HR and Health Plans

Speaker A: Hello and welcome to HR Nightmares. I'm Lisa Leath, the founder of Leith HR Group and chief people officer with Vantica, and I am here with two of my favorite people and one new favorite, uh, guy, uh, who's a guest. Seth Crawford. But you guys want to introduce yourselves.

Speaker B: Amy Conway and Beth Looney.

Speaker A: All right, we're going to get to Seth and let him introduce himself. But today, um, really happy to have you here because you're doing something special, um, beyond just your day job. And that's filling a gap, um, in a business community that you just identified and it has to do with HR people. So we want to talk about it. Um, and I had the pleasure of coming out to Raleigh and interacting with this new group that you've put together. So before we get into, um, this concept of an HR roundtable for senior HR leaders, um, why don't you just give us a little rundown on who you are.

Speaker C: Yep. So, Seth Crawford. Uh, I'm a benefits advisor in Raleigh for a company called Scott Insurance. And you want me to jump right into how we got to the HR roundtable.

Speaker A: Well, why don't you just talk a little bit about Scott Insurance and like what your day to day looks like.

Speaker C: Yeah. So Scott Insurance, we are a independently, uh, owned, uh, insurance firm. We do PNC benefits and bonds and we have 10 offices across the southeast, um, 100% employee owned, which is I think a cool part of it. Everybody from the front desk person to people like me to CEO all have a feeling of ownership in the company. And um, I feel like it's a great spot.

Speaker A: You know, uh, I loved hearing you talk about Scott. I didn't know anything about Scott Insurance until he reached out to me like a couple months ago or whatever. And I was surprised when I came to your office, which it was in a really nice spot. But like that you guys have several hundred team members.

Speaker C: Yeah, we got about 460 across all the offices.

Speaker A: Yeah, I mean it's good for us to know that there's somebody out there like this. Um, how'd you land in insurance? We joked about this as like, nobody goes to college for insurance, but all these like, all these brokerages and firms like Scott Insurance need people to get excited about insurance as a career.

Speaker C: Yeah. And so you very rarely will find like young, bright eyed, bushy tailed, excited young college graduates who want to go into insurance. And so we really don't hire many. I won't say never, but for the most part what we find are people who have been successful in A different sales environment, uh, who are looking for something different. And I think that most people, including myself, hear insurance. And it's like, you know, it's like sucks all the life out of you to hear just. Just the word itself. And so I had a friend who told me, um, when he heard that I was kind of looking to move on, that I should consider it. And I said, nah.

Speaker A: What kind of sales were you doing?

Speaker C: I was doing, uh, media and, uh, advertising, online advertising, sales before. So very different. Um, and in that role, the company was great. But eventually it got to a point where I felt like I was just selling something to sell it. And I wanted to really believe in what I was doing and feel like I was making a difference and helping people. Which is funny. Bringing us back to the insurance. So you wanted to help people, so you got into insurance?

Speaker A: Yeah.

Speaker C: Right.

Speaker B: Um, right, right.

Speaker C: But so what I found out is there is a lot of opportunity for, uh, companies, uh, on the benefit side to take care of their employees and cut costs. And if we can help somebody or an employer cut cost, typically that's going to trickle down to the employees in the form of either richer benefits or higher pay. Um, and what we also found out, there's just a lot of people that are kind of going through the motions. If they can just keep that renewal, showing up one time a year and getting a renewal check, why work harder? And we found a lot of opportunity that way.

Speaker A: Awesome. Well, that gets back to like, um, doing something that's a little bit more meaningful than just like hawking insurance. Um, so Seth reached out to me a couple of months ago. I got like a cold LinkedIn message. I'm sure you guys are the same. And you've got like hundreds of LinkedIn messages just piling up. And it's like, InMail, InMail, InMail. And everybody's just soliciting something and it's just like, oh my God, what do I open? Do I open them all just to get to zero? And, um, I opened his message. Cause I didn't know who he was and it didn't say InMail. And he threw me a compliment. So of course I was like, okay, yes, let's get sure. How can I get involved? But honestly, it was a compelling message. And he was describing, um, the Raleigh area, like business community, HR leaders, senior HR people from VPs and chief people officers that just did not have a cohort of folks to use as a peer group. And I feel super lucky. Since joining Vanica, I've got like the JMI Equity. So one of our private equity sponsors and Cove Hill Partners, like, they have Chro roundtables once a month. So I can jump on a zoom and like bounce things off of peers every single month, twice a month. But a lot of folks that work for. Some of the folks that showed up at this roundtable last week were from very large health care groups. Yeah. Um, and they don't have anybody.

Speaker B: They don't have internally and then they don't have the network externally.

Speaker A: Right. So describe like a little bit of the problem that you were seeing and then the solution that you proposed and pulled off last week.

Speaker C: Yeah, so obviously in my role, I work very closely with HR leaders and CFOs, and particularly the HR leaders seem to be. It's just like a lonely spot. A lot of times there are either by themselves or they're part of very small teams. And so they get given or they're, they're given very audacious tasks and goals. Uh, and oftentimes they don't have a playbook and they don't have other people to bounce their ideas off of. And not to jump ahead. But I think we found that during the roundtable that a lot of the people in the meeting were just loving the opportunity to hear what other HR leaders in different industries and companies were doing. Um, and so anyway, so I saw this need as I was talking to more people and said, I mean, I can get people together. I may not know what I'm talking about, but I've heard of HR Nightmares. I think Lisa knows what she's talking about. And so, yeah, I've said it before, but I kind of described myself as a little fan girl of the HR Nightmares podcast and reached out to Lisa as kind of like a shot in the dark. And she responded and came and it was an awesome experience.

