The Benefits Playbook

This episode features an interview with Suzanne Usaj, Senior Director of Total Rewards at The Wonderful Company. Suzanne leads strategy and execution for the company’s compensation, benefits and wellness suite of programs, delivering value to over 10,000 employees globally. In this episode, Kirk and Suzanne discuss The Wonderful Company’s unique approach to health benefits, including their focus on preventive care, direct contracting for specialty care, and the important role of their onsite wellness centers.-------“ When someone really needs help, when they're experiencing a situation that they've never experienced before,  which is a lot of the complex conditions in our healthcare system, how do we find specialty partners that may or may not be in those broad networks? But we build our own network and incentivize our members to go to that. So you still maintain a little bit of that benefits philosophy where you feel like you need choice, but you're driving people to be able to help make it easy for them to make high quality, low cost decisions for them and for, like I mentioned, the entire healthcare system.” – Suzanne Usaj-------Episode Timestamps:*(00:57): Suzanne’s career journey*(04:41): How The Wonderful Company serves their geographically diverse workforce*(10:16): How Suzanne works within and outside the system*(16:04): Connecting employees with suitable providers and streamlining the process*(21:11): How The Wonderful Company uses data to work upstream*(27:30): Clinics role in The Wonderful Company's strategy*(32:52): What’s next in Suzanne’s strategy-------Links:Connect with Suzanne on LinkedInLearn more about The Wonderful CompanyConnect with Kirk on LinkedInLearn more about Collective Health

This episode features an interview with Sara Richards, Director of Benefits at Red Bull. With experience spanning the consulting, TPA, and in-house side of benefits, Sara’s experience gives her a unique perspective around what’s possible when it comes to developing and administering customized health and welfare solutions. In this episode, Kirk and Sara explore strategies for simplifying and effectively communicating benefits, the practical implementation of point solutions, and utilizing AI to improve employee engagement and fraud prevention.-------“ I am optimistic for those who are willing and able to not stop fighting to change the status quo. I'm optimistic as long as you are willing to put in the work to not just keep going with things and to get ahead of trends and to look at the unconventional solutions.  If you dare and you don't give up, then I am optimistic that we will be able to make this better, and that we as the employers have this ability to bring our buying power to truly impact change. With a layer of pessimism of, and if you don't dare, then it's not gonna be a fun ride for you in the next five, six years.” – Sara Richards-------Episode Timestamps:*(00:51): Sara’s career journey*(06:28): Innovative communication strategies *(13:06): Direct contracting and primary care*(21:41): Shared savings and fraud prevention*(32:26): The role of AI in benefits*(36:41): Optimism for the future-------Links:Connect with Sara on LinkedInConnect with Kirk on LinkedInLearn more about Collective Health

This episode features an interview with Robert E. Andrews, CEO of Health Transformation Alliance (HTA), where he oversees the strategic direction of 60+ corporations that aim to fix our broken healthcare system. Prior to HTA, Robert served as a Member of the United States House of Representatives for nearly 24 years and was an original author of the Affordable Care Act.In this episode, Kirk and Robert discuss the evolving trends in health care, the potential impacts of gene therapy, and the importance of reducing friction in health benefits administration for employers.-------“ When you have 5 million lives, which we do, and $40 billion worth of spend, we're able to go to behavioral health providers and say, people shouldn't have to wait six weeks to see a psychiatrist when they're feeling anxious or depressed. Why can't they see them in six days or less? And we're able to do that to expand the networks that are available.  So that's how we measure our effort.  Both in terms of the price that you pay and we think more importantly, the service that you get and the quality of the work that you get. So we're really all about using the leverage of collective bargaining to improve outcomes.” – Robert E. Andrews-------Episode Timestamps:*(00:58): Reflecting on the Affordable Care Act*(02:17): Current health care system challenges*(12:50): Founding of Health Transformation Alliance*(19:08): Employer challenges and solutions *(30:43): Future of health care and AI*(37:53): Global health care perspectives-------Links:Connect with Rob on LinkedInLearn more about HTAConnect with Kirk on LinkedInLearn more about Collective Health

