CLEARly Beneficial Podcast · 2026-06-30 · 15 min
Key moments - from our scoring
Substance score
32 / 100
Five dimensions, 20 points each
As benefits renewal season arrives in late June, HR leaders and CFOs face mounting pressure to balance rate increases with employee wellness - a tension the speaker frames as a perennial conflict between Mars (CFO) and Venus (CHRO). This episode targets mid-market employers (500 - 5,000 employees) who often defer benefits decisions to brokers, offering three foundational moves before locking in 2025 coverage. First, executives should assess broker objectivity by shifting from commission-based compensation (where brokers profit from rate increases) to transparent flat-fee arrangements, using the Schedule A forms filed on Form 5500 as a starting point. Second, employers need visibility into claims data - understanding utilization patterns, frequent flyers, ER usage, and pharmaceutical trends - achievable by moving toward self-insured or level-funded plans rather than staying fully insured. Third, executives must recognize that point solutions (wellness portals, EAPs, disease management tools) often go unused without mandated employee education tied to performance reviews, wasting significant investment. The speaker leverages personal experience (including a case where he voluntarily reduced his own firm's commissions) to argue that honest conversations about what benefits truly cost employees - $10,000 - $12,000 annually per person - should drive strategic decisions rather than reactive cost-shifting.
For groups under 100 lives, commissions on health insurance are set by carriers and non-negotiable, but for all other lines (dental, vision, life) and for large group health plans (100+ employees), commissions are fully negotiable. When rates increase, brokers automatically receive higher commissions without reduction - a dynamic that should trigger a conversation about moving to flat-fee models instead.
The Form 5500 is filed annually for groups over 100 lives and must disclose broker commissions via Schedule A documents from each insurance carrier. Many brokers handle the filing on behalf of the employer using electronic signature, meaning executives often sign without reviewing the actual commission amounts being paid.
Self-insured and level-funded plans provide access to detailed claims data, allowing employers to see utilization trends, identify high-cost employees, understand prescribed medications, and measure ER overuse. Fully insured plans obscure this data, making it harder to implement targeted cost-reduction strategies and understand what's driving healthcare spend.
Increases of 5% or less are viewed favorably; 5 - 10% is absorbed reluctantly; but at 15% or higher, employers typically go into a 'tailspin' and become aggressive about shifting costs to employees through higher deductibles and contribution increases.
Most employees are unaware these tools exist. Without mandatory, communicated education - ideally tied to performance reviews - utilization remains extremely low (historically 2%, though COVID temporarily boosted EAP usage to 25%), making these tools ineffective despite significant investment.
Our reviewer’s read on each dimension, with quotes from the episode.
The episode surfaces a handful of genuinely useful practitioner tips - broker commission-to-flat-fee conversion, self-funded/level-funded plans for claims data visibility, and skepticism toward low-utilization point solutions - but the signal is diluted by lengthy analogies, rhetorical throat-clearing, and generic exhortations to 'have honest conversations.' A 15-minute episode yields maybe 5 minutes of extractable insight.
if it's a commission-based arrangement, every one of those lines of coverage...all those commissions are negotiable
utilization went from 2% of the employee population to 25% of the employee population, but now they're back down
The broker-compensation transparency angle has a small edge - especially the host's candid admission of self-reporting overpayment - but the framing (CFOs from Mars/CHROs from Venus, pressing the 'easy button,' clean-piece-of-paper renewal) is clichéd, and the three main recommendations are standard benefits-consulting orthodoxy recycled at a surface level.
