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The Business of Benefits Podcast
The Business of Benefits Podcast
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For decades, employers have been fed a lie: “There’s nothing you can do to control healthcare costs.” This couldn’t be further from the truth. The system is doing exactly what it was designed to do—profit off of HR, CFOs, and CEOs who believe that lie year after year.With 180 million Americans relying on employer-sponsored healthcare, it’s time to challenge the status quo. The Business of Benefits is your No BS, No Sales guide to the real solutions. No gimmicks—just the truth about how to take control, transform your benefits, and care for your most valuable asset: your people.Each episode dives deep into the data, exposing industry misalignments and inefficiencies that inflate costs while offering actionable strategies for designing financially sustainable, high-value benefits.Through eye-opening interviews with industry insiders, expert analysis, and real-world success stories, hosts Donovan and Chelsea pull back the curtain on the hidden flaws in the healthcare system. The result? An empowering roadmap for employers ready to break free from outdated models and unlock smarter, more sustainable benefits.If you’re tired of the same old sales pitch and ready to rethink benefits, reduce costs, and improve care—this podcast is for you. The truth is out there—are you ready to hear it?
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In this episode of The Business of Benefits, Donovan Ryckis sits down with attorney and national thought leader Alden J. Bianchi to expose one of the most costly and overlooked failures in employer-sponsored healthcare: the illusion of broker transparency. The Consolidated Appropriations Act (CAA) was supposed to fix hidden compensation. It didn’t. Instead, it created a fiduciary requirement to ask, without ever creating a requirement for brokers to actually tell. Employers are expected to manage fiduciary risk without pricing transparency, claims clarity, or conflict-free advice. Alden brings decades of experience advising Fortune 500 employers, consulting firms, and government agencies on ERISA, fiduciary duty, ACA compliance, transparency regulation, machine-readable files, and emerging litigation.In this conversation, he explains why:CAA compensation disclosures are “an absolute joke”Brokers and ASOs avoid disclosure by redefining themselves Employers are left negotiating blindfoldedCurrent PBM and ASO lawsuits are stalled by standing issuesFiduciary governance needs to mirror 401(k) standardsMachine-readable files and AI will change everythingHidden compensation lives in places most employers never lookTransparency is worthless without someone who knows how to use the dataIf you're a CFO, CHRO, HR Director, consultant, or fiduciary of a health plan, this conversation will change how you see the entire benefits ecosystem.What You’ll Learn:Why CAA broker transparency rules failedHow hidden compensation still influences broker recommendations Why employers must build fiduciary governance like their 401(k) plans The difference between named vs. functional fiduciaries How data, machine-readable files, and AI tools will reshape oversight Why market concentration and hospital power keep prices high How reference-based pricing and captives fit into employer strategy What upcoming congressional reforms might change Time Stamps:00:00 – Preview00:53 – Show Opener01:18 – Donovan’s Introduction02:04 – Meet Alden Bianchi02:49 – Alden’s Background (ACA, ERISA, Romney Reform)03:39 – Why Employer Healthcare Costs Exploded05:10 – Fiduciary Exposure and 401(k) Lessons07:17 – Donovan on Lack of Data in Healthcare08:49 – ACA vs. CAA: What Transparency Actually Changed10:12 – Machine-Readable Files: Why They Matter10:59 – Broker Compensation Rules Are “A Joke”12:14 – Why Disclosures Don’t Work (Undisclosed Incentives)14:02 – Donovan on Conflicts in Broker Comp15:30 – The True Fiduciary Standard for Employers16:14 – Alden’s B.O.L.O.s: Override Commissions, Referral Fees17:48 – Fiduciaries Must Become Quant Analysts18:54 – Who Is a Fiduciary? Alden’s Simple Definition20:36 – Why Fiduciary Exposure Is Personal21:13 – SHRM, CAA Compliance, and Employer Pushback21:56 – Challenges With Gag Clauses, RxDC, and Disclosures23:33 – Why Naming a Fiduciary Protects the Board25:40 – PBM Lawsuits: Standing Problems Explained27:35 – Why ERISA Remedies Are So Hard to Win29:20 – How PBM Practices Impact Premiums & Wages30:31 – Employers Subsidizing Medicare Rates31:13 – The $35,000 Family Plan Problem31:44 – Extreme Cases of 16x–21x Medicare Pricing32:29 – Alden on Reference-Based Pricing’s Role33:29 – Why Obamacare Didn’t Lower Costs34:27 – Hospital Profits, Medicare Rates & Misconceptions35:08 – Are Hospitals Really Underpaid?36:18 – Where Employers Should Actually Start37:43 – Incentive Problems in Broker/Consultant Models38:29 – Group Captives, AHPs, and Small Employer Solutions39:47 – Why Transparent Products Matter40:20 – Claims Reporting Problems (Body-Part Categories)41:18 – The Real Issue: Market Concentration, Not Just Benefits41:43 – PBM Regulation vs. Antitrust Problems42:26 – Broker Compensation Should Be on Page 1 of Renewals44:05 – Hidden Comp in MECs, Indemnity & Non-ERISA Lines45:48 – Excess Compensation, Double-Dipping & Fiduciary Risk46:03 – Alden’s Final Advice to Employers46:55 – Follow Alden on LinkedIn (B.O.L.O. Posts)47:28 – Closing Thoughts & Episode Wrap-UpConnect With Alden BianchiLinkedIn: https://www.linkedin.com/in/ajbianchi/Firm Bio: https://www.mintz.com/people/alden-j-bianchiConnect With Donovan / The Business of Benefits / Ethos BenefitsEthos Benefits: https://www.ethosbenefits.com LinkedIn – Donovan Ryckis: https://www.linkedin.com/in/donovanryckis/LinkedIn – Ethos Benefits: https://www.linkedin.com/company/ethosbenefitsPodcast Feed: https://www.thebusinessofbenefits.comSubscribe for Weekly Employer Insights!