Speaker A: Um, yeah, I would say it was really good. And when you throw a party, it's kind of like, will anyone show up? And we were like, I hope some people show up because like at Vanica, we're trying to get a foothold in the Raleigh market. So I want to meet as many people that I can put in my corner as absolutely possible to try to like, get access to talent and connect my own network out there. So I appreciated the opportunity. But, um, yeah, it was really good. It had me thinking about just like how HR Nightmares is a great avenue for people to listen and hear from us. But we would love a two way street and we love it when we get audience write ins because it's fun to Talk about your problems and you get free advice. Um, but I do think that this is probably an issue and a gap in a lot of communities. I know where, um, the majority of Leith HR Group consultants are. You guys, like in the Wilmington southeastern North Carolina area, it's either like SHRM or nothing. Like a lot of other bigger communities have disrupt HR or, um, you know, if you're in tech, it's. We've got the private equity.

Speaker D: Right.

Speaker B: Like certain industries specific. Yeah, I mean, I think about that too, just in the shift I made from coming from a large company where I had hundreds of HR peers and partners.

Speaker A: And you got together at least once a year, right? We did that at Cornell.

Speaker B: Yeah, we had a couple probably two or three times a year. We were all together in Seattle, like everybody. And then my team itself, just the regional directors, we got together another couple of times as well. And then we called a lot. And even then we didn't feel like we had enough time with our peers to kind of be bouncing. A lot of times it was just over some issue that we needed some advice on. But it never felt like it was about strategy and vision and some of the bigger change stuff. Right. And, uh, when you're in a big company like that, you don't really have a network outside. You're so busy with your network inside, you don't build it. So the minute you leave those companies. That's why networking is such a huge topic that we get approached with from different aspects around here to talk about. Because people that are in those big companies, their network is so internal. So to take that and have external and have some peers, other places that are doing things differently outside your organization or outside your industry, I imagine there's an appetite for that probably for every, you know, a CMO, a CEO. Ah, right. And we know CEOs have a little bit more of those opportunities.

Speaker D: Yeah, well, also, I mean, for the department of one folks, where I was a lot of my career, you really have no one to speak with. And I think that there's this competitiveness, like, oh, I don't want to really share that much about what's going on here because you might steal our talent or, you know, there's a lot of that. So I, I love this idea. And especially I think when you're maybe starting out there, I think there's a lot more opportunities for like maybe early career folks in, in our town, we

Speaker A: have a group, I think SHRM is mainly. And, and we talked about this, like, it's like this in Raleigh Too, which is a much bigger metro area than southeastern North Carolina. But like, a lot of the content and trainings and workshops are focused around sort of like some foundational basics.

Speaker D: Right.

Speaker A: Stuff.

Speaker D: Yeah, but it's great for an early career. Oh, it's uh. But for people that are later in their career, they need, uh, to have something. Yeah.

Speaker B: I feel like proactive topics, more around, you know, some of these big trends that are coming that we need to get ahead of. And it doesn't feel as much hat, uh, and probably because it's not maybe sectored off. Right. When you join an organization like that, you're with all different levels of experience and all different roles within hr. Not even everyone that belongs to SHRM is even an HR professional. Right. They carry that hat. But that's not their only job.

Speaker A: I know when I was a consultant, the beautiful part about having multiple clients was that you learned something from this CEO, something from that chro, that you were providing extra support to something from that cfo. And you could kind of take the best of everybody's styles and personalities and their cultures, and then you can use it and customize ways across different clients. So I think in a consultancy you almost get the benefit of a peer group without having a formal peer group. But when you're in. In an organization mid, mid size or larger, like, it's not, it's not easy. Yeah.

Speaker D: So how many people came?

Speaker C: So we had 10.

Speaker A: 4,000.

Speaker C: 4,000. We had 10 people, everybody.

Speaker B: That's great.

Speaker C: Being like the perfect size. And I think one thing that was attractive to the people that came was kind of what, to your point? We didn't come up with a topic and say, we're going to talk about this. Come. We threw out multiple options. And the thing that rose to the top pretty unanimously was talent density. And so everybody that came was excited about that specific topic and ready to get into it. And some of them, you know, were, uh, I m. Guess much further along in terms of having things to share. And others were there to kind of take notes to see what they could take back. And I mean, the conversation, I was worried that like, what happens if we get 20 minutes in and then like. No, like the conversation dies? And it was the opposite. I had to kind of like stand up and be like, I don't want to kick anybody out. But we are at, uh, time.

Speaker B: We're out of time that makes you feel good or like pivot to other topics. Right?

Speaker A: Yeah, we didn't even have to. I mean, we spent a good amount of time Talking. We spent the whole time, 90 minutes talking about talent density, um, and just talking about how AI, the AI change management strategies and how roles are transforming and training and, and like, you know, growing without adding headcount. Like, what does that look like operationally? So it was good.