I always joke that uh CFOs are from Mars and C HROs are from Venus, and it's very true
I knew we were being paid um way more than we probably deserve to be paid for the work we were doing
This is a solo host monologue with no guest whatsoever; the host is a benefits consultant at his own boutique firm (Clear Healthcare Solutions), and while he has apparent practitioner experience, there is no external expertise, seniority, or cross-functional credibility brought to the episode.
at our company, Clear Healthcare Solutions, uh, what we do aside from produce this podcast and bring great guests to the table, of which guest I have coming up in a few weeks is one of the powerhouses in health insurance in the United States
The episode includes some concrete figures - group-size thresholds (100-life Form 5500 trigger, 500 - 5,000 mid-market definition), per-employee premium costs ($10K - $12K), and EAP utilization stats (2% → 25% during COVID) - but named companies, actual dollar amounts from the commission anecdote, and sourced data are all absent, keeping specificity in the middling range.
utilization went from 2% of the employee population to 25% of the employee population, but now they're back down
you're now spending between $10,000 to $12,000 per year for one employee to be insured
There is no interview and no guest; the episode is an uninterrupted solo monologue, so there are no host questions, follow-ups, or productive challenges possible. The rhetorical questions posed to the audience function as transitions rather than intellectual probes, and the segment ends with a promotional pitch for Clear Healthcare Solutions.
So as you enter into this renewal season, I think that's one of the main things to focus on.
Computed from the transcript - who did the talking, and the words that came up most.
Benefits Decision Season is officially here! And if your broker is bringing you a renewal right now, the real question is: are you ready to make an informed decision, or are you about to press the easy button again? In this Hot Health Take, Vincent Catalano cuts straight to what HR leaders and CFOs need to do before they agree to anything this season. Three moves, in order. No fluff. First: assess your broker's compensation. If you are on a commission model, you may be handing your broker a raise every single year without realizing it. Vincent explains why moving to a flat fee structure is the most important thing you can do before any renewal conversation goes further. Second: know what is happening under the hood of your own plan. Most mid-market employers are flying blind. Are your employees using the ER when they do not need to? What drugs are being prescribed? Where are the costs actually coming from? If you cannot answer those questions, your renewal decisions are guesses. Third: audit your point solutions. Chances are you are paying for tools your employees have never heard of.
Transcribed and scored by The B2B Podcast Index.
1 - > SPEAKER_00: Welcome to the Clearly Beneficial Podcast, the 2 - > show where we rip off the band-aid and explore the future 3 - > of healthcare, benefits, and the people driving innovation in the 4 - > industry. 5 - > SPEAKER_01: Hey everybody, welcome to this episode of the 6 - > Clearly Beneficial Podcast. 7 - > It's uh the end of June, and uh smell that? 8 - > Uh that means it is benefits decision-making season.
9 - > And the larger the organization you are, the uh more in the 10 - > throes of uh looking at options and making decisions you are 11 - > right now. 12 - > Uh I always love that time of year uh where you engage with 13 - > clients, talk about uh what's going on, uh, bring the renewal, 14 - > and and sometimes have very hard conversations about what this 15 - > next year looks like. 16 - > Because here we are, June, end of June, you're starting to make 17 - > decisions. 18 - > Your broker might be bringing your renewal to you right now, 19 - > uh, if you're lucky.
20 - > And uh hence the that difficult decision-making period starts 21 - > where you're trying to balance the difficulties of rate 22 - > increases with the empathy you have for your employees. 23 - > And that's always the tough balance, right? 24 - > I I always joke that uh CFOs are from Mars and C HROs are from 25 - > Venus, and it's very true. 26 - > Um these are two people that think about their organizations 27 - > in in vastly different ways.
28 - > And unfortunately, in many cases, they don't share a common 29 - > language about dealing with employees. 30 - > And the larger organizations, when I say larger, I mean 5,000 31 - > to 10,000 or more employees, those folks, you know, they 32 - > generally are more sophisticated about their benefits 33 - > decision-making processes. 34 - > They're self-funded, they understand the risk, they know 35 - > how to mitigate it, uh, they understand cash flow. 36 - > Um, but when you start to get into the mid-market, which is 37 - > generally defined as that 500 to 5,000 size employee, uh 38 - > employer, um, you know, it's a it's not really as as 39 - > sophisticated a process as you want.
