administering customized health and welfare solutions.

In this episode, Kirk and Sara explore strategies for simplifying and effectively communicating benefits, the practical implementation of point solutions, and utilizing AI to improve employee engagement and fraud prevention.

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“ I am optimistic for those who are willing and able to not stop fighting to change the status quo. I'm optimistic as long as you are willing to put in the work to not just keep going with things and to get ahead of trends and to look at the unconventional solutions. If you dare and you don't give up, then I am optimistic that we will be able to make this better, and that we as the employers have this ability to bring our buying power to truly impact change. With a layer of pessimism of, and if you don't dare, then it's not gonna be a fun ride for you in the next five, six years.” – Sara Richards

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Episode Timestamps:

*(00:51): Sara’s career journey

*(06:28): Innovative communication strategies

*(13:06): Direct contracting and primary care

*(21:41): Shared savings and fraud prevention

*(32:26): The role of AI in benefits

*(36:41): Optimism for the future

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Links:

Connect with Rob on LinkedIn

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From Capitol Hill to the C-Suite: Insights on Healthcare Transformation with Robert E. Andrews, CEO of Health Transformation Alliance

Tue, 8 Jul 2025 09:00:00 +0000

This episode features an interview with Robert E. Andrews, CEO of Health Transformation Alliance (HTA), where he oversees the strategic direction of 60+ corporations that aim to fix our broken healthcare system. Prior to HTA, Robert served as a Member of the United States House of Representatives for nearly 24 years and was an original author of the Affordable Care Act.

In this episode, Kirk and Robert discuss the evolving trends in health care, the potential impacts of gene therapy, and the importance of reducing friction in health benefits administration for employers.

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“ When you have 5 million lives, which we do, and $40 billion worth of spend, we're able to go to behavioral health providers and say, people shouldn't have to wait six weeks to see a psychiatrist when they're feeling anxious or depressed. Why can't they see them in six days or less? And we're able to do that to expand the networks that are available. So that's how we measure our effort. Both in terms of the price that you pay and we think more importantly, the service that you get and the quality of the work that you get. So we're really all about using the leverage of collective bargaining to improve outcomes.” – Robert E. Andrews

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Episode Timestamps:

*(00:58): Reflecting on the Affordable Care Act

*(02:17): Current health care system challenges

*(12:50): Founding of Health Transformation Alliance

*(19:08): Employer challenges and solutions

*(30:43): Future of health care and AI

*(37:53): Global health care perspectives

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Links:

Learn more about HTA

Connect with Jen on LinkedIn

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GLP-1s Demystified: Strategies to Support Sustainable Behavior Change with Jen Jones & Cody Fair, Noom Health

Kirk McConnell, Jen Jones, Cody Fair, Collective Health, Noom Health — Tue, 24 Jun 2025 09:00:00 +0000

This episode features an interview with Jen Jones and Cody Fair from Noom Health. Jen is the Director of Clinical Solutions and supports teams with alignment on client needs and clinical programs. Cody serves as the Chief Commercial Officer leading the company’s commercial division and drives growth initiatives across all segments.

In this episode, Kirk, Jen, and Cody explore the importance of integrating GLP-1 medications with behavior change programs, challenges related to yo-yo dieting and coverage, and how Noom Health employs tools like body scans and AI to enhance user engagement and outcomes.

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“ There's just an incredible level of frustration at the employer level right now because they genuinely want to do something obviously, that is helping their employees and their members. They want to be able to provide these medications that they know can be incredibly effective. But at the same time, they have to be good stewards of the business and the cost. And that's again, really where the two come together is being able to provide a patient experience and benefit, but weighing that against the cost. And so trying to find a solution that allows them to go down that middle road where they can control the cost, but still allow an ideal patient experience and have the access to medications that can be effective.” – Jen Jones

“ What AI will allow us to do is to mine these massive data sets and really start to understand human behavior deeper to where we'll know the exact time that I should reach out to this individual with the exact note that I should send them to make sure we kind of keep them on the program, so to speak. For that person that's going to fall off the wagon and we're never going to see him again. It will give us the ability to figure out the times that we should reach out and how we should reach out and that type of messaging. Something that just pure human intervention would not be able to deliver.” – Cody Fair

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Episode Timestamps:

*(01:01): Jen and Cody’s journeys to Noom Health

*(06:02): The importance of behavior change

*(16:38: The role of GLP-1 medications

*(25:33): Managing GLP-1 costs and access

*(34:59): The future of GLP-1s and Noom Health

*(38:05): Leveraging AI for better health outcomes

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Links:

Connect with Cody on LinkedIn

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The Benefits Playbook: Season 3

Kirk McConnell, Collective Health — Tue, 17 Jun 2025 09:00:00 +0000

The healthcare system feels broken. Costs are skyrocketing, transparency is nonexistent, and too many people are left wondering, ‘Why is this so complicated?’ Welcome to The Benefits Playbook—where we fight the good fight for a better healthcare system.

