Ep #458: "Navigating Self-Funding Solutions for Small Business Healthcare - With Chris Corkran

David Saltzman: 0:01

As anybody who's been in the business and alive and on the planet the last couple of years knows, there's been a huge resurgence of interest in self-funding. The difference is that it's now gone all the way down to smaller groups, from one to 125 employees, say, and that represents most of America's small businesses. What's new in non-Bukus solutions for those groups? We'll find out on this episode of Shift Shapers.

David Saltzman: 0:41

And to answer that question and probably a few others, we've invited Chris Corkran. Chris is president and CEO of Creative Benefits Consultants. Chris, thanks so much for spending some time with us today.

Chris Corkran: 0:51

Absolutely Definitely glad to chat with you and see what kind of information we could partly relay for the small group self-funded world for your listeners.

David Saltzman: 1:02

Yeah, I think it's always important with Orissa cases to do them properly. I think it's even more important on the small group side because there's so many moving parts that you take for granted in the large group side that you just don't have on the small group side. So I think it's going to be really interesting and useful conversation. Before we start, tell us a little about your journey. How'd you come to be doing what you're doing today?

Chris Corkran: 1:22

Well, i think, like most people in the world, i ran into insurance by accident. We kind of was doing a bunch of odd jobs after college, had my resume out on multiple different career builder monster back in the day websites And I got a call from the regional sales director at Assurant Health one day and said, hey, you want to come in for an interview. And I said I've got my suit on right now. I've got my resume. Can I come right now? So I ended up swinging over to their offices and interviewing and got the job. Didn't know what a deductible was, didn't know what a copay was, but I learned pretty quickly and put some hard work into it and got it figured out and ended up working for Assurant for about seven years and became one of their top producing small group insurance reps there at Assurant Health. And after that I kind of went out and found one of my largest producing agencies that wanted to bring me on to start selling their independent TPA small group program. So I did that for about six or seven years and had some really good success with. That was the was the top producing program director, i guess, if you will, for for that small group health program And I was a level funded program and about three years as right right before the pandemic kind of shut everything down Had a decision to make of you know, do I, do I jump out and sell somebody else's program or do I go out and take what I've learned and all of the different knowledge points and resources and everything like that that I learned from being participant with you know, the next gen masterminds and health Rosetta and all of those different types of communities, and and try to take that information and build something myself.

Chris Corkran: 3:24

And so that's the direction I I chose to take in January of 2020. And then, of course, the whole world shut down and a little bit later that spring. But I think it really afforded me the opportunity to really grind at it and make sure that it was done correctly upfront. We put a lot of time and energy and resources into making sure that everything we were doing was compatible for those small groups, like you mentioned, because it is a very nuanced type of world. Once you get into an ERISA self-funded type of program and taking that out to five, 10, 15 life groups, you know we'd rather take more time on the upfront Side to make sure it's done right. Then you know, find out a year or two later that you know there's all these holes in it. So, so that's really what we did And we've had some really good successes over the past couple of years. Uh, and and running these programs. Um, and we're just, we're just off and running, uh, growing our, our product base and and our uh options for our groups each and every day.

David Saltzman: 4:35

So I will admit to you, as I have to others on this podcast, that I am not a small group guy, never been a small group guy, never wanted to be a small group guy. For me, the bigger the case, the better. it was back in the day when I was selling. So help us understand what are the particular problems that you run into or challenges that that need to get solved If you're going to have first a conversation with a small group about self-funding and then about actually kind of getting into the meat of it.

Chris Corkran: 5:03

Well, the first problem is just that most everybody's conditioned to think self funding is only available for bigger groups, whether it be a hundred plus or 500 plus or a thousand plus. Uh, most people have not in the business world, considered uh self funding an option for them. They think it's too risky, they think there's too much, um, you know, financial liabilities that are out there for for a smaller group and a business owner, uh, to be able to go down that path. Fortunately, one of the good things the the carriers have done over the last couple of years with their level funded programs is really started to open the eyes of the business owners in that small group space, the under a hundred space, that there is a way to get into the self-funded world, to have it be a non risky uh, non huge liability type of scenario, which is really kind of opened up the doors for bringing those larger group solutions into the group solutions downstream to those small group uh types of opportunities. So so the big thing is just, you know, making sure that, uh, the business owners that we work with, the advisors that we work with in this space, just understand, you know we are basically accomplishing the same goals uh with the same type of structure that a Bucca level funded plan does, but just doing it in a more streamlined, independent, transparent way. Uh, that really should benefit those groups and their employees in the in the short term and long term.

Chris Corkran: 6:35

So that's the first piece of the puzzle.

