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FinFit: The Evolution of Employer-Sponsored Health Benefits

Employer-sponsored health benefits are being reimagined to tackle rising costs and complexity. This episode of 'Secure' by FinFit, hosted by Charles Lattimer, features a discussion with Lamont Thurston, co-founder of BENERē, on supplemental insurance and innovative solutions in the benefits space.

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By Software And Technology · BenerēCharles LattimerFinfitHealth Benefits
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Key takeaways

01

Rising deductibles are pushing employers to rethink health benefits.

02

Supplemental insurances like critical illness coverage are on the rise.

03

Captives are becoming integral in employee benefits integration.

In recent years, the landscape of employer-sponsored health benefits has undergone significant transformation. With rising healthcare costs and the increasing complexity of health insurance, employers are seeking innovative solutions to provide comprehensive benefits to their employees. A recent study revealed that the average deductible for Americans has skyrocketed, creating a mismatch between the risk exposure for consumers and their savings. So, what's the solution to bridge this gap and is there a more efficient way for employers to offer health benefits that truly cater to the needs of their employees?

On this episode of SECURE, presented by FinFit, host Charles Lattimer, talks with Lamont Thurston, Co-Founder of BENERē, on this vital topic. The duo dive into the intricacies of employer-sponsored health benefits, focusing on the role of supplemental insurances like critical illness, hospital indemnity, and accident coverage. Their discussion covers:

– The rise of critical illness, accident, and hospital indemnity coverage in response to increasing deductibles.

– The concept of captives in the insurance industry and its application in the employee benefits space.

– The challenges and opportunities of integrating supplemental insurances into employer-sponsored health benefits plans.

Lamont Thurston, an economics major with an MBA in Finance, began his journey in the insurance industry by chance. With a rich background in corporate banking and finance, he transitioned to the insurance space, focusing on benefits and property and casualty. Over the years, Lamont has established himself as a pioneer in the captive insurance industry, bringing innovative solutions to the table.