In this HR Special, host Chelsea Ryckis sits down with friend and industry leader Lori Kleiman to talk about what it takes to level up from HR department-of-one to strategic business partner, without losing sight of day-to-day realities.We cover how small to mid-size employers can decide when to hire fractional or in-house HR, why headcount matters more than revenue, and the rising complexity of multi-state compliance. We also unpack the hidden opportunity for HR to lead on healthcare and benefits strategy.Chelsea explains renewal “stall” tactics, fiduciary responsibility on health plans, and practical steps HR can take to earn a seat at the table with data and action.What you’ll learn:When a company truly needs fractional HR vs its first in-house generalistWhy certifications like PHR and SHRM-CP help smaller employers hire confidentlyHow tech can increase HR workload and employee questions, not reduce themA simple path to move from tactical HR to strategic HR that drives ROIThe fiduciary duty HR has on health plans, what to ask from brokers, and how to escape the 60-day renewal crunchPractical ideas HR can implement now: communications, data access, compliance checklists, and off-cycle planningTime Stamps00:00 – Welcome to The Business of Benefits01:08 – Meet Lori Kleiman04:45 – Building an HR Business from the Basement07:15 – When Small Businesses Really Need HR10:02 – Technology’s Impact on HR Workloads12:18 – Tactical vs. Strategic HR15:26 – What to Look For When Hiring HR18:41 – How Much HR Certifications Cost21:10 – Using ExamEdge and Affordable Prep Options23:20 – Moving from Tactical to Strategic HR27:00 – Understanding Fiduciary Duty in Health Plans30:36 – How HR Can Drive Benefits Strategy33:22 – Why Benefit Renewals Feel Impossible36:10 – Taking Back Control of Your Renewal38:28 – Shaking Up Your Broker Relationship40:12 – Giving Back to the HR Community41:25 – Final Thoughts and Where to Find Lori Get more on our Guest at:Website: https://www.hrtopics.comYouTube: @lorikleimanhrtopics7385Whether you're an HR professional, CFO, CEO, or just tired of rising healthcare costs, this is your call to rethink benefits strategy and finally take control.Connect with Chelsea and Donovan:Website: www.businessofbenefitspodcast.comInstagram: https://www.instagram.com/ethoseffectpodcast/Chelsea: https://www.linkedin.com/in/chelsea-ryckis-8508a192/Donovan: https://www.linkedin.com/in/donovanryckis/--------------------------------
In this episode of The Business of Benefits Podcast, Chelsea Ryckis sits down with Dr. Zeev Neuwirth — physician, author of Reframing Healthcare and Beyond the Walls, and host of the Creating a New Healthcare podcast — for an unfiltered conversation about what’s really broken in America’s healthcare system and what employers can actually do to fix it.From the hidden “healthcare tax” driving wage stagnation to how misaligned incentives have created a medical industrial complex, this episode dives deep into the uncomfortable truth: only 20 cents of every healthcare dollar reaches doctors, nurses, and clinicians. The rest? Lost in layers of middlemen, bureaucracy, and profit-driven waste.Chelsea and Zeev explore how employer-sponsored healthcare became the backbone of American coverage, why primary care has been stripped of its purpose, and how direct primary care (DPC) and CEO engagement can completely change the game for employees and organizations alike. If you’re an executive, benefits advisor, or HR leader who knows there has to be a better way, this conversation will challenge everything you think you know about healthcare financing, delivery, and reform.Listen to this episode if you want to:Understand how healthcare financing and delivery actually intersectLearn how direct primary care can lower costs and improve outcomesHear real examples of CEOs transforming employee health and cultureBe inspired to rethink your benefits strategy without the sales fluffTime Stamps:00:00 — Welcome to The Business of Benefits02:15 — Dr. Zeev Neuwirth’s journey from clinician to system reformer06:40 — The truth about the “medical industrial complex”12:10 — Where your healthcare dollars really go18:45 — The failure of traditional primary care24:10 — Why CEOs are the missing link in healthcare transformation30:40 — Lessons from the Rosen Hotels model37:20 — Following