A health plan can spend $133,000 less through better navigation—and still face resistance to changing how employees get care. On *Community Connected Health*, Skip Lowe and Colton Storla unpack the tension behind rising renewals, including a reported $40 million medical claim, surging GLP-1 costs, and employers who can’t access their own claims or pharmacy contract data. They share practical strategies—from transparent PBM contracts and direct primary care to helping employees find high-quality, lower-cost care—and explain why shifting costs onto workers may only postpone the problem. Before signing a 2027 renewal, what information should employers demand? This is Community Connected Health, the podcast where we explore how employers, healthcare innovators, and advisors are transforming the way healthcare is delivered — right in their own communities. This podcast is hosted by Skip Lowe and Colton Storla of North Risk Partners, and new episodes release on the first Monday of each month on Apple Podcasts, Spotify, and wherever you find your podcasts. You can also connect with the hosts through LinkedIn or via email. If you're ready to rethink your health plan, empower your employees, and build something better — you're in the right place. The opinions expressed within this podcast and any related content are those solely of the hosts and guests respectively and do not necessarily represent the position or opinion of North Risk Partners or any other entities. Additionally, the information and opinions expressed on this show should be taken as such and should not be construed as medical or legal advice. - Rising employee health benefit costs and difficult renewal projections - Employer strategies for managing costs without relying solely on higher deductibles or employee contributions - Wellness programs and GLP-1 medications, including coverage decisions and potential costs - Managing high-cost medical claims through timely support and access to appropriate care - Greater transparency and access to health plan claims, pharmacy contracts, and pricing - Self-funded, level-funded, and captive health plan options - Pharmacy benefit manager transparency, rebate auditing, and independent PBMs - Direct primary care as a way to improve access and affordability - Care navigation to help employees find high-quality, lower-cost care - Questions employers should ask before approving health plan renewals Timestamps **Welcome and Fall Reflections (00:00:18)** Skip and Colton open the episode, discuss the busy fall season, and joke about Colton’s upcoming wedding. **Rising Benefit Costs and Renewal Anxiety (00:01:35)** They discuss rising premiums, stop-loss carriers exiting the market, and employers’ concerns about upcoming renewals. **Why Meaningful Health Plan Changes Take Work (00:03:01)** Skip and Colton describe the effort, data, and difficult conversations required to achieve savings and improve health plans. **Employer Priorities and Wellness (00:05:31)** They discuss employers’ varied priorities and compare wellness initiatives with optimizing health plans for more measurable savings. **Cost Shifting Versus Addressing Healthcare Costs (00:10:50)** They examine strategies such as higher deductibles and spouse surcharges, warning these can drive employees away without reducing underlying costs. **Employer Resistance and Trust (00:13:58)** They discuss employers’ attachment to familiar insurance brands, reluctance to make changes, and skepticism toward unfamiliar strategies. **GLP-1 Drug Spending (00:19:06)** They cover rising GLP-1 use and costs, coverage decisions, and the value of pairing weight-loss medications with supportive programs. **Managing High-Cost Claims (00:23:52)** They discuss catastrophic claims and ways to connect members with appropriate care and reduce plan costs. **Health Plan and Pharmacy Transparency (00:26:39)** They urge employers to demand access to claims data, pharmacy contracts, rebates, and independent audits. **Choosing Self-Funding and Challenging Brokers (00:29:02)** They describe self-funding options and encourage employers to seek advice beyond traditional insurance arrangements. **Pharmacy Benefit Manager Strategy (00:32:41)** They recommend transparent PBM contracts, full rebate access, claim-level audits, and careful vendor evaluation. **Direct Primary Care (00:35:12)** They discuss improving access and affordability through direct primary care and share examples of growing participation. **Healthcare Navigation (00:40:13)** They explain how navigation services help employees find suitable, high-quality care at lower prices. **2027 Health Plan Trends (00:44:02)** They predict greater demand for transparency, pharmacy scrutiny, cost-conscious care, and sophisticated funding strategies. **Questions to Ask Before Renewing (00:45:36)** Colton urges employers to review claims data, pharmacy contracts, and high-cost claims before approving renewal terms. **Closing Thoughts (00:46:09)** They encourage employers to focus on buying healthcare more strategically, rather than simply purchasing insurance.
