Addressing Affordability 

I started years ago in the insurance business, but before that I was a professional photographer in the fashion industry and really having the time of my life. But the lifestyle and the hours and the craziness of that didn’t lend itself to the next stage of my life, and that’s when my daughter Haley was born and the family said “It’s time to get a real job.”

The gig economy and all of that back then was just not the stable [situation] that would be right for that situation. My father was a personal lines insurance agent, my uncle was a commercial lines [agent], and all my cousins were lining up to be in the insurance business. And they said, “We’ve got a spot for you.”

I had taken on the idea that— growing up in a household where our father would not allow a candle to be lit or anything that was a potential claim to the house because he worked on claims all day long in personal lines—I was not going to be in personal lines. So employee benefits was different, it was something nobody in the family was doing. Right away I was put into the MassMutual producer school to start to learn about the business. With that, using contacts from my family to be able to open doors and get going quickly, I found success. And through that, building out how to cross-sell property and casualty insurance clients with employee benefits. No one else was doing it in my circles. And so I became kind of unique, and [it was] really a fun way to be in the insurance business and learning every day as that went on.

I’m extremely grateful to be in this situation, to work with peers that all have different perspective. There’s small group brokers, there’s large group, there’s some with national broker firms, there’s some regional or local firms. That’s the beauty of CEBE, it’s made up of all of those things.

I don’t have all the answers coming in as the chair, but I’m confident the answers are in the room. So bringing that out, making sure everybody’s voice is heard, is what’s going to make this successful.

One day in, what do I envision at the end? I really have two priorities. One is the coordination piece, because that is the responsibility of the chair. Beyond that, my personal goal is to help us to move faster. This could be the development of a subcommittee. This could be how we meet, how we prepare for our meeting before we have it. Because things are happening so fast right now. We’re in the crosshairs of a lot, whether it’s a legislative action or it’s a rule change or it’s something. Our ability to both respond and react appropriately and timely has got to quicken. I want, by the end of my time as the chair, [for us] to meet that challenge.

It comes off of affordability. The trend is that the buyers are more upset than we probably are ready to recognize. There’s frustration and there’s anger, because there have been so many different solutions tried yet affordability is still in front of us. The renewal season for [Jan. 1, 2026] was not good. And all of the fundamental items that make up what that increase looked like are all real items. So it’s trying to determine the balance between everything.

What used to be high cost looks minor today. I’ll use pharmacy as one example. Remember those days of name brand and generic, and our education was if there was a generic available and your body could tolerate whatever that was, you should be on the generic. It helps everybody, starting from the cost for the employer or member of the plan all the way through to paying for the full price of that drug at a plan level. But things have gotten complicated. Now there’s formularies, there’s brands that are not on formularies. There are these things called biologic drugs at a super high price. Now we have biosimilar drugs, which would be the equivalent of a generic for that. And then we have gene therapies.

What’s different about the new class of drugs isn’t just the big price tag; it’s that they work. In almost all situations, they are life-changing. Why would you want to deny access to that to anyone? You wouldn’t. But ultimately if you’re the plan and your plan has somebody who needs that drug, it’s going to impact the price for everyone on it. So how do we spread that risk and how do we approach just the pharmacy cost situation? Well, legislation has brought about new transparency around the pricing of things. It’s helpful, but it doesn’t really change the price, it just shows where the costs are and how they’re being worked.

There’s other changes that still have to happen to bring affordability around for these items. I do want to go into all the different kinds of complexity around affordability and the role of the broker because it’s changed quite a bit. I remember the days where just the large carriers and our knowledge of them and the relationship as a broker was enough to guide the client to a decision that was in their best interest and best outcome for them. But it’s not that simple anymore. Now, instead of having a choice of five different plan designs, there’s a choice of 50 different plan designs. The client cannot think about that or be able to tolerate that. They rely on their broker to narrow that down.