40 - > And in many cases, both the CFO and the HR team defer to the 41 - > broker to make decisions for them. 42 - > And um, and so here we are. 43 - > First, you know, let's not let's stop this process of, you know, 44 - > if if the increases are, you know, 5% or less, you're pop in 45 - > bottles and everybody wins. 46 - > Um, if there are five to ten percent, you're not happy, but 47 - > you've kind of budgeted for that, even though budgeting a 48 - > 10% renewal um is now, I think it's lunacy because you know, a 49 - > 10% increase on a thousand dollar a month premium is now a 50 - > hundred dollar increase for the next year.
51 - > So um that 10% ain't great. 52 - > And then you know, 15% is when everybody goes into a tailspin 53 - > and starts to look at what we should be changing uh this next 54 - > year, and they start getting aggressive and they're they 55 - > increase deductibles, they increase employee contributions 56 - > to health plans. 57 - > Um and uh usually it's the employee that ends up, you know, 58 - > taking the brunt of those type of decisions and hence the 59 - > push-pull between CFO and CHRO on those type of topics.
60 - > But the first thing I would have you do this year, um, before you 61 - > do anything else, is try to assess your broker's objectivity 62 - > and assess how they are paid. 63 - > Um if they're a group, you're a group over 100 lives, you're 64 - > filing a 5,500 form. 65 - > And that means that broker has to have their commissions 66 - > reported on that form. 67 - > Uh many times now the broker are the ones that are collating the 68 - > information and doing the filing on your behalf.
69 - > So you've probably, even though you've signed it or the CHRO or 70 - > CFO has signed it, you've never really understood that form. 71 - > And you get these schedule A's from the insurance carriers, 72 - > which would show how much commission has been paid to that 73 - > broker, and then that broker takes that Schedule A and the 74 - > other schedule A is from all the carriers that represent you for 75 - > all the lines of coverage, and then they send it to a 76 - > third-party service that collates it and does the filing 77 - > on your behalf, even though you do an electronic signature.
78 - > But guess what? 79 - > You've done an electronic skip signature, you haven't really 80 - > delved into that. 81 - > So the first thing I would have you do this year in this renewal 82 - > conversation is if you are on a commission-based model, have a 83 - > negotiation with your broker about moving it to a flat fee. 84 - > And there's a number of reasons for this.
85 - > First of all, the flat fee model is more sane. 86 - > It works to your benefit, um, not the broker's benefit. 87 - > Um, you also start to get an assessment of what that broker 88 - > is really doing for that money. 89 - > Are they just handling the day-to-day for you, which makes 90 - > you feel comfortable, so you'll pay them anything to do it?
91 - > Or do you have a set budget that you'd like to spend? 92 - > Because keep in mind, um, if it's a commission-based 93 - > arrangement, every one of those lines of coverage, unless you're 94 - > a small group under 100 in California or under 50 anywhere 95 - > else, um, if you're a small group, those commissions are 96 - > baked in. 97 - > You know, you can't change them for health insurance. 98 - > But for any other line of coverage, um, especially dental 99 - > vision, all those things, commissions are completely 100 - > negotiable.
101 - > And then when you're in a large group health arrangement, all 102 - > those commissions are negotiable. 103 - > So why pay commission at all? 104 - > Right? 105 - > Have the broker net out the commission from your rates, and 106 - > then you pay them a flat fee for the work they do for you.
107 - > And why is this beneficial to you as an employer? 108 - > Well, the key is that next year when you get a 5% increase, 10% 109 - > increase, that broker doesn't come back to you and say, hey, 110 - > you know, we're gonna lower our commissions commiserately with 111 - > that increase. 112 - > No, they get a 10% raise. 113 - > And so think about that.
114 - > That's something they probably never disclosed to you. 115 - > Nor have they really ever properly done a commission 116 - > review with you. 117 - > Um, you know, I remember a specific case with a client 118 - > where I knew we were being paid um way more than we probably 119 - > deserve to be paid for the work we were doing. 120 - > And it was a significant amount of money.