This episode features an interview with Jen Jones and Cody Fair from Noom Health. Jen is the Director of Clinical Solutions and supports teams with alignment on client needs and clinical programs. Cody serves as the Chief Commercial Officer leading the company’s commercial division and drives growth initiatives across all segments.In this episode, Kirk, Jen, and Cody explore the importance of integrating GLP-1 medications with behavior change programs, challenges related to yo-yo dieting and coverage, and how Noom Health employs tools like body scans and AI to enhance user engagement and outcomes.-------“ There's just an incredible level of frustration at the employer level right now because they genuinely want to do something obviously, that is helping their employees and their members. They want to be able to provide these medications that they know can be incredibly effective. But at the same time, they have to be good stewards of the business and the cost. And that's again, really where the two come together is being able to provide a patient experience and benefit, but weighing that against the cost. And so trying to find a solution that allows them to go down that middle road where they can control the cost, but still allow an ideal patient experience and have the access to medications that can be effective.” – Jen Jones“ What AI will allow us to do is to mine these massive data sets and really start to understand human behavior deeper to where we'll know the exact time that I should reach out to this individual with the exact note that I should send them to make sure we kind of keep them on the program, so to speak. For that person that's going to fall off the wagon and we're never going to see him again. It will give us the ability to figure out the times that we should reach out and how we should reach out and that type of messaging. Something that just pure human intervention would not be able to deliver.” – Cody Fair-------Episode Timestamps:*(01:01): Jen and Cody’s journeys to Noom Health*(06:02): The importance of behavior change *(16:38: The role of GLP-1 medications*(25:33): Managing GLP-1 costs and access*(34:59): The future of GLP-1s and Noom Health*(38:05): Leveraging AI for better health outcomes-------Links:Connect with Jen on LinkedInConnect with Cody on LinkedInConnect with Kirk on LinkedInLearn more about Collective Health

The healthcare system feels broken. Costs are skyrocketing, transparency is nonexistent, and too many people are left wondering, ‘Why is this so complicated?’ Welcome to The Benefits Playbook—where we fight the good fight for a better healthcare system.This season, we are joined by new host Kirk McConnell, Commercial Leader at Collective Health. This year, Kirk sits down with the boldest minds leading the health benefits revolution: industry disruptors, fearless benefits leaders, and healthcare changemakers who are taking real action. We’re pulling back the curtain on hidden costs, exposing the inefficiencies, and revealing the playbook for a system that actually works.If you're tired of the same old healthcare nonsense and ready to take action, join us for season 3 of The Benefits Playbook, brought to you by Collective Health.------- LinksConnect with Kirk on LinkedInLearn more about Collective Health

Ali Diab, CEO of Collective Health, and Halle Tecco, entrepreneur and educator, discuss the urgent need for a consumer-focused approach in healthcare. They share insights on how AI can transform member experiences while emphasizing the importance of personal interaction in healthcare services. Together, they explore the value of public-private partnerships in reducing healthcare costs and advocate for empowering consumers and employers to demand greater accountability within the system.

Michael Menerey, Senior VP at Alliant Insurance Services, shares his insights on the flaws of the traditional healthcare system. He discusses the critical need for price transparency and quality metrics, emphasizing that employers and employees must advocate for change. The conversation shifts to the advantages of self-funded health plans, highlighting their potential to control costs and improve care quality. Menerey also stresses the importance of tailored communication strategies to cater to diverse workforce demographics, ultimately enhancing the member experience.