Chris Corkran: 6:37

The second piece of the puzzle is simply employer and employee education. Uh, as you get into those smaller group levels, you're not dealing with multiple different layers of HR CFO, ceo, you know all of that stuff. You're dealing with the owner and maybe a trusted uh assistant, or sometimes even the wife of the owner or the husband of the owner, uh, as kind of the decision makers. So being able to talk a little bit differently, uh, in that small group space, about how it's directly impacting them and their bottom line, is going to be a little bit more important, i think, than, uh, the more broad stroke strategic approach that you might have with a 500 life group. Um, you know, being able to tell them you know you're going to save X amount on your premium this year. Great, that's our goal. But, uh, our longterm goal is to provide better benefits to your members and control your cost over the next five years minimum. Uh, so once they get that aspect of it that we're really just trying to help them purchase healthcare like they purchase everything else in their business.

David Saltzman: 7:46

It starts to open up a lot more doors and opportunities, but the large group market and self funding has gone really towards what I'd call an a la carte, kind of a build it yourself model. Is that the same thing on the small group size, or do you pre build plans? Tell me a little bit about the mechanics of of how that works?

Chris Corkran: 8:02

Yeah, and that's really speaks to why we created these programs and these structures. The way that we did is, you know, being involved with a lot of different advisors over the years and and starting to be a lot more involved in, you know, the next gen community, the health rosetta community. I know we met at the U powered symposium being involved with, um, you know those types of advisors that get it. They're doing those types of unbundled approaches on their bigger groups. Um, the consistent remarks were in conversations they didn't want or they didn't have the time or they didn't have the resources to build an unbundled health plan themselves for a 25 life case. After hearing that multiple times, i just said, well, okay, we all like these concepts, we all get the structure of them, we all appreciate all the pieces of it. What if I went out and built it for you? we come up with some standardized plan designs. We come up with some standardized vendor stacks. We streamline the process for quoting to almost make it as simple as quoting a all savers type of plan on a UHC level funded plan or a AFA plan to where you send in the RFP and then everything is built for you from TPA, stop loss, pbm especially medication solutions, medical management, telemedicine network reference based pricing vendor. All of that is kind of already pre packaged and pre built and, most importantly, pre vetted and pre rated by the stop loss markets that we work with to make sure that we are getting the appropriate discounts and we're not getting the right amount of money for the requirements that are available for everything that we're trying to do inside of our program.

Chris Corkran: 9:51

So we're very much a pre built type of solution for everything that we do to simply try to make it easier for the groups, for the advisors, for the employees to access these types of programs. Is this actually clear? or are they simply, once you get into them, right? because there's a lot more education that's involved, there's a lot more participation by the employees that is required in order to make sure these Mom's work the way that they should. But on the front side we try to make the ease of access as as simple as possible. So then that way you know an advisor is not looking at it and say, well, this is way too difficult to quote, i just don't even want to look at it. Or the group says I got to provide all of this information just to get a rate. You know, that's what starts turning people off from the self-funded type of solutions on those smaller groups. So we try to simplify and streamline that as much as possible to really provide that ease of access.

David Saltzman: 10:56

So let's go back to the employer conversation for a minute. As we're talking, i still think there's a you know the hurdle that we usually have with self-funded plans, especially when we're talking to a virgin group. They've never had it or thought about it, or they've got the conception, as you said, that it's just for jumbo groups. How do you de-scary that conversation?

Chris Corkran: 11:13

Yeah, i mean we've really, we've really done that by building. You know I kind of hate the term crawl, walk, run right, but I haven't come up with anything else yet but we've kind of built that structure within our platforms to where we can build something. That's a very simple program get you into a level-funded world, not really pulling a ton of levers, but it looks, smells, feels like a buca type of plan, but written with independent partners inside of the program. And then we scale up from there to be able to start pulling, you know, individual levers as we go, you know, still riding with a national network, but putting some basic medical management in there, you know, doing some prescription, medication management, sourcing of medications to make sure that we're getting the lowest net cost possible for brand names and specialty medications, and then all the way up to our highest programs that are pulling a lot of levers with reference-based pricing and aggressive steerage and more aggressive medical management and more aggressive prescription management. So we try to outline the process of. You know, here's kind of the scope, here's where we're looking at, here's where we think that would be a good fit for you.

Chris Corkran: 12:37

But where do you want to be? What are your goals? Is your goal to save as much money as possible and you don't necessarily care about disruption to your employees, okay, great, we can go further down the spectrum. Or is it? my employees will absolutely revolt if they don't have a network in place and they don't have a copay for everything that they're used to having. Okay, we go further down this way down the crawl spectrum. So you know, that's really kind of what we've devised, i guess, as far as our strategy to be able to, you know, have an advisor, be able to send us an RFP and we provide back to them multiple different options in that crawl walk run light, to where they can have that honest conversation with the advisor or with the, with the group as an advisor consultant to say, okay, where are you at, where do you want to be? Where's your budget at, where's your tolerance for disruption at? Okay, let's get here. But here's where we want to get you over the next couple of years And here's the steps that we're going to take to get you there.