Video TranscriptExpand ↓

Hey there. This is Charles Latimer, chief innovation and growth officer at Finfit, and you are host of the secure podcast. At Finfit, we're committed to making finance stress free for employees. We give them the resources to tackle challenges like inflation, credit card debt, unexpected of the expenses and student loan repayment so that they can be more productive and live happier lives. We do that by solving short term financial or challenges and helping build short term savings for emergencies and unexpected expenses. Now tune in to Cure podcast where we delve into the unique financial challenges your employees face. We talk about important new legislation, like the Secure two point o Act and offer fresh insights from experts committed to building financial well-being for your workforce. Don't miss an episode. Join us and get empowered to positively impact your team's financial future. Check it out. Welcome everybody to the secure podcast. This is Charles Latimer. You're a host. I am here today with Lamont Therson who's founder and CEO of Benery, an extraordinary mind in the world of finance and insurance and and a dear colleague of mine, Lamont. Welcome to the secure podcast. Good to be with you, Charles. Thank you. I don't know about extraordinary mind, but Well You gotta manage expectations here. I I would say, from my opinion, extraordinary mind. So you know what? With all the conversation, we've had a lot of great conversations over the past several months. And and, you know, one thing I I don't know that we've fully packed together, which is a little bit of your backstory. You know, how how did you sort of land here? I mean, what what was your academic background? What what kind of landed you into to your current role with Benerry and really innovating in the space of a employer sponsored, benefits and just innovating the and sort of revolutionizing the the how we look at supplemental plans and just the overall health insurance matrix? Yeah. Well, I I'll start with. I think I got into the insurance business by accident, like a lot of people that are in the insurance business, And once you find yourself there, you you think, gosh, I'm I'm glad this happened, but I was I was a econ major, finance graduate, studies, an MBA in finance. But right out of school, I went and taught English in Japan for a couple of years and headed back to Cincinnati, Ohio and went to work for a big bank that had three fifty or so Japanese owned companies that were clients and did corporate banking for about fourteen years and moved around the country. We did acquisitions and turnaround work, and I was leading groups and they dropped me in Toledo, Ohio, for two years, twenty years ago, and we found that we we love living here, and I said, well, I'm gonna take a little professional risk because I've been with the same employer for fourteen years. And it was a it was a great run and a great place to great place to learn and work and kinda grow as a business person, but I went to work for one of our board members in the insurance space. And I really thought that I would do property and casualty because all of my contexts up and down I seventy five were all finance people, and everybody I went to visit with said, we get a price reduction every year in our property and casualty, and it's a small line item, and we get a giant increase every year, and we've got major math problems in health care. So I focused on benefits and, you know, did self insured groups. And as that was transpiring, I was doing a lot of, referrals to the captive insurance industry, and captives are, you know, think of it as you know, benefits people always sort of sell themselves short in terms of understanding captives, but it's just formalization of self insurance. Is basically what it is. It's the intersection of finance and insurance. And, you know, I found as I did more and more of that work that that played to my strengths. So I became a captive consultant and formed and operated a lot of different captive insurance companies, and The the long story short is best practices in the captive world have been done for decades and decades. But it hadn't been applied to supplemental insurance. And so that that was sort of the the genesis of, you know, I was a finance guy, but doing benefit and property and casualty is usually where all the finance guys are and and and ladies as well. So, that's that's kinda what happened. So so that's interesting that you made that leap from over into the supplemental side. Could could you just, for our audience, and and we we have a a sophisticated audience of of HR and benefits executives. But could could you just kind of give from your perspective the backdrop of of captives and just the overall, employer sponsored health plan over the last twenty years or so. Sure. Sure. So as I said, cat the the captive industry has been around since the fifties. There are thousands and thousands of them. Most of our clients, own their own captive insurance companies and they've done, you know, workers compensation, auto liability, general liability, medical malpractice, you know, more property and casualty, but the fastest growth area, in the industry, by far, is in the employee benefit space. And it's the lower end of the market, size wise of employers There's a very large trend to do medical stop loss in a group captive to kind of smooth out the wild roller coaster ride that catastrophic claims can cause. So there there's an abundance of employers that are going into that. And then on the upper end, you know, very large companies are saying, okay, how do we take the more catastrophic things that happen and put layers of that into the captive insurance company that that we own. What Benery has done is taken a, you know, ca captives are good at exposing and kind of, creating more efficiency, for things that are in in the market. And what I mean by inefficient is, low claims ratios and not a great value proposition for the premiums that are being spent. And in the case of critical illness, accident, and hospital indemnity coverage, claims ratios for days have been very, very low. And So captives, when you unbundle all of that and sort of go self insured or quasi self insured to the extent possible, with the regulatory constraints. It it was an opportunity for disruption and In the first, handful of years, we have about a million employees in the program. So, I I I think Wow. I think messaging is is resonating. Absolutely. So so what has sort of prevented sort of supplemental insurances