This season, we are joined by new host Kirk McConnell, Commercial Leader at Collective Health. This year, Kirk sits down with the boldest minds leading the health benefits revolution: industry disruptors, fearless benefits leaders, and healthcare changemakers who are taking real action. We’re pulling back the curtain on hidden costs, exposing the inefficiencies, and revealing the playbook for a system that actually works.

If you're tired of the same old healthcare nonsense and ready to take action, join us for season 3 of The Benefits Playbook, brought to you by Collective Health.

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Links

Connect with Ali on LinkedIn

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The Healthcare Consumer Awakening & Digital Health with Ali Diab & Halle Tecco, Collective Health

Sasha Yamaguchi, Ali Diab, Halle Tecco — Tue, 15 Oct 2024 09:00:00 +0000

This episode features an interview with Ali Diab and Halle Tecco. Ali is the CEO and Co-founder of Collective Health, the world’s leading employer health benefit plan administration platform. Prior to co-founding Collective Health, he held executive and management positions at AdMob by Google, Goldman Sachs, Microsoft, and Yahoo!. Halle is an entrepreneur and Adjunct Professor at Columbia Business School, Course Director at Harvard Medical School, and Collective Health Board Member. Passionate about fixing the U.S. healthcare system, she founded Rock Health, the first venture fund dedicated to digital health, and co-founded companies such as Cofertility and Natalist. Halle is also the co-host of The Heart of Healthcare podcast.

In this episode, Sasha, Ali, and Halle discuss consumer-focused healthcare, the role of AI in enhancing member experience and the care economy, and the potential for public-private partnerships in managing healthcare costs.

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“Are you a consumer-focused or customer-focused healthcare company? Or are you a self-interested healthcare company? I think, sadly, a lot of the incumbent players in our industry are more self-interested than they are customer-focused. I think that's the thing that is the hallmark of Collective Health. That's why we exist because we don't think people are being served in the way that they should with that kind of customer obsession that we see in other industries that leads to great things, including the appropriate use of technology to make that experience better.” – Ali Diab

“I think that because we are the end payers through tax dollars, through lower wages, through direct payment, out-of-pocket spending, we deserve to have the players listen to our needs and our demands to lower the cost. But unfortunately, we have an industry that's profiting quite nicely from us, so it's going to take a lot of work, collective work. But, we have no choice. We can't leave the system to our children and grandchildren like this.” – Halle Tecco

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Episode Timestamps:

*(01:04): Ali’s personal health journey that led to Collective Health

*(06:28): Halle’s journey in digital health

*(15:42): How digital health is changing the industry

*(25:55): The impact of member experience

*(31:19): The role of AI in healthcare

*(44:27): Future trends in healthcare

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Links:

Connect with Halle on LinkedIn

Listen to The Heart of Healthcare

Connect with Michael on LinkedIn

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Understanding Healthcare's Flaws and Finding Solutions with Michael Menerey, SVP of Alliant Insurance Services

Sasha Yamaguchi, Michael Menerey — Tue, 10 Sep 2024 09:00:00 +0000

This episode features an interview with Michael Menerey, Senior Vice President of Alliant Insurance Services. He currently oversees and manages the Los Angeles employee benefits team and is focused on new business development and recruiting and developing talented team members. Michael has been with Alliant for over 20 years in various roles such as Vice President and Benefits Consultant. In 2021, he was named by Risk & Insurance Magazine as a 2021 Power Broker® Award Recipient for Employee Benefits.

In this episode, Sasha sits down with Michael to discuss the broken aspects of the traditional healthcare system, the lack of price transparency and quality metrics in healthcare services, and the necessity of tailored communication strategies for different workforce demographics.

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“When you're fully insured, there's just not a lot of levers that can be pulled from a cost containment standpoint. Once you move into that self-funded world, there is just a whole universe of different levers and tools at your disposal that can not only control cost, but can also improve the quality of care for employees and improve the member experience, relative to what it is in a traditional insurance model or even the traditional healthcare system.” – Michael Menerey

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Episode Timestamps:

*(01:19): Michael’s career journey

*(02:54): Why healthcare is broken

*(11:49): The benefits of self-funded health plans

*(20:18): Three point solutions that every employer should consider

*(24:36): How workforce demographics impact benefit plans and communications

*(35:23): Michael’s advice for how to manage your day

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Links:

Connect with Brian on LinkedIn

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TPA: The Quarterback of Self-Funded Plans with Brian Olsen, Partner, Employee Benefits at Sterling Seacrest Pritchard

Sasha Yamaguchi, Brian Olsen — Tue, 20 Aug 2024 09:00:00 +0000

This episode features an interview with Brian Olsen, Partner of Employee Benefits at Sterling Seacrest Pritchard. Brian is an experienced Client Advisor specializing in creative employee benefits strategies to mitigate risks of health plans for companies ranging from 50 to 5,000 employees. His expertise resides in data management solutions and analysis, pharmacy cost containment, and complex contract negotiations.