Speaker C: And I was telling Lisa, so we did a survey after just to kind of see was this valuable? Is this something that people want to do again? And we've gotten six responses back so far of the 10. So that's pretty good. All six were like, very valuable. I want to do this again. We would love to do it every other month. So like, that's been kind of encouraging to see. And one of the questions that I asked in the survey was what was the most valuable part of it? And some of them talked about the content, but most of them specifically were just being in a room with other HR professionals and hearing what they're doing.

Speaker A: Yeah, uh, senior leaders. It was good. So anyway, something to consider and like, if you don't, um, have something like this in your area and you're listening, it might be something. And you're a senior HR leader. Like it might be something to consider, um, getting off the ground and you can partner with, you know, somebody like a Scott Insurance, they bought the Panera.

Speaker C: Um, and I mean it was really pretty easy to put on.

Speaker A: Right.

Speaker C: Like we had the registration link and the survey of topics, uh, on the front end and beyond. Just like pushing that out and buying some Panera. That was all of the prep. And then I was able to grab Lisa to be like the content expert and it was awesome.

Speaker A: Yeah. And just like facilitate the conversation. So I don't know, it's something definitely for our team to consider doing in the area up in Richmond where we've got like some clients up there as well. Yeah.

Speaker B: Do you feel like you'll. Or you would expand that idea? Like, was there an appetite from those HR leaders that there are other executive leaders in their orgs that could utilize that same kind of forum?

Speaker C: I think so. We specifically threw out the idea of getting HR leaders and CFOs in the same room to kind of talk about the same topics, but how they could work together. And that seemed to be received really, really well. Um, and just another plug for Lisa real quick, just, you know. Cause we're on the HR nightmare.

Speaker A: Let's go.

Speaker B: Right.

Speaker C: So one of the, uh, survey results was like, hey, I loved it. Lisa did a great job. It's going to be a really hard task to top that as a speaker next time.

Speaker A: So another Leith HR Group consultant might

Speaker D: be a great facilitator.

Speaker B: Yeah, maybe we'll m. Come down. Like we're not busy enough.

Speaker C: Yeah, I know.

Speaker A: It's like, oh, um, well, cool. I think, you know, I, I agree with that because so many CFOs. This is why Leith HR Group exists is because the CFOs hate dealing with people problems. Okay. So they call the second they get sick of it. Like they need, they need like somebody to take people. They give up very quickly. Yeah, yeah. And like this is an easy sell, the CFOs for us. So I know when CFOs are in a room, especially together, their largest line item, almost every single place is people. Right. Salaries, wages and benefits. Um, so I could definitely see that, um, being a great collaboration. I've done that before, uh, with JMI roundtables and it was really, really good. Um, CMOs. Yeah, I mean, geez, you could do this with anybody. This is such a good idea. And like, to your point, like, this is easy and if you don't have kind of the money to foot the bill, go find a partner. Um, there's usually, there's lots of people that want to get access to these senior leaders. So like, go find a great partner that's willing to. And also, like, it wasn't a sell. You literally identified a need in the business community, put an event on and like people will return. So like, that builds trust and rapport. It's kind of like, uh, hey, at the end of the HR nightmares is a great way for you to get to know Leith HR Group and what we're bringing to this table and the kind of personalities that you would be working with. You can like them or you don't. Right. So it's your choice.

Speaker B: We have a mix.

Speaker A: Yeah, we have a mix. Um, so it is, it is also a great way, if you're thinking about, oh, I like to do that and I would be interested in sponsoring something like that. This is a great way to get access to like a subset of senior leaders, decision makers, economic, you know, buyers for your services and go sponsor for 100, $200 for like a breakfast, um, get them out of there before 10am so they can get back to work. And like, you'll get, you can get people there if you have good facilitators, good topics, good relevant topics and you can get people engaged. So yeah, go build that trust and get some business.

Speaker B: Yeah, I think that it's just great to see someone focus on those higher level leaders. And I Think since I've lived here, we have so many great programs in Wilmington for leaders, but it feels like they're a little earlier tenured leaders. Right. A little bit younger in career, earlier stages of management. And so often like, we're the guest speakers on that, but then we ourselves don't have that same kind of forum. Like the development has kind of stopped or it's really us to hire an executive coach and work one on one. Like, it feels like when you get to a senior level, it's much more like you're working on such high level stuff. It's in a little bit more of a silo and not as much this like classroom setting of 40 people. And I think this is a good mix of some of that. Right. And even keeping it smaller, you know, I think is a good thing because it helps with the discussion, it keeps it manageable.

Speaker D: Uh, I don't think you need confidentiality. Yeah, I was, I'm sorry, I was

Speaker C: a little, uh, concerned when I first like, you know, we had about 20 people sign, uh, up, then 10 people show and I was like, oh, man, only 50 showed up. But honestly, after being in that room, I, I don't think it could have been as productive with any more people.

Speaker B: Yeah, yeah, you would have to kind of have some breakouts of like the conversation. Because it's hard for everyone if you're only there for an hour, two hours. It's hard for more than like 10 to 15 people to really all have a voice and have a part.

Speaker A: Well, um, the other cool part when I was at Scott Insurance is this. This. Was this like your main office or was this.

Speaker C: That was our Raleigh office.