from coming in to as an embedded part of the plan to date. Is it the sort of just the overall cost, and and is it that is it the claims ratio that just you know, the CFO can't get their mind around, and so it just sort of sits off the periphery. But it becomes that, you know, a a part of the stop loss equation as well. But you know, could you kinda walk us through what why the sort of the it seems like, on the surface of, of course, you'd want everyone to have sort of critical illness hospital indemnity to kind of smooth out those catastrophic events. Why is that, you know, sort of sat on the sidelines for so long? And and what's the trend right now? Yeah. Well, I think we start with, over the last twenty years, these coverages have grown from about four billion dollars of premium to about twelve billion dollars of premium in a falling rate environment. So that's not because of inflation that's because of adoption. And and the reason for the adoption is, you know, you have a sophisticated viewership even if you just read the paper and you're not in the industry, we all know health care has gotten pretty expensive in the last twenty years. And the outlet valve for that is, and this is where it it really aligns with the work that you do at Finfit, deductibles are getting higher and higher. Out of pocket maximums are getting higher and higher. And when you look at the average deductible and you pair that with what the average savings rate is, we have a mismatch from a risk standpoint for the consumer. So to fill that, you know, gap, if you will, it's been let's offer, you know, critical illness, which is the the the big three majors are stroke heart attack and cancer, which, you know, everybody has basic life insurance at a company, but not everybody has critical illness, but you have way more likelihood of having a critical illness event than passing away while you're on the job. So there's been growth there, hospital indemnity, if you're admitted to the hospital, pretty much gonna hit the deductible. Know, we were talking to a health insurer the other day, and they said, we've we've gone through our studies. And if you get admitted, so if you spend one night in the hospital, you're gonna you're gonna pretty much hate your deductible. So that's a big exposure for, for people, you know, that can't necessarily avoid avoid the deductible. And then accident is, you know, really popular with, families with young children, or young people that more active in, you know, a lot of, extracurricular activities and stuff happens. Didn't happen as much during COVID. So claims went down, but normally it's pretty active. So does that help? Did I did I? No. That that helps a lot. I mean, it it it's interesting, that that I actually I'd never really thought about that the on the accident side, that that would, you know, decrease in the middle of a pandemic makes complete sense. People are sort of a little bit more contained in their environment. So kind of help help the listeners kind of humanize this a little bit. I mean, so we when we when you, you know, at at the end of your, you know, election on your plan, I mean, maybe maybe you have the ability to volunteer into a critical illness or a hospital indemnity. I don't know that a lot of folks know what that is. I mean, you know, I mean, you know, I think if I hold all my colleagues, you know, I don't know. Maybe half of them would say, yeah, I checked the box or, you know, maybe, you know, maybe they didn't. And So can can you just kinda help help lead, you know, what, you know, you did a wonderful job explaining those, you know, what they cover. When it's a voluntary benefit, you know, what what happens on a human level when when that gets just skipped over and glossed over? Yeah. Well, I I'm gonna I'm gonna circle back because I didn't answer the second part to your question about why these hadn't been done in a cap it before, but you just touched on one of the reasons. And that is they're voluntarily enrolled. Right? So and and At most employers, the voluntary coverage enrollment will be, you know, twenty, thirty percent So one in five, one in three, employees will take the coverage, and the majority are still fully exposed. And to give you to kinda humanize this to your point. Six months ago, we were working with a a a journalist, a business writer who had a side hustle, doing content development. And so we were writing some blogs, and as he was getting to know us and we were explaining what we do, he started openly crying, physically crying on the call. And, you know, my team was paused and said, look, have we offended you somehow? And he said, no, I he he said, During open enrollment, I ignored this. I did not elect coverages, and I just got diagnosed with stage four cancer. I'm a journalist. I don't make a lot of money. We are, extremely stressed out. My wife and I and I wish I would have understood what a critical illness policy could have done for me, because we're, you know, we're in a world of hurt and and unfortunately, four months later, he passed away. And so I always feel like, you know, I it's not to sell somebody something. It's to have them understand what it's meant to match up with. And then on the employer side, who's wearing the fiduciary hat, how do you make sure that the the maximum amount of claims for the premiums being paid or being delivered. So the transparency is a big theme. Right? And this is the second reason that they hadn't really been looked at from a captive perspective before. People weren't aware to you you said it earlier. The CFO, this doesn't hit their line item. It's payroll deducted from the employees. Out of sight out of mind, not a lot of attention paid to it. Well, now it's such an important strategic component of what the overall delivery of the of the health insurance is that people are really starting to look at it. So one of the hurdles to doing this has been because it is voluntarily paid or payroll deducted, employers would have an inherent conflict of interest by writing this in their own captive assurance company. You know, it's a it would be a prohibited transaction from a department of labor standpoint or an erisa standpoint you cannot earn a dividend or take back, money from your own employees because you have a Not that employers would do it, but the feeling is if the potential is there to keep claims low and then I get a bigger dividend, that's a problem. And employers don't want to be situated that way. So the way we solve for that is to put a hundred plus employers with a million