In this episode, Sasha and Brian discuss the intricacies of working in the TPA space, the importance of clinical data in managing healthcare costs, and how to advise clients on network selection, PBMs, and stop-loss insurance strategies.

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“The TPA is the quarterback for a client's self-funded plan. Pulling together all the different players: the PBM, the stop-loss, the broker, the client. Making sure everybody is working as one to execute the plan for the self-funded health benefits. The biggest benefit is a client's flexibility as they're coming to design that game plan. What kind of network do we want to use? How do we want to pay certain types of claims?” – Brian Olsen

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Episode Timestamps:

*(01:40): Brian’s career journey

*(05:49): Understanding the TPA model

*(12:42): Pharmacy benefit management insights

*(18:02): Non-ERISA business and transition challenges

*(26:27): Importance of clinical data insights

*(30:07): Brian’s advice for those new to the industry

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Links:

Email Brian

Connect with Kristen on LinkedIn

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One Size Doesn't Fit All in Benefits with Kristen Jordan, Benefits & Wellness Manager at Chime

Sasha Yamaguchi, Kristen Jordan — Tue, 30 Jul 2024 09:00:00 +0000

This episode features an interview with Kristen Jordan, Benefits and Wellness Manager at Chime. She is responsible for the development, implementation, and maintenance of various programs that enhance employee well-being and satisfaction. Kristen has a proven track record for designing and managing benefit plans, wellness initiatives, and vendor relationships that align with the company's vision and values.

In this episode, Sasha sits down with Kristen to discuss the importance of benefits education, customized wellness programs, and the impact of a leave of absence management tool.

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“When we think about wellness programs, you really do have to tailor them to your specific company. You can't just put a one-size-fits-all program in there because you may not see the results or the engagement that you're looking for when it comes to implementing a wellness program.” – Kristen Jordan

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Episode Timestamps:

*(01:21): Kristen’s career journey

*(04:29): Wellness and benefits at Chime

*(14:16): How Chime supports employees

*(18:21): How Chime builds each year’s benefits plan

*(24:09): Ensuring a great member experience

*(33:00): Kristen’s advice for those new to the industry

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Links:

Learn more about Chime

Connect with Doug on LinkedIn

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Strategies for Managing Pharmacy, Gene Therapy, & GLP-1s with Doug Ramsthel & Jaclyn Rielly, Burnham Benefits

Sasha Yamaguchi, Doug Ramsthel, Jaclyn Rielly — Tue, 9 Jul 2024 09:00:00 +0000

This episode features an interview with Doug Ramsthel and Jaclyn Rielly of Burnham Benefits. Doug serves as the Executive Vice President and Partner of Employee Benefits, and Jaclyn is the Vice President of the Irvine Office.

In this episode, Sasha, Doug, and Jaclyn discuss how the shift in pharmacy is affecting employers and members, the rising trend of GLP-1s, and why covering gene therapy drugs is important.

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“If I can convert somebody from a drug where I'm getting a $382 rebate to a cheaper drug where my net cost is a lot lower, that's a better benefit strategy. The only way to do that, in my opinion, is to take control as an employer. Self-fund and be able to start hitting these control buttons that will customize the plan, so you're focusing on the right things. Whereas the PBMs could be focusing just on their rebates because they're getting a slice of it. That's how they make their money.” – Doug Ramsthel

“Employers are really starting to get creative when it comes to managing their drug spend, and they have to, while focusing on different financial factors, as well as member behavior, when it comes to controlling costs. As plan costs for prescription drugs increase, member costs typically follow suit, whether it be through increases in cost sharing or premium contributions. With over 70% of office visits and hospital visits involving drug therapy, the rising costs of pharmacy are becoming more and more visible at the member level. I think the biggest shift, though, in pharmacy affecting members today really is that of access and affordability.” – Jaclyn Rielly

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Episode Timestamps:

*(01:13): How the shift in pharmacy is affecting employers and members

*(16:18): Doug discusses his book and obesity treatments

*(19:46): Doug dives into GLP-1s

*(33:08): Jaclyn discusses gene therapy drugs

*(45:50): Jaclyn explains the value-based formulary idea

*(49:40): Final thoughts on gene therapy drugs and GLP-1s

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Links:

Connect with Jaclyn on LinkedIn

Connect with Dr. Das on LinkedIn

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Innovative Solutions for Mental Health & Addiction Treatment with Dr. Smita Das, VP of Psychiatry & Complex Care at Lyra Health

Sasha Yamaguchi, Smita Das — Tue, 18 Jun 2024 09:00:00 +0000

This episode features an interview with Dr. Smita Das, Vice President of Psychiatry and Complex Care at Lyra Health. Smita is board certified in psychiatry, addiction psychiatry, and addiction medicine and has over 20 years of research experience. Previously, she served as President of an American Psychiatric Association District Branch and chair of the APA's Council on Addiction Psychiatry. Smita is also a clinical associate professor of Psychiatry and Behavioral Sciences at Stanford School of Medicine.

In this episode, Sasha and Smita dive into Lyra Health’s Complex Care Program, how the conversation around sobriety is changing, and how addiction and mental health psychiatry differ and intertwine.

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“There's so many places where somebody can fall through the cracks, for one reason or another. It could be coverage. It could be that they couldn't find a facility or that there were too many options and they had analysis paralysis, or they went to a place that wasn't actually evidence-based or at the bar that we expect at Lyra. Then, they're actually worse off because now maybe they've paid out of pocket tens of thousands of dollars and they didn't actually get better.” – Dr. Smita Das

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Episode Timestamps:

*(01:28): Smita’s career background

*(05:25): Why point solution access is important

*(09:15): Smita explains Lyra Complex Care

*(23:50): How addiction and mental health psychiatry differ and intertwine

*(29:15): Examples of employers who have accessible recovery programs

*(33:12): Smita’s advice for employers looking into complex care

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Links:

Learn more about Lyra Health

Visit Rethinking Drinking

Connect with Matt on LinkedIn

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Empowering Members to Make Better Care Choices with Dr. Matt Resnick, Chief Medical Officer at Embold Health

Sasha Yamaguchi, Matt Resnick — Tue, 28 May 2024 09:00:00 +0000

This episode features an interview with Dr. Matt Resnick, Chief Medical Officer at Embold Health. He is a member of the founding executive team and led the development of measurement and analytic stacks. Today, he is responsible for growth and all go-to-market functions, leading a team in developing strategy and building products that align with market demands and deliver exceptional value.

In this episode, Sasha sits down with Matt to discuss the importance of quality care measurement, how it can benefit both employees and employers, and how measurement tools change based on patient age.

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“All of us spend countless hours, minutes researching all of the relatively superfluous purchases we make, like on Amazon. Yet, when it comes to finding a doctor, we trust our neighbors. The reality is most of us like our doctors and most of us don't have enough knowledge to know whether what we did was the right or the wrong thing. Even people who have bad outcomes actually like their doctors. The reality is we know if you walk in door A or door B, your likelihood of winding up on an operating table in a year with back pain is tenfold different.” – Matt Resnick

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Episode Timestamps:

*(01:15): Matt’s career background

*(07:18): Why quality care measurement is important

*(19:00): How Embold helps members find quality providers

*(29:49): How quality care measurement helps employers

*(34:04): How measurement tools change based on patient age

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Links:

Learn more about Embold Health

Connect with Dan on LinkedIn

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Navigating the Shift to Self-Funded Health Plans with Dan Hodges, SVP of Employee Benefits at Woodruff Sawyer

Sasha Yamaguchi, Dan Hodges — Tue, 7 May 2024 09:00:00 +0000

This episode features an interview with Dan Hodges, Senior Vice President of Employee Benefits at Woodruff Sawyer, where he provides strategic consultation and counseling to clients on their employee benefits programs. Dan has over 25 years of experience consulting a large cross section of employers including those in healthcare, not-for-profit, high-tech, service, and hospitality. He is also an expert in self-funding, consumerism, and HSA style plans.

In this episode, Sasha and Dan discuss transitioning to self-funded health plans, choosing a TPA versus an ASO, and the future of employer benefits.