121 - > And it was a new VP of HR in the role, and um I you know 122 - > progressively went to them and I said, Hey, we're getting paid 123 - > too much. 124 - > And I have a number in my head, which I think is a fair number, 125 - > and he goes, I agree. 126 - > Um, I have a number in my head that's a fair number. 127 - > And I went first, he went second, and his number was 128 - > actually higher than my number.
129 - > And he said, Well, because you were honest and straightforward, 130 - > we'll go with my number. 131 - > So it was the right thing to do, and not only the right thing to 132 - > do for the client by netting out all the commissions and going 133 - > flat fee, it was also right just to do the right thing. 134 - > Now, did that affect me personally? 135 - > Absolutely.
136 - > It it tinged it dinged my bonus that year in the worst of ways 137 - > because of the way that was calculated with the brokerage I 138 - > was with. 139 - > But that said, you know, it still made me feel good that I 140 - > retained the client, they were happy with it with the outcome, 141 - > and it was a good decision. 142 - > So, you know, I I kind of view this notion of of commissions 143 - > almost like going um to a nice fine restaurant and they give 144 - > you a wine list that's you know that thick, and you don't know 145 - > anything about wine, you don't know what's on the list, you 146 - > don't want to appear to be a cheapskate to your date or 147 - > whoever.
148 - > But when I look at that at a wine list in a fancy restaurant, 149 - > the first thing I do is talk to the Somalier and I say, Hey, you 150 - > know, this is my budget, this is the kind of wine I like to 151 - > drink. 152 - > Um, can you propose some wines that meet my budget from the 153 - > region I want to drink wine from? 154 - > And it's an honest conversation and they appreciate it. 155 - > That is way better than you looking at that big binder and 156 - > going to some region of France in the book that you don't 157 - > understand the wine, and you picking a bottle of wine that 158 - > costs five times more than you want to spend.
159 - > Same thing goes for brokering. 160 - > Okay, have the honest conversation with your broker, 161 - > talk about what they're being paid, ask them to lay it all out 162 - > honestly and transparently, and then say, So, do you think 163 - > that's fair? 164 - > And let them justify what they're being paid. 165 - > And then no matter what you do, even if you choose to a number 166 - > which is maybe higher than you want, make sure it's on a fee 167 - > basis, not a commission basis.
168 - > So as you enter into this renewal season, I think that's 169 - > one of the main things to focus on. 170 - > The second thing to focus on, especially as it comes to health 171 - > and health care costs, is how do you know what's going on under 172 - > the hood of your own organization? 173 - > Right? 174 - > Do you see the data?
175 - > Do you understand what trends are happening? 176 - > Do you understand the drugs that are being prescribed to your 177 - > employees? 178 - > Do you understand who the frequent flyers are? 179 - > Do you understand, you know, where the the costs and who are 180 - > generating the costs mostly are people using the ER, you know, 181 - > um unacceptably low, you know, in a large amount?
182 - > You know, how is it that your people are using the tool you're 183 - > giving them? 184 - > And I think that is that is an important part of it, is getting 185 - > to the data. 186 - > And the best way to get to the data is by you know considering 187 - > a pivot from fully insured type contracts to self-insured or or 188 - > uh level-funded type contracts where you can see the data and 189 - > understand what's going on under the hood more effectively. 190 - > And then you can engage with any number of good point solutions 191 - > to help you rein in those trends and costs.
192 - > Um speaking of point solutions, so you know, the preponderance 193 - > of these things has been out in the marketplace. 194 - > So this would be number three. 195 - > The preponderance of point solutions that have been out in 196 - > the marketplace has been very high for the last, you know, 197 - > five to ten years. 198 - > Um, and I would say many of them have an absolutely nebulous ROI.
199 - > You know, is the money you're spending worth what you're gonna 200 - > get back? 201 - > Have they proven that they can save you money? 202 - > Have they proven they can improve the health of they can 203 - > they can improve the health of your employees? 204 - > And you know, I I think the answer is that a lot of them 205 - > really don't do that.