Speaker A: Okay. So, um, we talked a lot about. I was just kind of getting to know him and trying to trick him into being on the podcast, um, and hanging around. Um, but I asked him like, why are you in insurance? And he kind of described it a little bit. But why don't you talk a little bit about the mentor program that you have? I mean, it's aspirational for most companies and most people can't even get it off the ground, let alone sustainability, sustain, maintain. Sometimes keeping a great initiative going is harder than getting it off the ground. So, like, talk about when did it start? What does it look like? Um, what's your part in it?

Speaker C: Yeah. So after I made the decision that I wanted to kind of move forward in the benefits consulting world, I was talking to a few different companies and the reason that I ultimately chose Scott was, I mean, they just give you so many Resources on the front end. So one of the coolest parts is everyone who's hired from Scott. Like I said, typically, you know, we're hiring people who have had successful sales careers for, you know, they're in their mid-30s, we're bringing them in, but they know absolutely nothing about insurance. And so Scott will connect them with a mentor. So the first two years at the firm, you are paired with a specific person, and that person has, like, skin in the game to make sure that you do well. And so you, you know, they bring you on all the calls, all their prospecting, um, meetings, all their client meetings. And I was saying, I was telling Lisa, I'm pretty sure that my mentor, even though they're being compensated a little bit for doing it, he's probably left money on the table because he spent so much time with me, uh, on that. You know, just on the development piece. And, um, at first I was like, man, he's. He's going above and beyond. He's so good, and he is good. But then I look around the company, and every single person in the company, once you're there for, you know, long enough, is expected to be a mentor at some point. And they all go above and beyond. And so I just. I feel like, uh, you look across the industry, and a lot of companies are kind of like hiring a sink or swim. We'll hire 100 people. We hope, like, a handful of them pan out. And we're kind of the opposite. We only hire a handful of people every year. And. And for the most part, those people make.

Speaker A: It sounds magical.

Speaker B: Where are some of your other locations?

Speaker C: So we're in North Carolina. We're in Raleigh, Greensboro, um, and Charlotte. And then in Virginia, we have Richmond, um, Lynchburg, um, Greenville, South Carolina, Nashville, Tennessee. And, uh, we're about to open an office in the Tidewater region of Virginia as well.

Speaker B: So kind of this region, are there specific industries and business businesses that you partner with or you cross kind of all sectors.

Speaker C: So it kind of depends on what side. Like, a lot of our pnc, um, brokers focus more on industry because it kind of matters for us. On the benefit side, really, the most important thing is, uh, employee total, but across. And there are certain things that matter, are nuanced industry to industry. But for the most part, if, you know, if it comes down to how many people are on the plan and then, um, just the cost containment, um, strategies we can put in place.

Speaker A: I have a question for you. Should I be. Should I be mad?

Speaker B: What is your broker fee?

Speaker A: Yeah, Should I be mad at my broker when my, um, premiums go up, like, 30% every single year. And tell me, like, the. Can you tell us the truth? Like, I feel like it's like almost just a silly game that we play every single year. It's like, well, there's a no shop, and, like, you can get a better deal if there's a no shop. It's like, well, why wouldn't we just negotiate with everybody always and try to get the best exact plans? Like, I don't get it. It almost feels like it's like a charade. Okay.

Speaker C: The notion the no shop is a charade. The no shop only benefits the carrier.

Speaker B: Yeah.

Speaker C: Because if the carrier's like, this is our best offered, but don't go shop. They're saying that because they don't want you to find a better offer and leave them. Um, now, is it your broker's fault if the premium goes up? Not necessarily. It could be. You know, if they're kind of like, mailing it in and they're not looking to see if there are savings within your pharmacy program, they don't have you with an independent, uh, pbm or if there's something with a soft. I mean, there are things they could do, but right now, costs are just going up across the board.

Speaker D: Um,

Speaker C: as we talked about from the prescription side, there's a lot of specialty drugs that are really driving up the cost. So typically, your pharmacy cost makes up about 25% of your overall health spend. Um, and of that, a huge percentage. And it's only growing more and more. Is a specialty drug. And just think of a specialty drug as any drug you see advertised on TV or in a magazine.

Speaker B: Name brand doesn't have generic options.

Speaker C: Exactly.

Speaker D: Uh, Skyrizi.

Speaker C: Skyrizi is an example.

Speaker D: Humira.

Speaker C: And so it's kind of yes. And, like, if your premium is going up every single year, there's likely a trend that could be addressed, uh, beyond just like, hey, we had a couple a cancer scare. We had some freak things happen. But if pharmacy is consistently driving your renewals up and up and up, it's likely that you are not with the best pbm. Uh, I don't want to get too in the weeds on this, but that's good, I guess.

Speaker A: Like, how would you describe for anybody listening, you know, whether you're an HR professional or an owner of a business, or you're just a listener learning, like, how would you describe, uh, picking a great broker? Like, what are the qualities that you look for?

Speaker C: So a great broker should make sure that you are never surprised by a renewal. So that's the one thing that the broker can control. They can't control whether your premiums are going to go up. But if you have a good broker who has got you kind of out of this carrier controlled environment where they, they have all the power and they can strip, strip things out, break things out a little bit and you can have access to your data, you should know six months ahead of your renewal about what you, what your renewal is going to look like. Um, so a lot of times we hear people saying like, I get my renewal so late, we have 45 days to make a decision and we end up just kind of like doing the,

Speaker B: you just renew whatever. Yeah.