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“You also have a lot more flexibility just on how you design your program. The different pieces that are baked into a fully insured program, how you can break those out, how you can go to specialty markets and get either better service or lower cost for that part of your program. How you can get better programs for your employees to take advantage of within a self-insured program. There's a lot of flexibility that you get, both in terms of service to the employer, service to the employee, and cost savings to the company.” – Dan Hodges

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Episode Timestamps:

*(01:22): Dan’s career background

*(06:33): Dan breaks down transitioning to self-funded health plans

*(23:25): Choosing a TPA versus ASO

*(26:00): Woodruff Sawyer’s unique offering

*(34:32): The future of employer benefits

*(36:52): Dan’s advice for people new to the industry

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Links:

Learn more about Woodruff Sawyer

Learn more about Tria Health

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Pharmacogenomics and Personalized Pharmacy Care with Jessica Lea, Founder & CEO of Tria Health

Sasha Yamaguchi, Jessica Lea — Tue, 16 Apr 2024 09:00:00 +0000

This episode features an interview with Jessica Lea, founder and CEO of Tria Health. Jessica is passionate about pharmacists providing patient-centered care to improve the health outcomes of patients. She has a Doctor of Pharmacy degree from the University of Missouri-Kansas City, maintains board certification in psychiatric pharmacy, and has an Executive Masters in Business from Rockhurst University. Jessica is a healthcare innovator and has been recognized as one of the PharmaVOICE100.

In this episode, Sasha sits down with Jessica to discuss the revolutionary study of pharmacogenomics, the craze around weight loss drugs, and how Tria Health supports its members.

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“We're starting to get to a place where we have a better understanding of more medications that we know are affected by the way in which your body may metabolize or not metabolize the medicine, as it relates specifically to your DNA. The other thing is that not only have we gained more understanding of more medications, but we've also gotten to a place where it's a little more cost-effective in testing the right people who we believe would benefit from this.” – Jessica Lea

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Episode Timestamps:

*(01:24): Jessica’s career background

*(04:31): How Tria Health supports members

*(14:51): Jessica dives into pharmacogenomics

*(27:50): How pharmacy and medical interact

*(32:07): Jessica’s thoughts on weight loss drugs

*(41:32): Jessica’s advice for those starting their own businesses

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Links:

Follow Tria Health on LinkedIn

Connect with Jessica on LinkedIn

Connect with Mike on LinkedIn

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The Basics of Healthcare with Michael Caussin, Licensed Health Advisor

Sasha Yamaguchi, Mike Caussin — Tue, 26 Mar 2024 09:00:00 +0000

This episode features an interview with Michael Caussin, former NFL tight end and New York Times bestselling author. Mike became a licensed health advisor in 2023 and helps individuals and families find the health coverage they need.

In this episode, Sasha and Mike get back to the basics of healthcare. They discuss why healthcare education is so important, how to navigate life events, and what people don’t know about coverage options.

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“I want to be an asset to people in whatever I'm doing in my life. Let me teach everyone that's watching or following the simple basics of your day-to-day coverage. I've gotten much more positive feedback than I ever imagined of people commenting or messaging me on how helpful it's been. Which obviously for anyone, it's validating to get that reassurance that you're actually helping somebody.” – Michael Caussin

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Episode Timestamps:

*(01:15): Mike’s career background

*(07:27): How Mike uses his Instagram to educate people

*(11:45): Mike’s advising process

*(18:49): How Mike helps people navigate life events

*(27:24): How Mike improves member experience

*(32:48): Mike’s advice for those new to the industry

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Links:

Follow Mike on Instagram

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The Benefits Playbook Season 2 Trailer

Sasha Yamaguchi — Tue, 19 Mar 2024 09:00:00 +0000

Welcome to The Benefits Playbook podcast! We have a really exciting announcement: a new season is on its way!

Last season, we had the privilege of sitting down with some of the best minds in employee healthcare including benefits leaders, brokers, and consultants. They shared expert advice on creating a winning benefits strategy. Everything from how to build an inclusive benefits program, to making the leap to self-funding, to delivering a great member experience. If you haven’t tuned in yet, catch season 1 wherever you listen to podcasts.

Our second season is bringing some new voices into the mix, including Tria Health’s Jessica Lea, NFL player turned Licensed Health Advisor, Mike Caussin, and our very own CEO and Co-founder, Ali Diab. We’ll cover why understanding the basics of health benefits plans is important for members, we’ll dive deep into AI and how it’s influencing our industry, and we’ll explore revolutionary fields of medical and pharmacy study.

Join us for season 2 of The Benefits Playbook, brought to you by Collective Health.

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Links:

Connect with Ben on LinkedIn

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Creating a Safe Workplace Through Inclusivity, Benefits, and Education with Ben Greene, Public Speaker & LGBTQ+ Inclusion Consultant

Sasha Yamaguchi, Ben Greene — Tue, 30 Jan 2024 10:00:00 +0000

This episode features an interview with Ben Greene. Ben is an international public speaker and LGBTQ+ inclusion consultant, as well as an author and an advocate for transgender youth. In 2019, he gave a successful TEDx Talk called “Where are you sitting?” and has since traveled the world speaking in different domains like HR conferences, DEI summits, and government agencies like NASA.