This episode features an interview with Brian Olsen, Partner of Employee Benefits at Sterling Seacrest Pritchard. Brian is an experienced Client Advisor specializing in creative employee benefits strategies to mitigate risks of health plans for companies ranging from 50 to 5,000 employees. His expertise resides in data management solutions and analysis, pharmacy cost containment, and complex contract negotiations. In this episode, Sasha and Brian discuss the intricacies of working in the TPA space, the importance of clinical data in managing healthcare costs, and how to advise clients on network selection, PBMs, and stop-loss insurance strategies.-------“The TPA is the quarterback for a client's self-funded plan. Pulling together all the different players: the PBM, the stop-loss, the broker, the client. Making sure everybody is working as one to execute the plan for the self-funded health benefits. The biggest benefit is a client's flexibility as they're coming to design that game plan. What kind of network do we want to use? How do we want to pay certain types of claims?” – Brian Olsen-------Episode Timestamps:*(01:40): Brian’s career journey  *(05:49): Understanding the TPA model*(12:42): Pharmacy benefit management insights*(18:02): Non-ERISA business and transition challenges *(26:27): Importance of clinical data insights*(30:07): Brian’s advice for those new to the industry-------Links:Connect with Brian on LinkedInEmail BrianConnect with Sasha on LinkedInLearn more about Collective Health

This episode features an interview with Kristen Jordan, Benefits and Wellness Manager at Chime. She is responsible for the development, implementation, and maintenance of various programs that enhance employee well-being and satisfaction. Kristen has a proven track record for designing and managing benefit plans, wellness initiatives, and vendor relationships that align with the company's vision and values.In this episode, Sasha sits down with Kristen to discuss the importance of benefits education, customized wellness programs, and the impact of a leave of absence management tool.-------“When we think about wellness programs, you really do have to tailor them to your specific company. You can't just put a one-size-fits-all program in there because you may not see the results or the engagement that you're looking for when it comes to implementing a wellness program.” – Kristen Jordan-------Episode Timestamps:*(01:21): Kristen’s career journey  *(04:29): Wellness and benefits at Chime *(14:16): How Chime supports employees *(18:21): How Chime builds each year’s benefits plan *(24:09): Ensuring a great member experience*(33:00): Kristen’s advice for those new to the industry-------Links:Connect with Kristen on LinkedInLearn more about ChimeConnect with Sasha on LinkedInLearn more about Collective Health

This episode features an interview with Doug Ramsthel and Jaclyn Rielly of Burnham Benefits. Doug serves as the Executive Vice President and Partner of Employee Benefits, and Jaclyn is the Vice President of the Irvine Office. In this episode, Sasha, Doug, and Jaclyn discuss how the shift in pharmacy is affecting employers and members, the rising trend of GLP-1s, and why covering gene therapy drugs is important.-------“If I can convert somebody from a drug where I'm getting a $382 rebate to a cheaper drug where my net cost is a lot lower, that's a better benefit strategy. The only way to do that, in my opinion, is to take control as an employer. Self-fund and be able to start hitting these control buttons that will customize the plan, so you're focusing on the right things. Whereas the PBMs could be focusing just on their rebates because they're getting a slice of it. That's how they make their money.” – Doug Ramsthel“Employers are really starting to get creative when it comes to managing their drug spend, and they have to, while focusing on different financial factors, as well as member behavior, when it comes to controlling costs. As plan costs for prescription drugs increase, member costs typically follow suit, whether it be through increases in cost sharing or premium contributions. With over 70% of office visits and hospital visits involving drug therapy, the rising costs of pharmacy are becoming more and more visible at the member level. I think the biggest shift, though, in pharmacy affecting members today really is that of access and affordability.” – Jaclyn Rielly-------Episode Timestamps:*(01:13): How the shift in pharmacy is affecting employers and members*(16:18): Doug discusses his book and obesity treatments *(19:46): Doug dives into GLP-1s *(33:08): Jaclyn discusses gene therapy drugs *(45:50): Jaclyn explains the value-based formulary idea  *(49:40): Final thoughts on gene therapy drugs and GLP-1s-------Links:Connect with Doug on LinkedInConnect with Jaclyn on LinkedInConnect with Sasha on LinkedInLearn more about Collective Health