Own Your Benefits

Brandon Ernstes and Steve Gingrich

Most employers spend millions on healthcare without realizing how much control they actually have. Own Your Benefits is for forward-thinking leadership teams who want to take ownership of their healthcare and benefits strategy. Through conversations with industry leaders, healthcare experts, and employers, you’ll learn how to lower costs, improve employee health, and turn your healthcare program into a competitive advantage. Hosted by Brandon Ernstes and Steve Gingrich.

Episodes

  1. Oct 28

    What to Do When Your Self-Funded Plan Has A Bad Year

    A 140% loss ratio looks like a disaster. If you’re looking at that in your first year self-funded, the obvious conclusion is that you made a mistake. In this episode of Own Your Benefits, we walk through what we’d actually tell an employer sitting in that position. The short version is that 140% isn’t one number, it’s two, and they behave completely differently. If the claims are landing under your specific deductible, your stop-loss carrier hasn’t paid much, and that side of your renewal may come back in single digits. The increase lands on your aggregate claims budget instead, which isn’t a fixed cost at all. Those are dollars going out to pay your employees’ claims, and you can still do something about them. We put the same year against a fully insured plan for comparison. At that loss ratio, fully insured, you’d be looking down the barrel of a renewal that nearly doubles your premium, with no lever to pull. Self-funded, roughly 30% of your spend takes a small increase, admin stays close to flat, and the 60% that moves is a budget rather than a bill. If you’re halfway through a hard year, ask your consultant for your renewal projection now. Not a market trend number applied to everybody, but a projection built off your own claims and what’s actually happening in your plan. You shouldn’t be seeing that for the first time when the renewal is released. Chapters: 00:00:00 - What a Bad Year Actually Looks Like 00:03:31 - Aggregate Claims Are Rising, and Why 00:07:01 - Why 140% Isn’t the Number That Matters 00:10:00 - What the Same Year Would Cost You Fully Insured 00:12:37 - How Underwriters Reward Employers Who Do the Work

  2. Oct 14

    You're Paying More Than Your Claims Are Worth

    Most employers treat a medical bill as a number they owe. It arrives, it gets paid, and the only question anyone asks afterward is what it does to the renewal. The leadership teams getting different results ask something else first: is this amount even correct? In this episode of Own Your Benefits, Steve Gingrich and Brandon Ernstes lay out the two levers that actually move healthcare spend. Pay less for the claims you're already getting, and prevent the high cost ones from reaching the severity they otherwise would. Everything else is a version of those two. Brandon's framing is that neither one is available to a company that's only buying insurance. If nobody is looking at the plan during the year, nobody is finding anything. On paying less, the examples are concrete. Brandon describes a member driving over an hour each way for a recurring infusion. Moving that site of care into the member's home saved four hours a week and reduced the plan's cost on that drug by roughly 40%. Steve walks through a claim where an IV bag, the tube, and the needle were each billed separately, and an air ambulance charge that came back around 50% below what was first presented. None of that fell on the member, and none of it changed the care anyone received. On prevention, they make the case that the highest impact move an employer has is getting every employee and spouse in front of a doctor with blood drawn. They say roughly 40% of plan members do it today and they aim for 90%. They also get into GLP-1s, and why telling your PBM you don't cover them for weight loss accomplishes very little if there's no rigorous prior authorization process behind it. Chapters:00:00:00 - The Two Ways to Pay Less for Healthcare00:03:34 - Same Care, Same Drugs, Different Price00:06:37 - What a High Performing TPA Actually Catches00:10:17 - Why Prevention Starts With a Blood Draw00:14:30 - GLP-1s: Why "Not for Weight Loss" Isn't Enough00:17:58 - Access, and the Provider Who Knows Your Name

  3. Sep 30

    If We Ran Your Health Plan, Here's What We'd Do

    Very few people get hired at a company to run a health plan. It lands on a CFO's desk because it's the second or third largest line on the P&L and somebody has to own it, usually with no background and no obvious first step. In this episode of Own Your Benefits, Steve Gingrich and Brandon Ernstes take the seat instead of advising it. The setup is a 250 person company, fully insured, just starting to look at self-funding. What would they actually do, and in what order? Steve starts with awareness, because it's hard to get pitched a shiny new program when you already know exactly where you stand. That means benchmarking per employee per year spend nationally and against peers of similar size, industry, and geography. It also means asking how the carrier and the broker get paid, whether contingencies exist, and whether anyone's incentives are pointed the same direction as yours. Brandon starts with the leadership team. What's the culture, how engaged are the mid-level managers, how would a sharp change be received, and what does the demographic makeup look like. Higher tenure and lower turnover push you toward investing in a plan rather than buying insurance. Then the mechanics: what a captive actually is underneath the buzzword, how to vet a TPA, a PBM, a network, and a concierge, and why reference based pricing lives or dies on how easy the plan is to use. Anyone can adopt it and save money. Doing it without fixing access buys you frustration you'll pay for later. Chapters: 
00:00:00 - If We Were Running Your Health Plan
 00:01:11 - Step One: Know Exactly Where You Stand
 00:03:48 - Buying Insurance or Running a Plan? 
00:06:28 - Captives, TPAs, PBMs, and What to Vet 00:10:56 - Why Access Decides Whether RBP Works
 00:15:38 - Prevention and the 90% Exam Benchmark

  4. Sep 2

    The Cheapest Healthcare Strategy Is Having A Great Culture

    Every employer looking to spend less on healthcare starts in the same place: plan design, network, contracts, vendors. All of that matters. But the leadership teams getting the best results tend to have something that costs nothing to buy and can't be bought at all. In this episode of Own Your Benefits, Steve Gingrich and Brandon Ernstes make the case that culture is the multiplier underneath every high-performing healthcare program. Brandon bet that around 90% of companies running a high-performing program also have a genuinely good culture. The logic is simple enough. Engagement is what makes a strategy work, and you can't get engagement out of a workforce that only thinks in terms of what's in it for me. Steve is blunt about where that starts. He says he's a selfish person by nature and has to work at it daily. They get into what that looks like inside an ESOP, why they hire for culture before skills, what an 8,000 employee company did when it realized it had clinics, pharmacies, and more data than it knew what to do with, and why neither the carrot nor the stick gets you where you want to go. In this episode:0:00 - Nobody Is Unselfish by Default5:16 - Your Job Is Not Your Purpose10:40 - Culture First, Skills Second: Hiring Inside an ESOP18:55 - The Ace Hardware Referral That Traveled D.C. to Montana25:19 - Why Nothing in Healthcare Is One Size Fits All30:38 - The ATV Test: Will Your Contract Actually Pay?36:47 - The Knowledge Gap AI Is About to Create42:21 - Carrots, Sticks, and Data Nobody Knows What to Do With47:44 - Clinical Wellbeing and the Two Ways to Pay Less for Claims

About

Most employers spend millions on healthcare without realizing how much control they actually have. Own Your Benefits is for forward-thinking leadership teams who want to take ownership of their healthcare and benefits strategy. Through conversations with industry leaders, healthcare experts, and employers, you’ll learn how to lower costs, improve employee health, and turn your healthcare program into a competitive advantage. Hosted by Brandon Ernstes and Steve Gingrich.