In this episode, Sasha and Ben discuss inclusion consulting, what carriers get wrong about member experience, and the platinum standard of inclusive healthcare.

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“The biggest thing would be really making sure that gender affirming care is covered by your benefits plan. Gender affirming care looks like things like top surgery and bottom surgery, which is what they're called colloquially. That's what I would consider the silver standard of gender affirming care coverage. The gold standard would include things like facial feminization surgery. It might include something like voice therapy. Also, for LGBTQ folks overall, different fertility options. Looking at something like IVF. Care that includes inclusive family-building or adoption coverage, and working that in with your parental leave as well. If we want to talk about the new platinum standard, something else that I hate that I have to recommend, but that is becoming increasingly important to both LGBTQ people overall, as well as parents of transgender young people, is relocation coverage.” – Ben Greene

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Episode Timestamps:

*(01:11): Ben’s background

*(05:56): Ben explains his role as an inclusion consultant

*(12:11): Do’s and don’ts of creating an inclusive workplace

*(16:38): Must-have benefits

*(22:25): What carriers get wrong about member experience

*(27:21): Ben’s advice for those looking to become an advocate

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Links:

Visit Ben’s website

Follow Ben on Instagram

Follow Ben on TikTok

Pre-order Ben’s book

PFLAG

Human Rights Campaign

GLSEN

GLMA

Connect with Emily on LinkedIn

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Designing Braggable and Unique Benefits Programs with Emily Munroe, Global Head of Benefits & Wellness at Live Nation

Sasha Yamaguchi, Emily Munroe — Tue, 9 Jan 2024 10:00:00 +0000

This episode features an interview with Emily Munroe, Global Head of Benefits and Wellness at Live Nation. Emily began her career in banking and finance before making a career change to HR. She began in HR serving growth-and-expansion stage biotech and pharmaceutical companies in Compensation and Benefits. She has also worked in global Benefits roles for a consulting firm, tech and retail, and now entertainment.

In this episode, Sasha and Emily discuss must-have benefits, how to get buy-in from leaders, and creating braggable programs.

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“My tactic has been to start in the ERGs first. Get the voices that I think are impactful in the company, the ones that folks are listening to that aren't necessarily just leaders, but get them on board. Once I have them working with me to increase the awareness of really important impactful programs, I think it comes a little easier.” – Emily Munroe

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Episode Timestamps:

*(01:20): Emily’s career journey

*(04:17): What Benefits & Wellness looks like at Live Nation

*(06:24): How Live Nation builds their benefits programs

*(13:19): How benefits leaders can get buy-in from other leaders

*(16:41): Emily explains Sober Nation

*(25:09): Benefits programs must-haves

*(32:30): Emily’s advice for those new to the industry

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Links:

Follow Live Nation on LinkedIn

Learn more about Live Nation

Connect with Serafina on LinkedIn

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The Importance of Building an Inclusive Benefits Plan with Serafina Miller, Senior Principal Consultant at Mercer

Sasha Yamaguchi, Serafina Miller — Tue, 5 Dec 2023 10:00:00 +0000

This episode features an interview with Serafina Miller, Senior Principal Consultant at Mercer. Serafina has been in the industry for over two decades, specializing in group account management for multiple industries like banking, biotechnology, transportation, engineering firms, and law firms. At Mercer, Serafina partners with employers to ensure their employee benefits programs integrate with compensation strategies and business objectives, as well as aligning with the organizations’ DEI strategies.

In this episode, Sasha sits down with Serafina to discuss designing inclusive benefits plans, why self-funding is a win-win for finance and benefits teams, and the importance of provider alignment.

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“A lot of conversations in these last handful of years about provider alignment to the communities in which they serve, and really pushing insurance carriers to work on their provider diversity. Hiring more Black, Latine physicians, transgender physicians, non-binary physicians, because there are certain conversations that are much easier to have because there's an alignment of life experience. There's a believability factor that's built into that dynamic. It encourages more people to get more engaged in their healthcare. We're so focused on preventive care, if we have more diverse physicians, people will get more engaged in their preventive care and ideally live, the goal is longer, healthier, and therefore, happier lives.” – Serafina Miller

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Episode Timestamps:

*(00:32): Serafina dives into Mercer

*(05:54): What size groups are moving to self-funded

*(08:47): Ancillary and PTO trends in the benefits space

*(12:09): What family-building, fertility, and reproductive health benefits look like

*(18:00): Components of an inclusive benefits program

*(26:46): The importance of virtual care

*(28:56): Serafina’s advice for those new to the industry

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Links:

Connect with Michael on LinkedIn

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Building Benefits Connectivity Through Infrastructure with Michael Levin, Co-founder of Ideon

Sasha Yamaguchi, Michael Levin — Tue, 14 Nov 2023 15:05:00 +0000

This episode features an interview with Michael Levin, Co-founder of Ideon, an infrastructure platform powering digital experiences in health insurance and employee benefits. Michael has over 20 years of experience driving innovation and bringing quality and choice to new markets. Prior to Ideon, he served as the Chief Operating Officer for Affiliates Risk Management Services (ARMS), where he recruited a new leadership team, transformed and upgraded financial operations and audit systems, and led business plan development. He also founded Media Sciences, Inc., bringing quality, value, and choice to the printer supply market.

In this episode, Sasha and Michael discuss building infrastructure in the benefits space, the importance of decision support tools, and the trend of same-day benefits.

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“There's so much that we can do around creating better member experience. We can get coverage in place in days, not weeks, so that you don't get to the doctor and have a coverage issue. Or if you were to leave a company and you need to avail yourself of COBRA, that it is seamless as opposed to a three week or four week set of challenges. You should be able to understand the differences in real language between plans and understand the tradeoffs of making an investment in one place versus another. There's so much we can do around education, around transparency, ‘Is this the right doctor based on their experience, their training, their outcomes for me?’ Transparency and pharmacy and costs associated with that. But, there's so many areas of the member journey that could be improved from enrollment all the way through, through using these products. The good news is there's a lot of really great companies led by really great founders who are passionate about solving these problems and they will be solved. There's a lot of activity happening, so this is being solved for today. All of us have a good reason to expect great outcomes over the coming years.” – Michael Levin

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Episode Timestamps:

*(00:57): Michael explains Ideon

*(06:40): The importance of infrastructure in the benefits space

*(13:52): The power of accurate provider data

*(19:10): Michael dives into decision support tools

*(23:53): How we can improve member experience

*(26:40): Michael shares his favorite healthcare story

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Links:

Connect with John on LinkedIn

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Self-Funding Isn’t Just for Large Groups with John Meister, Principal & Senior Vice President of Employee Benefits at Newfront

Sasha Yamaguchi, John Meister — Tue, 24 Oct 2023 09:00:00 +0000

This episode features an interview with John Meister, Principal and Senior Vice President of Employee Benefits at Newfront. John provides top-tier consulting, creative strategies, and employee advocacy on behalf of his clients nationwide. Prior to Newfront, John spent five years leading Client Strategy and Execution at Woodruff Sawyer and held Employee Benefits roles at One Digital and Burnham Benefits.

In this episode, Sasha sits down with John to discuss transitioning to self-funded solutions, key components of a great member experience, and building point solutions into benefits programs.

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“When I talk with some companies that are unfamiliar with self-funding, really, they think it's just this totally apples and oranges approach. I try to just explain to them, ‘Hey, built into your premiums right now, we can take a look at what the insurance companies are doing for self-funding. They have stop loss built-in. They have their PBMs built-in. And there’s just layers of admin costs and profit built into each of these that then comprises your premium rate that you're getting charged.’ Just by trying to compare it to what they know right now, to then what it would be to self-funding, that also, I think, is usually a big light-bulb moment for a lot of clients. Just to feel like, ‘Oh, this isn't actually that much different than what I'm doing.’ It's just, ‘Hey, we're going to set the rates for what we say you should budget for. It's going to be that set number that you're used to.’ Conversations like that usually are the foundation to then go on.” – John Meister

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Episode Timestamps:

*(01:13): John explains Newfront

*(08:19): How John talks to his clients about moving to self-funded solutions

*(24:14): The key components of a great member experience for clients

*(28:49): John discusses point solutions and the difference it makes in benefits programs

*(31:51): John’s advice to those new to the industry

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Links:

Read Bapu’s book Random Acts of Medicine

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Designing Benefits for Employee Productivity and Retention with Dr. Bapu Jena, Professor of Health Care Policy at Harvard Medical School

Sasha Yamaguchi, Bapu Jena — Tue, 10 Oct 2023 09:00:00 +0000

This episode features an interview with Dr. Bapu Jena, an economist, physician, and professor at Harvard Medical School. He bridges his professions to explore the economics of healthcare productivity and medical innovation. Bapu is also a faculty research fellow at the National Bureau of Economic Research and practices medicine at Massachusetts General Hospital.

In this episode, Sasha and Bapu discuss his book Random Acts of Medicine, provider-level quality scoring, and designing employer-sponsored benefits.