206 - > Or even worse, you've been sold two, three, four, five-point 207 - > solutions, you've been sold a portal, everything's on the 208 - > portal, blah, blah, blah. 209 - > You send your employees there. 210 - > Nobody ever uses these tools. 211 - > Don't even know they're there.
212 - > I mean, this is the same problem we've had with EAPs for many, 213 - > many years. 214 - > The EAP was a great tool, it's been around a long time. 215 - > The only time they came back in favor was during COVID, where 216 - > utilization went from 2% of the employee population to 25% of 217 - > the employee population, but now they're back down. 218 - > So, so unless people know those tools are there.
219 - > So that leads to the next potential thing you really start 220 - > to think about is employee communication. 221 - > Um, benefits, especially healthcare, especially to train 222 - > your employees how you want them to behave using your health 223 - > plan, is probably one of the most important things you could 224 - > do. 225 - > Education is key. 226 - > It should be mandated, it should be tied to a performance review, 227 - > it should be something that employees take seriously so they 228 - > understand how to use this very, very expensive tool that you're 229 - > giving them.
230 - > The typical employee now, especially if you're covering 231 - > 100% of the premium, you're now spending between$10,000 to 232 - > $12,000 per year for one employee to be insured. 233 - > Think about that. 234 - > Now you add their family, of which you're probably 235 - > contributing something to their family, and the employees also 236 - > contributing. 237 - > So the deep dive here is what are you doing to truly help 238 - > mitigate the costs of your plan?
239 - > Okay. 240 - > What are the things you are willing to, you know, to lean 241 - > into? 242 - > What are the changes you are willing to make? 243 - > What is your truly your emotional fortitude to make the 244 - > changes you need to do?
245 - > Because this is truly has morphed in the last couple of 246 - > years into a business decision. 247 - > It's a people decision, but it's a business decision. 248 - > And so, how do you make the best decisions possible? 249 - > So these are just a few things you should be thinking about as 250 - > you go into this, you know, interesting season of uh 251 - > renewal.
252 - > Um, and let's you know, think about that word for a second, 253 - > renewal. 254 - > What are we renewing? 255 - > Okay, we're taking a policy, we're taking a look at it. 256 - > And are we gonna take the same thing and just take the increase 257 - > and keep moving on, press the easy button?
258 - > Sure, that's one thing. 259 - > But let's think about that word renew. 260 - > Okay, we want to renew ourselves, we want to renew what 261 - > we're doing. 262 - > Sometimes it takes a clean piece of paper and some good 263 - > conversation and difficult conversation to take a look at 264 - > really what you're doing and why.
265 - > And what are the sacred cows that you have that you don't 266 - > want to change? 267 - > And so um, it's that time of year, folks. 268 - > I hope it works out for you. 269 - > Um at our company, Clear Healthcare Solutions, uh, what 270 - > we do aside from produce this podcast and bring great guests 271 - > to the table, of which guest I have coming up in a few weeks is 272 - > one of the powerhouses in health insurance in the United States.
273 - > So I'm not gonna name names right now, but um, this will be 274 - > one of one of the best episodes we've ever had. 275 - > Um, but at Clear Healthcare Solutions, aside from producing 276 - > the podcast, you know, we're here to have those conversations 277 - > with you, to um be strategic, to listen to you, to help you frame 278 - > what you want to do next for your employees and your 279 - > organization so you can make better decisions, save money in 280 - > the long run.
281 - > And I'm not, you know, we're not here to replace a brokerage 282 - > relationship. 283 - > We don't want to be a broker. 284 - > Okay, let's just say that out front. 285 - > But we want to make sure you've got the tools to keep your 286 - > broker in check, to keep your process in check, and to help 287 - > you build new processes that make sense to help you put your 288 - > company on the right strategic track for a long-term benefit 289 - > stability for you and your employees.
290 - > So thank you for participating in this conversation and 291 - > listening to this. 292 - > And uh, we'll see you next time. 293 - > Thank you. 294 - > This podcast reflects the personal views of the host and 295 - > guests, not their employers or sponsors.
296 - > See you next time.
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