Speaker C: The least friction, just kind of doing what we could do. And so a good broker should make sure that you are, uh, aware of what the renewal is likely to be and then have options for uh, alternatives. So Instead of having 45 days to make a decision, if, you know, six months out, you can start kind of like, all right, as soon as we get the renewal number from the carrier, we know we're going to go to market and see what else is out there. We're going to explore a captive option or we're going to maybe look at an uh, assessment to see what it would look like to go self insured if they're currently still fully insured with the carrier.

Speaker B: Yeah, I mean we have so many really small headcount clients and there's just, I've found with my clients, luckily, because we have multiple clients, I think I've been the best preparer of what's happening because I have clients I think six out of 12 months. I have renewals at those various clients. And so I've been able to kind of say like, hey, just get prepared, like this is what I'm seeing. But at the same time, like I get so often from a lot of our brokers, like the rate is the rate because your headcount is below 25 or whatnot. But for me, some of it has also been about like the quality of service from the broker. You know, are they trying to make it easy? Are they communicating with us throughout the year? It's not always the rate. It's sometimes just am I getting responded

Speaker A: to or like education?

Speaker B: Yeah, like we had one broker that we work with on big clients and I got their small group for a different client and uh, I loved the one team and then the team I got that dealt with small groups. I'm like, no, um, no, it Was not the same. We got that standard. Oh, five days before you have to make a decision. Here's your renewals. I'm like, this is a nonprofit group. We can't continue to pay 30% year over year. And yeah, we change brokers for that reason. We're like, the service here is just not hitting for me.

Speaker D: I think that's the key for some of our clients with the smaller headcounts. We just had a renewal for 54% of an increase, and we're a nonprofit.

Speaker A: And you accepted it like you had to.

Speaker D: Nope, we didn't. We went. I, uh, the consultant in me. No, but I definitely was like, this is not going to fly. How are they going to make up that extra. It was over $100,000 for a nonprofit.

Speaker C: So two things to think about for smaller, uh, employers and that. That does not benefit me in any way. But there are two, um, there are two association groups.

Speaker A: Yeah, I was going to mention that.

Speaker C: So the NC Chamber, uh, has recently set theirs up, and I think it's been around for maybe a year, but it's pretty new. And, um, that is an opportunity to get into a larger pool so that instead of, you know, you have 20 employees and you have one person get really sick, and that one person could be the driver of a 30% increase, you get put in a larger pool. So you can kind of help contain those. Those increases. And then the other one on the nonprofit side is the, uh, North Carolina center for Nonprofits. So I'm pretty sure if you are a member and membership is like, I don't think it's really that expensive, but if you're a member of the NC center for Nonprofits, you can get in their association. And it's the same setup. Their plan is very similar to the, um. Yeah, NC Chambers.

Speaker B: The hba. Yeah, the Home Builder Association. They have that. Now. I haven't found that the. I think it's been good for the. The small companies that weren't in the game to begin with and didn't even have a benefits offering. It's been really positive for them.

Speaker A: It has. I think you've got a new customer, um, that's leveraged the Chambers association health plans and saved like 20% off. Like a. Another plan that was quoted to them. But just for anybody listening association health plans. It just means you get buying power. You're a member of some group. It could be the Chamber, could be the Home Builders association, could be the center for Nonprofit. But you have to pay dues to be a member. And that gives you access to these association health plans. You can't like go on obamacare.gov or whatever to get the plans. You have to go to a broker. You have to talk to somebody like Seth and he will leverage those rates. I know for the chamber they actually offer 20 different unique plans. So you're not bound to like you have to pick the PPO that's only

Speaker B: going to work for like you just have one choice.

Speaker A: You've got 20 different plans. I don't know what it is but like in your state where you're listening but like go look up association health plans, you're probably a member of something that gets you access to these, to these plans that have better buying power, right? Yeah, that's the whole concept.

Speaker D: When we were trying to help with that group with a 54% increase, we a lot of the broker friends that I had said that we should be considering self insured. What do you think about that?

Speaker C: Well, it depends on the size. Uh, if you are really we kind of put the number at like anything under 50 employees, the risk is probably too high to go fully self insured. Um, but if you're at 50 or even actually below 50, there's still options like being level funded. And so being level funded is truly the value. I'm saying something, if people are going to latch onto that, that's the wrong thing. So at the end of being a level funded, if there's a surplus between the claims, pay claims and then the premium, there's a surplus, you split that with the carrier. So.

Speaker D: Mhm.

Speaker C: You know, you may get you know, a few thousand dollars back.

Speaker A: Have you ever seen anybody get money back?

Speaker C: Yeah, they, it does happen.

Speaker B: Most of mine are level funded. I mean I have to probably, I've

Speaker D: never gotten money, never.

Speaker C: So anyway, so good, so good point. It's very rare. And that's not the value of it though is you get access to your data when you're fully insured, you get no data, you get no access, you get 40 days, 45 days out. Like hey, here's what it is. Sorry.