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“If you're an employer and you're thinking about how to structure your benefits for your employees, you're going to think about which hospital systems you want them to have access to. You're going to think about what doctors’ groups or doctors’ practices you want them to have access to. Naturally, you're going to want to have information on what is the quality of those places. But then how do you measure quality? What we might say about a particular doctor in terms of their quality, might be a function of their actual skill and the true quality that they provide. It could also be a function of the resources that their practice has, or the types of patients that they see. If you want to know something about what is the true effect of seeing that particular doctor, you've got to sidestep all these thorny empirical problems.” – Dr. Bapu Jena

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Episode Timestamps:

*(01:09): How the fields of healthcare and economics correlate with each other

*(04:02): Bapu dives into his book Random Acts of Medicine

*(10:09): What provider-level quality scoring is and how it works

*(18:00): Bapu’s thoughts on employer-sponsored benefits

*(25:21): Good spend versus bad spend when building benefits plan designs

*(27:29): Challenges providers and payers will face as healthcare evolves

*(36:33): Bapu shares his favorite healthcare story

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Links:

Random Acts of Medicine Substack

Listen to Freakonomics MD Podcast

Connect with David on LinkedIn

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The Human Side of Health Benefits with David Duenas, Life Science Practice Leader at HUB International

Sasha Yamaguchi, David Duenas — Tue, 26 Sep 2023 09:00:00 +0000

This episode features an interview with David Duenas, Life Science Practice Leader at HUB International. HUB International is a leading full-service global insurance broker providing property and casualty, life and health, employee benefits, investment and risk management products and services. David has served the company for nearly 20 years in Consulting and the Life Sciences Practice space.

In this episode, Sasha and David discuss how to move to a self-funded solution, crafting a better member experience, and the value of human connection.

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“I think the biggest challenge that we face is the complexity of the healthcare system. And that's everyone in that, in the delivery of that benefit. Whether it's at the carrier level, the consulting level, the providers, the hospitals, and getting all of that to integrate and speak to one another for the benefit of the employee. That, I think, is really the biggest challenge. Our industry is probably one of the few that takes all of its complexity, all of those connection points – and they are many – and we just drop this on the lap of the employee or the participant, if you will, and we just hit them on the rear end and say, ‘Good luck.’ And the fluency of most employees is they don't interact with the health plan with any commonality. They're just not there on a daily basis, so it's foreign to them. And so, we could try and increase their fluency but also the delivery, so it makes it easier for them.”– David Duenas

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Episode Timestamps:

*(00:54): David’s answer to “Why do you do what you do?”

*(02:06): Challenges members are facing in the healthcare industry

*(04:06): Components of a best-in-class program

*(06:17): The directive David sees from the carrier industry

*(09:46): How David talks to clients about moving to a self-funded solution

*(16:31): How the hospital experience trickles down to employers

*(23:45): David shares a story from the early days of his career

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Links:

Email David

Connect with Lee on LinkedIn

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TPA vs. ASO: Which Is Right For You? with Lee Lewis, CSO & GM Medical Solutions at Health Transformation Alliance

Sasha Yamaguchi, Lee Lewis — Tue, 12 Sep 2023 09:00:00 +0000

This episode features an interview with Lee Lewis, Chief Strategy Officer and General Manager of Medical Solutions for Health Transformation Alliance (HTA). At HTA, he spearheads efforts across 50 large employers and six million employees to transform healthcare, save lives, and save millions of dollars. Lee has spent his career advising Fortune 10 employers, insurance companies, medical associations, and the Departments of Justice and Labor.

In this episode, Sasha sits down with Lee to discuss the benefits of a TPA versus an ASO, virtual primary care, and putting trust back into healthcare.

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“If you are a huge employer, if you’re AT&T or Walmart, you have enough leverage that carriers will build systems in place that enable you to do creative things. The difference between a TPA and a carrier is, it's still remarkable but it's smaller. The gap is smaller. But, if you're a small employer, you don't have the buying power with any carrier anywhere. You're a rounding error to them. You're not going to get any type of flexibility or creativity supported. Whereas, if you work with an independent TPA, you can still access a lot of those things that might otherwise only be accessible for a huge employer. Secondly, getting data is really hard with large carriers. If you have a TPA, you have the chance to get your data like a large employer might, even though you're smaller.” – Lee Lewis

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Episode Timestamps:

*(01:09): Lee breaks down TPA versus major carrier options

*(04:53): Busting the myth that TPA is more complicated than ASO

*(10:39): The top 3 components of a best-in-class healthcare benefits program

*(22:05): Lee’s opinion on virtual primary care

*(28:27): Lee discusses self-funded versus fully insured

*(33:17): Lee shares his favorite healthcare story

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Links:

Listen to Broken Benefits Podcast