So then you have to add the layers of the different plan designs. And it’s not offering one, sometimes it’s three plans or five plans. How are we going to educate the member base, the employees and their dependents, on what’s the best choice for them? Then you have to layer in different point solutions. So we look at the data, because now on most groups we have good data. Well, it’s one thing to get the data, then you want to do something with the data. Well, now we can go conditions and say this group has this particular condition more prevalent than other groups. So we benchmark the group and say, “OK, there’s a red flag, what are we going to do about it?” Well, there are now hundreds of point solutions for any given disease state or category. We need to know what’s available for our size group and know that they’re going to look for some ROI measure [of] utilization and outcome for the spend they have for bringing in that point solution.

The basic core of a broker is a translator, because the language that’s used in employee benefits is not common language to the member of the plan, let alone the CFO or HR that helps to make these decisions. We are constantly translating it, and we’re narrowing [down] choices so that the decisions they have to make look very clear, they’re data-based, and they have outcomes in mind so that we can say that we’re working on these challenges together.

All of the work that we’re doing, if this was not being done for our clients, affordability [issues] would have hit a lot sooner. We have delayed it, and in many clients we have delayed it by years. But this anger that I talk about, this frustration with the buyers, and that can be all three levels.

The members of the plan, they’ve experienced higher out of pockets and they’re not happy about that. It can come to the point where they start to not seek appropriate healthcare because of the cost. This just cannot be the right solution for them. Health savings accounts were introduced as a plan design, but the education necessary to be able to thrive in that environment wasn’t a direct match. But with the advent of AI and the advent of new data tools and the advent of education, that brings us to a point today where we can educate good consumers on healthcare using these new tools. I like the coming together of those things.

Then, at the employer level, they are constantly trying to tweak the plan. But they know every time they make a change, they’re viewed by the members of the plan, “You’re just trying to save money.” When really, as the broker, we’re trying to bring win-win scenario situations to the employer, meaning the plan can win and the member can win. An example of that might be a site of care or education on alternative drugs that would have the same effect.

But all of this now comes down to personalizing healthcare at a member level. Then you bring in trust. If it’s the health plan that’s reaching out, there’s sometimes some skepticism around, well, “My health plan wants me to do something different. Oh, they’re trying to save money.” Making sure that what we’re doing is bringing some of these point solutions forward that are trusted by the membership, so the savings of site of care or alternative drug therapy or other things that could be available to them are actually trusted and then implemented.

When we’re looking at new talent coming into one of our platform companies, it starts with we need a cultural fit. Our culture is about serving our clients, and how they might demonstrate that. They could have been a top athlete or they could be an academic winner of awards. We want candidates who have found excellence in something that they have in their past. It shows us their tenacity, their willingness to battle through challenges, to rise to the top of the game of whatever it is that they have taken on.

And with that it’s a curiosity, because the media or others have looked at our industry and it hasn’t been a magnet to young talent saying, “Oh my gosh, that’s my first choice of career.” As we talk to folks, there are some great things about our industry and why you’d want to be a part of it. But it is a collection of people who want to meet that challenge and help other people through it. So I look for that curiosity.

I look for a work ethic in something they’ve done in their past and their openness to learning. Because the way that they understand employee benefits today could be being on their parents’ plan, whether that was a good experience for them or not a good experience for them, and understanding that there’s reasons why things are going on and to understand the layers. It’s not an easy learning process, meaning it doesn’t happen overnight.

The old style of education was to shadow somebody for a couple of years to absorb how they did things and learn from those experiences. What we find with the new talent is they are bolder and they want a role in a meeting. You are not bringing somebody out just to observe. They want to know what their role is, and then they want to preplan for a meeting, and then they want to have some dialogue after the meeting is done. Was the objective met, what went right, what went wrong?

I’m looking at the new talent and saying, “This is what the world’s going to be.” I want to understand how they learn best, because some learn by book study, which aren’t books anymore, but online study, and then some learn with field experiences, and others want to be thrown into the fire. It’s a combination of that that molds together the next generation of talent. What I have to be clear on: They’re not going to be a professional consultant overnight. So they have to absorb the fact that they are beginning a professional career journey. And all along there are rewards, but there are challenges that need to be met. You never stop learning in our career.