employees all in one giant mixing bowl, and nobody has an incentive to keep the claims low. They all wanna get the best value prop position and have a clear sight line into how the financials are running, for the employees. So that's that's kind of the the genesis of there was more attention paid to it. We were able to create a program that there was there was nowhere to hide. You know, commissions are outlaid. The carrier expenses outlay, the cost of running the captive is outlay, larger claims fund. And if the claims don't get paid, it goes back as a plan asset to be reinvested further for the benefit of the employees. So it, it took us a while to, to get there and to market to become more attuned to both the importance of it and the opportunity to, have a better, have a better model. So Well, boy, that I mean, it's what Benerys says, re really done a huge value alignment, you know, to make sure that everyone's interest are co aligned, you know, and, you know, to your point, that transparency, you know, in terms of just sort of opening up this conversation writ large for the American workforce. What what what are the competing insurances? You, you know, the sort of, I guess, the dental vision, those sorts of things that that are that are im embedded on the health plan, and is what what's the overall what are the conversations you're having with HR executives and and and just overall benefit administrators as as they look at sort of their plan design, and what is the sort of bringing the supplement? These critical illness and hospital indemnities more into the sort of employer funded side. What what what sort of conversations are you having around, you know, the give and take there? So I'll give you, I guess a few things to think about there, Charles. The first is a lot of times we're brought in to employers that don't offer these coverages today. We had a Fortune five hundred C CFO say I I I say, well, let's start with why you don't offer him today. And the CEO said, they're rip off. In his words, not mine, I said, okay, that's a good starting point. So the lack of transparency in the in the perceived perceived in real, low claims ratios are an issue. Here's how we've solved for that. Okay. You have my attention now. I'm gonna see how the numbers work and I think that there is a need for it and they were surprised by the uptake. So the first step is is it offered or not? And then to your point on, I I wouldn't call them competing. Well, in a way, they're sort of competing for a finite number of dollars that an employee is willing put towards their benefits package. And the the way that we, enroll benefits today is not strategic. It is in the chronological order that these coverages were created. Right? First, there was medical, and then they were like, well, maybe maybe we could do the same thing for dental. No disrespect to dental, the limits are really low. You're prepaying for your cleanings, and everybody maxes out a thousand dollars. That's not exactly, you know, catastrophic, it's it's a sort of a financing of your trip to the dentist, and we usually enroll vision third and vision is a disc account program masquerading as insurance. You know, it's, it's it's not true insurance. And so what we try and do from an educational standpoint is say, look, here's your medical, and I think you know, and even in the C suite where you go, yeah, our average deductible is fifteen hundred dollars. Know, so we we have a good health insurance program. That is true for the top half of the pyramid. For the bottom half of the pyramid, from a payroll standpoint, a trip to the hospital, I'm starting the spiral, right? Cause I didn't have fifteen hundred dollars or or you know, without a pot with coinsurance, you know, it could be five thousand dollars. That was not in my family budget. And so now I'm headed to the payday loan center or putting it on my credit cards that are already, you know, running pretty high. So let's put that second because the employees are are looking at, you know, psychologically, this is order of importance, not chronological order of invention. Let's put them second. And the minute you do that, adoption goes up And then I was gonna ask if there was touch aerial difference in adoption. So is it I mean, is is that different significant? I mean, is it, like, the difference between, like, ten and thirty or, you know, is it Yeah. That's a pretty that's a pretty good guess. You know, twenty to forty, sometimes twenty to thirty. It just depends on how good the technology is and is there a decision support mechanism in the system? If there is, it goes up, you know, even more. But the other trend, and and I think you mentioned it, is a lot more employer funding of these items. Because as I mentioned, everybody has basic life. And if you look at, in a given year with a big population, not that many people are like, gosh, you know, thank you employer, you know, my spouse was covered. But in any given year, there's a heck of a lot of trips to the hospital and diagnoses and and, you know, trips for stents in emergency bypass and all, you know, all the things that during our work lives are gonna happen So there's a trend, especially in a high deductible, plan, an HSA compatible plan. Big trend in in employer funding of one or two of those lines of coverage. And, you know, I I the the thing that I like about that is you cover a hundred percent of the employees. It is a very meaningful, you know, if if the employee is diagnosed with cancer and a check is sent to the home for ten thousand dollars to support the family during a time of, you know, already a lot of stress and nerves and everything else about how this story is gonna gonna end major kudos to the employer for covering a hundred percent of those. It's not that Russian roulette of. Gosh, I hope it was one in one of the one in five people that signed up and did it voluntarily. So I just see, you know, I see an opportunity for employers to to stand out from, at some level, funding it. So So I I'm curious. When when you shift from a voluntary benefit into an employer funded model, did do do the claims is there a material reduction in claims? Or or or is it pretty consistent? Well, So, there there's two ways to answer that question. I mean, obviously, the claims, go up pretty dramatically because you're four fold, five fold, increasing the number of covered people, but you're you're indirectly touching on one of the reasons claims have traditionally run low here. And I I call it the wind at the back of the industry, where the employee