Chris Corkran: 13:38

I'm really big on allowing the advisors to be advisors. We love working with people that get that concept versus a spreadsheet or broker, you know, whatever you want to call them, because those are the ones that are really going to a sell it correctly, but then also be use that long term strategic approach to it, which I think is even more important for these. You know, 1520, 30 life cases, then you know, then it can be even on the 500 life cases because the cash flow is maybe a little bit less. You know they're they're struggling to hire and retain employees, maybe they're struggling to keep the doors open. And so if we can, if we can do our small part to help them financially, but also help them by offering potentially better benefits to their members. That becomes a recruiting and retaining tool for, you know, for that smaller group.

David Saltzman: 14:38

So I want to drill in on something that you said in that crawl, walk, run continuum. If we take the position that a level funded plan is kind of like a fully blown cell funded plan with training rules with some of these groups, do the training wheels stay on forever? Do you migrate some of them out of that once you've gotten some data and can make better choices? What's that continuum look like?

Chris Corkran: 14:58

Yeah, we really leave that up to the advisory room, to the group. We have the capability to pull those training wheels off as we get further down the spectrum. But honestly, a lot of those groups in that certain size range, the training wheels are just fine. Now there's there's different additional levers that we can pull, you know, to minimize the necessity of the training wheels. But the predictable monthly expense is something that I think a 20 life group really appreciates.

Chris Corkran: 15:28

Now, obviously, if you, as you get further into it and you have an advisor that really gets it and a group that really buys into it, yeah, we can. We can start pulling off some of those, you know, some of those additional levers and training wheels to make it a more aggressive type of program, a little bit more of a variable type of payment structure like a traditional self funded program does. But honestly, what we've seen is a lot of groups in that space they really appreciate you know the predictable, you know monthly expense And then we can start to pull those levers on the benefit side of things, on the additional cost containment side of things, and then when they get a big refund check at the end of their year because they've done all the stuff that they're supposed to do. You know that's. That's like Christmas morning for them.

David Saltzman: 16:12

And creating cash flow from your healthcare plan is not a sentence that many people believe is anything other than fantasy. Exactly So, out of curiosity, you know you were. I know you work with a bunch of brokers or advisors or you know whatever we want to be called these days. What's the number one objection that they hear And how do you overcome that?

Chris Corkran: 16:31

Where's the Buka logo on my ID card? You know this is a Blue Cross. Why do I have to do all these extra steps to, you know, to just access my healthcare plan? Why can't I just go wherever I want to go for the services that I want to have? And those, those objections can be easily answered.

Chris Corkran: 16:50

But you know, being able to get the audience with the employee to be able to answer it, i think, is probably the biggest challenge. You know, obviously, being in a more remote workforce now today it's harder to have. You know, in person employee education meetings, you know it's a little bit more difficult to get people. People want the best thing without having to do what they need to do for it. Nurse Deb at a movie says you know people want a half price signal plan plan with doing nothing for it. Right, you know, but we can save you the money, we can get you to the price point that you want to get to.

Chris Corkran: 17:33

But the further down that crawl, walk one spectrum that you're going to go, the more involved the group is gonna have to be, the more involved the employees are gonna have to be and sometimes The biggest culprit is the more involved the spouses have to be so. We always encourage people to invite spouses employee education meetings and make sure that they understand What we're doing and why we're doing it. And really it's not. The employer does not want to race to the bottom dollar and just get the cheapest plan possible. The goal of everything that we're trying to do inside of all of our plans is to bring better benefits to the members and improve their quality of care inside their health care plan, which I think, at the end of the day, everybody appreciates as long as they know about it.

David Saltzman: 18:21

We've got about a minute and a half left and I'm curious. You know, one of the recurring things that that you power conference that we were at Was, yes, we love having all of these best in class pieces to be able to bolt on, but we still want, as you said, the one logo Is there. Do you see a movement coming where there will be an infrastructure that replicates that kind of one logo feel, even with all of the disparate parts?

Chris Corkran: 18:46

I do and, frankly, that's one of the reasons why we've tried to Brand our programs underneath a program name, you know, like a catalyst for our run approach or our gateway plans for our walk approach, you know. So that way, you know, people can look at it and say, alright, this is a program. Here's all of my vendor stack inside of that, and we're continually working on how do we consolidate that even more to a single phone number, to a single app, to a single website, to be able to allow them to access the plan just like they were if they were on an end of plan But, you know, still being able to maximize the, the vendor stack, in the way that it was created to be used.

David Saltzman: 19:34

That's a great place to end our conversation, but we do hope, chris, you'll come back as this evolves and as you guys pick up more speed and learn more. Chris Corcoran, president and CEO of creative benefits consultants, thanks for sharing your expertise with our audience.

Chris Corkran: 19:46

I appreciate, david, and I hope to chat with you again soon.

Host: 19:54

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