Speaker D: Um, it is shocking though when you get the data you're like if you're,

Speaker C: if you're level funded, like I just had a group that just switched to being level funded and now they're five months in and they know that they have one really high cost claimant on a specific uh, drug and that's helping us inform, like inform them to kind of one know what to expect and then also just like look at some alternatives to you know, is the drug they're on, are there any alternatives, are

Speaker B: there options for that formula?

Speaker A: I'm gonna say something as like a family that has like a lot of really sick people that benefit from using specialty drugs anytime. Like they get off, uh, whatever Humiris Guy Rizzi, like they're healthy on those. Like those are the original formularies. And so I get like a little funny with the whole formulary thing because it's like if I have a healthy population because they're taking Skyrizi, like do I really want to force them to go on some generic that like could possibly put them. Yeah, exactly. I'm like, uh, I don't have anybody like out on leave because they're dealing with plaque psoriasis issues like I. Or they're Crohn's or ulcerative clays. I get worked up. But it's just frickin nuts that Skyrizi makes the entire premium renewal just so out of whack. It's like a couple of people, I have a huge population with like a lot of souls on the plan and like, and a couple people using Skyrizi like wax the whole thing out. And of course we got like people having babies. People are gonna have babies. We need babies. Babies. Babies are good. They like, everybody hears in the news there's not enough babies. Um, so like we need babies. But like I, and I have a young population. They're having babies.

Speaker B: Right.

Speaker A: It's jacking the premiums up. But it's like there's events, the events are having a baby. Like aren't we expecting?

Speaker B: Yeah, those should be like expected that

Speaker D: a couple times a year you got

Speaker B: out of the way, you got 250 people you can expect once or twice a year. We're going to have a baby.

Speaker A: Yeah. You know, it's not like I'm working at a chemical plant and like everybody's walking around without a mask on and like dipping their hands in hydrochloric acid and like stuff like, like these are a good thing. These are computers, you know, like healthy people being healthy. And the premiums are so whack.

Speaker C: I will tell you, the Skyrizi is definitely much more, uh, at fault for the rise than the babies because typically what carriers are concerned about is ongoing risk.

Speaker A: Yeah.

Speaker B: So a baby, it's that prescription month after month. And Skyri, some, a lot of those drugs are treating things that you're never gonna get off that drug.

Speaker A: Yeah.

Speaker B: Right. And so a lot of those ones that you mentioned. Right. Those are for illnesses that there is no cure for that.

Speaker A: But don't we want them to be healthy? Like how does this work?

Speaker B: Behind but it just means that you're always gonna be paying for that.

Speaker A: You'll always be paying for it. But I won't have an event and like try to die or code at the hospital and you'll have to deal with my, you know, million dollar week long stay in the er. I mean it's just.

Speaker D: I'm with you. So there is, I am with you on that.

Speaker C: There are some conversations around like even on GLP1s about like all ah, right. Should we make it cost this much and should they be covered by the plan? Because in some cases they are preventative. Um, because most preventative care is covered. But it's kind of the definition of what is considered preventative is something right.

Speaker B: That's not necessarily what people are using that for all the time. Well and like here in North Carolina there's one carrier that it's just nothing across the board, even if it is to treat diabetes, will not cover it. But then one carrier does cover it and it's like now we need to look. So I think it goes back to how you know, you choose a broker. And I think what I've seen just in the last couple of years is I have leaned towards if we're looking to make a change. Right. I don't always recommend a change immediately for a new client. I like to get to know their stuff, what's happening. Some of them have long term relationships with certain brokers. But when there is an appetite for the change, I tend to go to the group where we can get some data and analytics. And not every broker team is spending the money to upgrade their internal system so that they can start pulling that data and analytics. And so that's what's made me kind of get rid of one broker, you know, for the last couple of years. Make these choices then to this other one that I'm like, they have put money into creating their own tool to be able to pull this data so when we go into these renewals we can make better informed decisions.

Speaker C: I really like the way that you're framing that about like it's not always just about the cost because to your point, sometimes the cost is the cost. But having a broker who's going to be proactive, where you're not going to be surprised by things or bringing, bringing issues to them, they all the issues in your plan they should know and bring to you before you're. You're running to them asking like what do I do about this?

Speaker A: Mhm.

Speaker D: Well, the customer service piece is really huge for me, especially with these smaller companies. They just don't have the resources to deal with these oddball things that happen. And so if we have people that are really conscientious, very you uh, know, able to pick up the phone and call anytime, it's important. But it was interesting when we tried to get some help for that big increase. Everyone came there must be new because I haven't seen that. But everyone came with the data about the plan so we knew all of the kind of outliers that were affecting it.

Speaker B: So yeah, I was like you said, maybe it's new probably because that group you're talking about has a little higher headcount. It's the ones we don't get. I don't get any data on my employees. The ones that have like less than 25 people. Yeah, it's very difficult.

Speaker C: Well, it's also funny like that you mentioned that is that the group that you're with, the carrier that you're with is not going to give you the data, but everybody. You can run uh, an employee census through different AI tools that will then spit out.

Speaker B: Mhm.

Speaker C: The all of the conditions, all of the drug spent just based off of census data. And so the carriers have access to the data. It's just whether or not they want. It's in their interest to share it. So if it's not in their interest to share it, they're not going to.

Speaker D: Yeah.

Speaker B: Oh, that's interesting.