has something happen and they just completely forget that they have this coverage. Or, you know, I I I I've gone to Best Buy and had a mail in rebate and promptly thrown the bag away and not, you know, because I'm bad at paperwork. I haven't followed through on it. That happens all day every day because these aren't, auto adjudicated typically. There are there is a trend to do medical claims integration. So if x happens on the health care side, reminder is sent to the employee and, help in that scenario. So communication and reminding employees that they have a valuable benefit is, you know, is is certainly a best practice. But what the captive does is says, okay. If the employee forgets that they have the coverage and they didn't file the claim because claims usually run lower than what is predicted as a general industry or, in this part of the industry, It's at least gonna go back for reinvestment, as a plan asset. And short of being able to match up the the dividend with the exact employee that was payroll deducted, which with turnover, and it's a de minimis amount. And we like it when employers say, well, that's what we wanna do because know we've found our people. You know, they're trying to do absolutely the most and the best they can do for for the, employee, but administratively, it would be, a kind of a fool's errand to try and do that. When that dividend is returned as a plan asset, how how are companies typically using those resources today? Or is there particular trend there or or is it just all over the board? I would say all over the board. The big the big categories would be technology. So upgrading, Ben Admin, we had an employer that the added decision support and participation and enrollment and decision making and migrating to plan designs that they were hoping to have, higher, migration to was successful. Wellness, including, you know, financial wellness is is certainly you know, we're we've been talking about the financing of illness, and we don't talk enough about the avoidance of illness through, you know, stress reduction from a financial standpoint or or a health standpoint, We had a we had a a a very large employer during COVID that had never had an EAP program. And their decision was pretty simple. Look, we've looked at the participation rates in, in the EAP program, and it's two to three percent utilization, until COVID happened and everybody was under, you know, duress and had nowhere to call, they used the dividend to fund, an EAP program and still fund that today from an ongoing standpoint. So, anything that is an allowable expense under, Arissa as a plan asset, is, you know, and and I always say it's a fungible dollar. So where where is your pain the greatest? And I'm I'm still yet to meet a human resources group that says, no, we're we're really over resourced. We we we have too much money. You know, everyone says I've got a laundry list of things I'd like to roll out. And, I can't, you know, it's it's a little bit like wellness where you can't prove a negative So, you know, we we know it's the right thing to do, but how do you show an ROI? And sometimes that's a bit tricky. So Yeah. Every every HR executive I've ever talked to is like, yeah, I'm in human resources. I'm still trying to find the resources because it doesn't Yeah. Forever. Yeah. Well Let's just say, it's not an overfunded category. Yeah. The irony to that is they're they're looking for the resources, and then in the same sentence, you query, and they say our number one asset, our most important asset is our people. That's right. And, Yeah. The great irony. Right? And I I I really I I really appreciate you connecting, financial precarity and and and these insurances as well and just overall stress reduction. Can can can you talk about your your experience and insights in terms of being appropriately insured, you know, with things like, you know, critical illness, hospital indemnity and making sure that you have plan design that really, you know, if you do have a catastrophic event, you know, you're gonna be covered. You know, you're gonna have some, you know, a safety net as it were. Talk to me a little bit about the connection between financial precarity and reduction of stress and having the appropriate plan designed. Well, it the the good news is during open enrollment, there are a lot of choices like the emergence of, you know, pet insurance, and, you know, we we just started a pool for legal insurance, and we didn't know that much about it, but There's care navigation companies like Concierge Services to help you navigate health care. Well, in the legal insurance front, it's kind of a legal navigation insurance and service for that. So there's just a plethora of things out there But how does the employee in their individual situation figure out, look, I, again, I have a finite number of dollars. I get enrollment fatigue where Alright. I'm on the fifteenth thing that I could buy. What should I get? And that's where I think, you know, education and communication become so important because You know, we should all, to the extent possible, save in into our HSA account, you know, it's triple benefited. I think everyone, you know, let let's start at age thirty, thirty five. Should have a critical illness policy. You know, we all want disability and we all want life. But, again, the likelihood of something happening for, for, demographics or census when we get a file from an employer where they have a lot of young looking for the company. Hospital indemnity is wildly popular because you when you're admitted to the hospital, it could be a bad reason like being in a car accident, or it could be a totally joyous reason, like having a baby, and you're gonna have that, you know, admittance thousand dollars, fifteen hundred dollars, and then a per diem, which usually they have you in and out pretty quickly, but for a small premium to share that among everybody is is a good thing. So the there's no, like, simple answer to that. I think it's, you know, having each employee have as much information tailored to what their situation is both in terms of the resources they have and and, you know, the life stage that they're in, if you will. And and and frankly their health situation. I I think, you know, and and I sometimes if you like a broker record here, but I I think there's such an opportunity to use data and take a very outcomes based approach here to tell just such a different story. That, you know, to really empower HR executives and and benefit executives to tell a different story up to