Unit 5: PBMs and claims management

"I asked him, 'What is it that you're teaching undergraduate students about benefits?’’…Just two slides. That blew me away." - Kyle Minick

My guest this week is Kyle Minick, Vice President of Employee Benefits at Summit Financial Group. Kyle returns to the show to expose a massive systemic failure: Universities are not teaching HR professionals how to manage their second-largest expense.

Kyle shares the shocking story of how he discovered that major university HR programs dedicate almost zero curriculum to healthcare strategy. Instead of complaining about it, he decided to fix it. We discuss the 6-week accredited college course he built from scratch to teach the next generation of buyers about Stop-Loss, PBMs, and TPA contracts before they enter the workforce.

But before we dive into the classroom, we dissect the broken market they are inheriting. We debate why Reference-Based Pricing (RBP) is failing in hospital-dominated markets like Texas, why relating prices to Medicare might be backfiring, and whether the government should step in to establish a "median price" for care.

Tune in to see how we can bridge the education gap and finally train buyers to demand better.

Thank you to our 2026 sponsors!

ParetoHealth: ParetoHealth empowers midsize employers with a long-term solution to reduce volatility and lower overall health benefits costs. Visit ParetoHealth.com to learn more.

Samaritan Fund: A program that connects those who need help to the support they need. We are proud to offer the Samaritan Fund Program. Visit SamaritanFundProgram.com to learn more.

Vālenz Health: We're Vālenz Health, your partner in improving health literacy, reducing plan spend, and delivering high-value healthcare. Visit ValenzHealth.com to learn more.

Imagine360: Imagine360 helps self-funded employers save on healthcare with smarter health plans. Cut expenses by 20-30% with custom solutions. Contact us today at Imagine360.com.

Chapters:

(00:00:00) Why RBP Struggles in Texas Monopolies 

(00:03:30) The "Medicare Price" Fallacy 

(00:11:00) Should the Government Set a Median Price? 

(00:25:00) The Education Gap: How Universities Failed HR 

(00:29:25) The "Two Slide" Curriculum Problem 

(00:33:00) Kyle’s Solution: Building an Accredited Benefits Course 

(00:43:00) Teaching HR to Audit Their Consultants 

(00:54:30) The Syllabus: Stop-Loss, PBMs, and Contracts 

(01:07:00) How to Enroll & The Future of Benefits Education

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