Speaker D: I was happy to know though like all of the renewals. I just did a renewal today before I got here and um, everyone, even though the rates are increasing, all of my clients aren't switching the percentages. So they're still covering the same percentage. And I just think that that's great. That's a good testament that how much they care about their employees.

Speaker A: Yeah.

Speaker D: So no one's changed?

Speaker B: Well, I think that yeah, a lot of our groups just have conscientious owners of knowing like if it's expensive for us, of course it's expensive for that individual on our team. Right. And that's where I've had some that I still have one employer that for that reason he insists on every year 100%. He's like my only one that I've ever had in all of my businesses I've worked with that still pays 100% and he's just like, you know what, it's a big feat and I've been there and struggle to pay those premiums. And like, if I can do it, I'll do it for as long as we can do it, you know, and

Speaker C: good benefits, like, the whole purpose of benefits is for recruitment and retention, right? So, uh, if it's not doing what it's supposed to be doing, if people are leaving and that's. That's a reason, or if there are just better options out there of your competitors, like, you're always at risk of losing great people because of that. So I think that's why we see a lot of employers willing to eat some of these increase instead of passing them on. And sometimes, I mean, we've seen employers who really, really want to take care of their people and still and just have to pass on some of those costs just because it's not feasible to take them all on.

Speaker A: We've talked it, we've talked about it. And after this year, the increases just mental. Um, but we decided to absorb it for the fourth year in a row. Um, and we're going to take the opportunity to get some mileage out of it. Like, hey, 99% of other companies don't absorb the premium increases without changing the plans at all. Okay, we didn't change the plans at all.

Speaker D: That's what we're doing too. It's like, uh, let's tell that story.

Speaker A: Yeah, you got to tell the story

Speaker D: and get that mileage that's huge so that you can then retain the people.

Speaker C: So benchmarking is something that's like, not fancy. Everybody does it, but not people don't really lead with it as much. We are like all in on benchmarking, because if you don't really know or if you're like a. All right, Lisa Vantica, thank you for saying that. But of course you're gonna say that you want m me to stay here, but you can come and say, like, look, we got this done by a third party actuary, and this is what they're saying, that we stack up against other people. I think that the way that communicates to an employee is a little different than just, hey, we're telling you we're doing a really good job.

Speaker A: Yeah, I love it.

Speaker B: That's really good. And showing them, uh, sometimes it's showing. Doing a better job, showing them from a total compensation what that looks like. And it's like, like, yes. Maybe, you know, you don't realize it because it's not just in your salary line, but it is making your paycheck higher. You know, like, you, you don't think about it like that all the time when you're paycheck to paycheck. Right. But it's like, well, the reason why your take home pay is a couple hundred dollars higher is because your employer is covering these benefits.

Speaker D: I love doing. I love doing the big reveal with those total comp segments.

Speaker A: Um, people are always like, what? I like nailing them home. So this is. Spouse can see them on the counter. Yeah, that's like something more effective than telling the. The team member understands, like, I'm getting taken care of. But the spouse is usually the one that's. You need to ask for a raise. You need to. And it's like, here you go. And you can see the track record of like where the pay has been and like the pay escalation, like over the years. And it's like, oh, I didn't realize

Speaker D: my guy today was so funny. He's like, well, this is such great news. I'm going to pin it to my bulletin board in my office. I was like, let's not do that.

Speaker A: Um, um, I have asked. I actually was talking to the HR operating advisor for JMI M and she was saying like, what kind of stuff do you want to talk about at the upcoming Chro roundtable in the fall? And I said, I think we got to talk about benefits because it's out of control. So I'm curious, are you seeing any unique out of the box trends that maybe our audience should be thinking about? I was throwing out there to her. Like, I'm thinking about hiring a medical doctor. Like somebody to literally be on call for my employees so that we can keep them off of insurance, you know, so I can have them prescribe or like evaluate the Sky Resi thing or that. Like, should I just hire a medical doctor? I don't even know what they cost. Would it be better?

Speaker B: So you say that. So I have a new group that we work with that is with a broker that I had not worked with before. I don't know them. And they're not on a traditional like Blue Cross, Blue Shield United plan. And I can't speak to it as well. I haven't gone through renewals and stuff yet. So. But I just got kind of an intro to it and they're on this different kind of plan. And the whole point of the plan is, you know, your first call is to the nurse line. And that nurse line basically connects you to where you can get care at kind of the best prices within this, like, larger network. You probably know more about these things.

Speaker A: Yeah.

Speaker B: And it. And. Or it's like basically instead of going to the CVS's and the Walgreens, they're going to more of those local mom and pop type pharmacies and getting better rates. But it's like if the employees aren't educated on that plan and they're not calling that nurse line, they could end up paying twice as much for a surgery when really had they just gone maybe the hospital that was 40 minutes down the road or something, we could have paid half as much. So it's keeping the premiums down for both the employee out of pocket and down for the client. So it's a different kind of plan.

Speaker D: I love that we had, um, our broker that came in with all of his information. He said that getting a knee replacement at our local hospital was $18,000, but if they went across the river 15 miles down the road, 6. Hm thousand dollars.

Speaker A: Oh my gosh.

Speaker D: But no one ever. I mean, I wouldn't know.

Speaker A: It's like going to Turkey for a hair transplant.