the C suites in particular the CFO. You know, around the impact of, you know, if if you reduce financial stress, there's an overall halo effect. Associated with that. I mean, and, you know, and you're actually Yeah. And especially in the self funded space. I mean, you know, and and I I think there's a real opportunity You have actually have a really unique background because it may come from finance and then you, entered in, you know, into the insurance space and you know Japanese. I mean, this is these are these are these are these these are a this these are a host of skill sets. And so what what do you see as a a either your own personal interest or even beneries or broll in terms of helping illuminate through a database, a a data driven, lens, a new story up into the c suite. Around sort of plan design, the reduction of financial stress, its impact in terms of just overall, not only health outcomes, but business So, yeah, I'm just curious. You said around thinking about that or or you're really just so busy trying to kind of re shift how the the mental model around how how these particular benefits are are utilized? Well, first, Charles. I've just exhausted my fluency, in in Japanese. So let's start there. I I think you I think you bring up an important topic, and it's it's really funny that you bring this this question up. An hour ago, I was on a call with a head of, benefits for a Fortune five hundred company. And so we were going through kind of strategic planning, scratch pad and I showed her the way that we look at the world in terms of if you're gonna go to finance and say, I need something, Let's at least have some assumptions on what is the cost outlay, what is the human capital component of that, and then what do I think the financial impact can be. Basically, a pro form a statement for when I'm asking for dollars. And when you do that, you immediately garner, like, it it's taken more seriously. And we we have a little tool that will do the payback period, the net present value, and the, internal rate of return on any investment that HR is asking for. And, you know, it's direct it's a directionally correct answer. The the company then can turn their financial analyst loose on it and and dial that in, they're gonna get to the same directionally correct answer. We can argue about the assumptions. But at least we're having a business argument now, not just, hey, I went to a conference and I saw this cool new PEPM thing and I I want it because I think the employees would like it. It's, you know, and and we see this, and this is where you have to start sort of construct the argument with finance, do we have a turnover problem? Yes, we do. Okay. Have you guys ever quantified the turnover problem? Yeah. We we have bigger than a bread box smaller than a refrigerator. Okay. Well, let's let's pick a dollar amount Let's talk about how we can impact turnover. Do we have a presenteeism problem? Do we have an absenteeism problem? And a lot of times, those are things related to health issues going on or, money problems. Right? And and the whole person comes to work, And, you know, don't quote me on this, but I think one of the biggest divorce drivers is, issues with, you know, household budgets and Absolutely. So Almost forty percent of all turnover can be associated, the financial stress. I you know, we you you I I think this this the line of inquiry, the line of focus is a hundred percent consistent with what I see. And I I mean, I I'm wondering, I mean, is the the opportunity just to do something as simple as, for for those folks who have critical illness and hospital indemnity insurance. What what is their likelihood for turnover within a twelve to twenty four month period as opposed to, you know, a control group of those who don't have it, you know, you know, and Yeah. Yeah. And I I I'm literally we get that specific. You, you know, it you know, it's that kind of real direct storytelling that I'm trying to, you know, think through a whole host of layers to do on our side at Finfit, you know, and and and, you know, certainly you know, look look at partners like Benery to kinda help help us tell that sort of, I think, very rich landscape of of financial resiliency for the American worker. And there's a whole host of pieces in here that I think can be really interesting on that on that on that painting, that landscape. What what what do you think of it? Is that a little too granular or meaningful? I think it's hard to from a granular standpoint, it's hard to point to any one thing. But the the overarching thing that I see is, we're all doing a pretty good job of explaining the what Right? We're not doing a great job of explaining the why. Like, why am I putting this front of you or why do I think, you know, and we were talking about the why with, from HR to finance for why we need the next thing, and and not just my opinion, but here's the math. Like, that's a a more powerful argument to make. But the why do the employees of, you know, why did you come here and why are you staying here and why do we have the benefits package that we have? And why are we, you know, rolling out this new initiative and why does wellness matter and why do we need to biometrically screen you? Like, it's not to be invasive. Or trying to, you know, potentially save your life kind of a thing. So I would just say, you know, if you queried a hundred employers, they would say, yes. Our benefits program is absolutely part of our recruitment and retention strategy. Indirectly, it sort of becomes part of their brand and part of that, you know, best places to to work in America, path that a lot of companies are on. But, you know, the the companies that are that are maximizing the perceived value out of those dollars invested are explaining the why. Right. That's a terrific point. And I, you know, I I think there's so much sort of, glossed over sort of you know, I just need to sort of lip service to, you know, I think wellness. I mean, but what what what I really love about you know, beginning to sort of take critical illness and hospital indemnity and have it be a a core part of the plan that's employer funded. Is you're you're smoothing out in it. I mean, inside of a population, I don't know what exact numbers are. You let me know. And say, if in an employer funded model, I What percentage of that population are gonna be doing claims every year? I guess let's start there. Yeah. We we don't quote me on the numbers, but for hospital, hospital admittances and then major catastrophic items, You know, you're talking about more the severity and less of the frequency, but I wanna that's a risk pool is. You know, I put in a small amount of money to potentially get a big amount of money if the unexpected or, you know, the the the the catastrophe happens. You know, we we all we all have, insurance on our homes and very few of our homes burned down in any given year. But if it does burn down, I sure as heck want insurance for, you know, every my house and everything that's in it. So, the frequency isn't as as high, but we know for a fact that in any given population, there's gonna be trip the hospital, it shows up in all the claims data. And there's gonna be some, you know, it might be mel you know, melanoma and not serious, or it might be stage four, like I described before, I want a hundred percent of the employees to have a safety net for that. Yes. And, you know, they're all doing the best that they can to to save and to be responsible. And, protecting that is, something that we're trying to do it voluntarily in the, you know, if we had eighty percent participation, I'd say, the final twenty percent are, you know, they they kind of are getting they're getting not what they deserve, but they're they're the minority. The reality is the minority are are signing up for it. And yet, you know, I I hate to think that eighty percent of the people that have a catastrophic event could have had a financial protection. So the question for the employer is how do you're spreading those dollars around and would you get a lot of mileage, especially when only two to three percent of employers are truly funding that on an employer paid basis today. It's growing, but it's still a real chance for people to stand out And and the other thing that's kinda cool about that, Charles, is it it's sort of like a fifty percent off sale if you do it employer funded. And How so? That that's interesting. Well, when let's start with the pricing. Is that how it works? I mean, is it? Well, let's start with the pricing of the program from the carrier side. There's immediately a reduction of the uncertainty around who will sign up. If I'm only getting one in five or one in four people to sign up, are they gonna be the frequent fliers of the people that are most at risk? So I add a risk premium to that. Whereas if I if I know I'm having enrollment of the full population, the risk premium goes away, and I get a twenty percent reduction off the price immediately. If I'm if I'm doing it in a in a captive environment where I know I'm funding it as the employer, I've already gotten a twenty percent reduction. I'm gonna get a a dividend back on the claims So once I do that, I don't really need to move that program so I can go net of commissions, and commissions in this space can be twenty to seventy percent. Seventy percent. As far as seventy. Yep. In in first year. And then with every with turnover, it's the, you know, the seventy percent that keeps on giving, unfortunately. But I can go net on that. Right? And because I don't need to move it, I don't really need to broker it So, on an employer paid basis, I can go net. So I get a twenty percent discount, and then let's take twenty percent there and then at the end of the year after the claims are paid, that cushion, you know, of the claims fund further goes back, and Historically, our our dividend has been about twenty percent, but we're underwriting to ten. So once we rightsize that, that's ten percent. So twenty for for less risk, twenty for what commissions are, and ten for the dividend, and you get to a half off sale. And so for the employer to offer it to all employees, the employees don't know that it's a half off sale for the employer, it's a really good value play. Right. See, that's a bait. I mean, the in these moments, I I sort of wanna take you know, I see, let's say, you know, we we have a see, of a thousand person company. And and I wanna ask her to do, you know, contemplating a, you know, making this a hundred percent employer funded insurance And, you know, looking at a number, let's just say the claims on that population, like, ten percent. You you know, somewhere around that. And and say, well, you know, it's not that high. You you know, maybe just leave leave this on the sideline a little bit as a supplement. I'll, you know, volunteer into it. I I would ask that CEO to literally get a hundred random employees and bring them out to dinner. Yeah. And then make the decision after dinner. Yeah. Yeah. And and I and for whatever reason, I mean, I think, especially when we deal with these large population numbers, we throw around, well, five percent is not that much for ten. That's not that bad. You know? Fifteen. It is so easy to sort of delaminate from the human experience for some reason. You know, I and And this to me just feels like one of the real low hanging fruit, for the American workforce to build resiliency because what you're doing is you're really, removing that sort of, that really dramatic hit on the expense line that's it can be almost impossible to come back from from a family standpoint. You know, it and it's just exacerbating. I'll support what you're saying, in a different way, and and apologies for geeking out on all the insurance stuff. But for that same, for that for that for that same CEO, which they're gonna be self insured for their medical. The question is, do you buy medical stop loss insurance for catastrophic claims? And the answer one hundred percent of the time, unless you're, you know, Walmart size, there's handful that maybe go completely without, but in the the vast majority, being like ninety nine percent of self insured companies, the answer is, yes, we buy medical stop loss in insurance. Alright. Why wouldn't we offer a catastrophic medical stop loss insurance for the family because a ten thousand dollar out of pocket maximum is the equivalent of you buying, you know, a million dollar coverage for your company. And I you wanna hug at the Christmas party? You know, have have the person that had a diagnosis for something come up and say, you can't tell you the amount of stress that you have saved my family by, covering that for us. You know, it's, it's, it's meaningful and and love your example of a hundred people. It makes it more more human, but, and then we know you know what makes it human for me, and I think what I'm taking out of this entire I really want I love that phrase. I'm gonna hold on to that phrase that, you know, how are we building a medical stop loss for the family? And Yep. You know, because that's I think that's