Speaker B: Yeah, A BBL Turkey her hair.

Speaker A: It's a fitness. My friend just mentioned it this week.

Speaker D: Know about that.

Speaker A: Much cheaper.

Speaker D: I know about that.

Speaker A: Um, what, so what do you think? What are you seeing, like out of the box?

Speaker D: I love the, the school nurse idea, the work nurse.

Speaker C: So first of all, things like that being creative and thinking outside the box is, is number one thing. We always caution though that there's no silver bullet. You can do the greatest thing and, and people are still gonna possibly get sick. But pharmacy is where there's the most opportunity. The PBM that you're with, if they are one of the big like Optum, CVS Care Mark, there is just so much waste in there that is just going to overhead.

Speaker B: Why do you think Medicare only lets you get your prescriptions at Walmart? Like it's like they're trying. Well, where is. I only know about this from my

Speaker A: parents, like what's happening with the Mark Cuban stuff.

Speaker C: So the Mark Cuban stuff is great. And oftentimes like you'll find that employees and even I'll do this sometimes if I go to the pharmacy and the drug that's going to be through my insurance is going to be this amount. I can go check real quick on like Cost Plus Drugs. I might just be like, I'm just going to get this directly from Cost Plus Drugs because it's so much cheaper.

Speaker A: Yeah.

Speaker C: Um, but getting an independent pharmacy that passes off on all rebates back to the employer is one thing. You can do international sourcing, which is another big Deal. And so a lot of the, again, not getting.

Speaker A: I wanted to do that. And they don't like source from third world countries. They're sourcing from like Canada. Yeah. Ah, it's like, yes, please.

Speaker C: So that's one thing. And there's also just a ton of, again, if you're working with a good broker, there's just a ton of opportunities out there. Like there's programs that can help take some of your highest cost, uh, claimants off your plan by putting them into different state and federal programs. So there are 1100 state and federal programs out there that your employees may or may not qualify for. But. And getting them off helps your plan and it's usually better coverage for them.

Speaker A: Yeah.

Speaker C: There's other programs that uh, will pay you basically to go see certain doctors.

Speaker B: Right. M. Right.

Speaker C: And to your point, from like a steerage and like helping make sure that, you know, because right now if you go within a carrier's network, everything's contained there. So they want you to go to the hospital and get that $18,000 knee replacement and not go even sometimes just across the street to the freestanding clinic. MRI is a big thing where you could get an MRI for, you know, I'm just going to make up numbers, but you know, $500 here, $3,000 literally across the street at. Within the medical system. So the thing is there's not one like big shiny trend, but it's the, it's basically all, basically looking through for the margins across the board is where you can uncover savings.

Speaker D: And to be honest, an HR person needs a broker for that. We can't do all of that by ourselves. So that's the importance of.

Speaker B: Well, we certainly can't. When we have people on. We have seven clients and they're all on different carriers. I'm like, wait, which, who am I talking to today? You're United or Blue Cross? Where am I logging in?

Speaker D: We just to try to offset some of these high costs. One of the employer I was with today, um, we're doing pet insurance and it's going to be great.

Speaker A: People wanted it. I asked people if they wanted. They don't want it.

Speaker B: What a rip off.

Speaker A: Yeah, I don't need my little French

Speaker B: bulldog and I can't even get, you know, unless she has some major issue. I mean, I keep it because I'm sure she eventually will. But I'm glad that I love like

Speaker D: the little, like I've got a little rain cloud over my head. I'm sorry.

Speaker B: I'm so excited about my pedestal There.

Speaker A: Um, okay. Where do people find you?

Speaker C: Me specifically?

Speaker A: Yes.

Speaker C: So I am, um, in Raleigh, but I kind of work all over the state. Scott Insurance. Do you want my email address? LinkedIn.

Speaker A: We'll post it.

Speaker B: We'll post your LinkedIn.

Speaker A: Seth Crawford, Scott Insurance. It's a great firm. Employee owned. They want to be a partner. They do benchmarking. If you.

Speaker D: If.

Speaker A: Can people reach out to talk to you about getting a benchmark on your plan?

Speaker C: Yeah.

Speaker A: I mean, who do you want to work with?

Speaker C: I mean, anybody. If anybody wants a benchmark, uh, we can help you get that at,

Speaker D: like,

Speaker C: no, uh, what's the term?

Speaker A: No cost to you.

Speaker C: Yeah, no cost to you. You don't have to work with us. We would love to give you the benchmarking just so you know what's out there and how you stack up against your competition.

Speaker A: That's beautiful. All right, awesome. Um, and I'll leave you with. First of all, thank you for being here. Second of all, thank you for letting me facilitate the roundtable last week. And I would highly encourage anyone listening to consider how you can take the lead and get in charge of getting a group together, a peer group together, whether you're are a CEO, a cfo, a cmo, a chro. Um, go.

Speaker B: Go do it.

Speaker A: If you're. If you're wanting it, you're needing it. Like, what are you waiting for? Take. Take the bull by the horns and go do it yourself. Um, this is HR nightmares. We'd love to hear from you. Don't forget to write in with your questions. We are HR consultants. We're not your HR consultants, but we'd love to be. Leathhrgroup.com um, make sure if you like this episode, you hit, like, subscribe, tell your friends, and we'll see you next time. Thank you so much.