language that a CFO can understand as language, you know, chief human resources officer can understand. And and and it also it pulls it into almost this be should become a part of the conversation for the as, you know, through the fiduciary lens, honestly, you know, and and I'm so speaking of that, I mean, What sort of steps do we need to take in terms of, you know, you know, absent regulation? You, you know, of of sort of creating this sort of medical stop loss for the family, which I love that. And and, you know, just ensuring that we continue what seems to be a really a trend in this regard? Well, again, if you have empirical evidence or tangible evidence of the why, it helps. And you and I have had, you know, many discussions. You're more of an expert on this than I am, but the percentage of bankruptcies for for Americans that have a medical imprint on them is the majority not always, not always the sole driver, but very, very often, a major contributing factor, if not the the sole reason for bankruptcy. The thing is eighty percent of that time, these people have insurance. Like, they're not these aren't iris, you know, irresponsible is probably not the right word, but, uninsured, you know, people that just said, you know, I'm bulletproof. I'm not gonna sign up for any insurance. Again, regulation aside. They have insurance, and they're still declaring bankruptcy. So let's let's use the math, and how do you personalize that? I'm not sure, but the the statistics nationally don't lie that we need medical stop loss for the families in these catastrophic situations. And the the one thing we haven't mentioned, because we're using sort of the the the big, sudden fortuity of having a medical event like a heart attack Let's not forget about the the runaway cost of specialty drugs and the massive pipeline of all the therapies that coming out and everything else. Like, we could be a MIT math professor and not be able to solve some of these situations that that we're in and that are not getting any better. And, you know, the federal government's trying to do a little bit, with the drug issues, but My fear when I see that is we already have a cost shift coming to the private sector for employer funded. If they squeeze this into the balloon and say, look, we're not gonna pay exorbitant prices versus the rest of the world anymore as the federal government guess what happens on the other end of the balloon. Right. Right. And the other end of the balloon is the employer funded share of the market, which is, you know, it's already running health care is already running higher than general inflation, and pharmacy is running higher than health care inflation. And when you squeeze that into the balloon, on the on the Medicare Medicaid side of things, gas on the fire. It's unsustainable. It's unsustainable. I I I think you perfectly frame the the problem set, though. And this is something I think is worth continuously repeating, which is, you know, a eighty percent of of those folks who have gone through bankruptcy because of medical debt and insurance. Yep. And and and that that to me is if that doesn't inspire the industry to sort of get a blank piece of paper, and reapproach plan to sign. I don't know what will. I mean, because I mean, that that just says it's not working on some level. Well, it's it's not the employer's fault, though, because, you know, they the outlet valve, you know, short of just not having an insurance program is we're trying to make the math work and, you know, plan designs have suffered because of it. And I think we need a bunch of creative release valves. I mean, you know, I I don't know the answers are, but I mean, certainly calls for a part two of this discussion in the future. You know, where where, you know, we get together and solve all the all the world's problems. And, you know, we we we could It'd be awesome if we could tackle the demand side of it as well. Like, let's let's get in the, staying out of the federal business. How do we Exactly. Place in the hospital business. So Exactly. So so in our next conversation, I'll I'll find that an MIT mathematician to join us and see see if we can, you know, make some headway. But, I'm I'm a high school algebra guy. Yeah. Let me tell you. Yeah. I I I I still use my own seven dollar calculator I got from Staples. If he gets much past that, I'm in trouble, you know. And so you're you're you're you're indicating your age, Charles, because our kids are just using their phones for everything. Right? So they the fact that you have a calculator let let let me tell you. Far before my calculator, story, my age was indicated. That makes two of us. Tell you, Lamar, every time we have an opportunity to sit down, I I learned so much you bring so much insight into this space. You know, I mean, you you really have a a really keen perspective on, you know, not necessarily how to solve everything, but you're really focused on a couple of core areas, you, you know, and and and innovating with inside of your company, Benery. I just think things that are one, just make so much financial sense on the employer side, with your captive model. And the dividend that goes back to support just your employees at an ongoing basis. But really, I mean, how do you smooth out those catastrophic events for the American work And and and I really do believe that the work that you're doing is can you can absolutely possibly contribute to the financial resiliency of all American workers. And and just just on behalf of everybody, thank you for the work that you're doing in that regard. And and just also thank you for the time today. And I I sincerely appreciate that time, but I also appreciate your insights. And it's always great to chat. Thanks, Charles, for the kind words. And, likewise, it's the the feeling of the energy I get when we, interact, or interact is, certainly mutual. So I appreciate the invitation. Absolutely. We'll see you soon. I'll have you back. Alright. See you soon. Thanks.

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About the Experts

SA
Software And Technology

Host, Secure presented by FinFit

Charles Lattimer hosts 'Secure' presented by FinFit, exploring topics related to employer-sponsored health benefits. His discussions focus on innovative solutions within the benefits space.

LT
Lamont Thurston

Co-Founder

BENERē

Lamont Thurston, an economics major with an MBA in Finance, has established himself in the insurance industry, with a focus on benefits and property and casualty. He is a pioneer in the captive insurance industry.