the money: the employer’s power to change healthcare43:30 — The caregiving crisis and what leaders often overlook47:00 — Final thoughts and resourcesGet more on our Guest at: Dr. Zeev NeuwirthAuthor of Reframing Healthcare and Beyond the WallsPodcast: Host of Creating a New Healthcare PodcastLearn more: zevnewworthhealth.comWhether you're an HR professional, CFO, CEO, or just tired of rising healthcare costs, this is your call to rethink benefits strategy and finally take control.Connect with Chelsea and Donovan:Website: www.businessofbenefitspodcast.comInstagram: https://www.instagram.com/ethoseffectpodcast/Chelsea: https://www.linkedin.com/in/chelsea-ryckis-8508a192/Donovan: https://www.linkedin.com/in/donovanryckis/
Tired of shiny pitches and vague promises? In this solo episode, we break down a practical, repeatable system for holding your benefits vendors accountable so your plan actually performs. From rock-solid RFPs to airtight contracts and respectful escalation, you’ll learn how to set clear expectations, track outcomes, and course-correct fast.In this episode, you’ll learn:How to design an RFP that prevents surprises laterWhat to demand in contracts: performance guarantees, termination language, fees, BAAs, data sharing, and fiduciary statusThe must-ask questions about integrations, cybersecurity, conflicts of interest, and compensationA simple cadence for accountability meetings that gets results, not excusesReal examples of catching hidden fees and fixing slow vendor response timesHow to build team culture so your staff holds vendors accountable the right wayWho this is for: Employers, HR leaders, CFOs, and anyone ready to transform a “set it and forget it” benefits program into a high-performing plan.If the truth is out there, are you ready to hear it?Like, share, and subscribe for more no-BS guidance on benefits that serve your people and your P&L.TimeStamps:00:00 Intro and why accountability matters02:10 Build a better RFP07:35 Contract must-haves and red flags13:25 Demo everything and verify claims17:40 Meeting cadence and escalation that works23:10 Real-world examples and fixes28:30 Culture of accountability inside your team32:10 Final takeaways and next stepsIf this helped, like, subscribe, and share with a leader who needs to hear it. Tell us in the comments: What is the first change you will make to your benefits strategy?Whether you're an HR professional, CFO, CEO, or just tired of rising healthcare costs, this is your call to rethink benefits strategy and finally take control.Connect with Chelsea and Donovan:Website: www.businessofbenefitspodcast.comInstagram: https://www.instagram.com/ethoseffectpodcast/Chelsea: https://www.linkedin.com/in/chelsea-ryckis-8508a192/Donovan: https://www.linkedin.com/in/donovanryckis/
Welcome back to the No BS. No sales pitch. Just real solutions podcast. This week our host Chelsea Ryckis sits down with Justin Held, CEBS of the International Foundation of Employee Benefit Plans (IFEBP) to unpack what HR, CFOs, and CEOs need now: neutral education, fiduciary guardrails, and a practical path to future-proof employee benefits.In this episode:What IFEBP is and how it helps plan sponsors with objective, non-lobbying educationCEBS breakdown: curriculum, timelines, and why employers fund itFiduciary duty basics after ERISA and why CAA 2021 put health plans under the spotlightThe 2025–2026 benefits agenda: PBM contracts, data analysis, chronic conditions, GLP-1 coverage, mental and behavioral health, peer support models, and AI in plan administrationHow to run a strategic review of your plan: surveys, focus groups, utilization data, KPIsSimple, high-impact changes most members won’t even notice, but your budget will.Timestamps:0:00 Intro1:08 What IFEBP does and why it’s neutral6:35 Conferences, toolkits, and daily benefits headlines10:12 CEBS overview and chapter network14:45 ERISA fiduciary duty in health and retirement19:18 Trends: PBM contracts, GLP-1, mental health, AI, fraud prevention28:40 Peer support models for mental health33:10 How to future-proof benefits with data and KPIsIf you are an employer, CFO, or CEO who is tired of trend increases and status quo advice, this conversation will give you a path to real savings and better outcomes. If this helped, like, subscribe, and share with a leader who needs to hear it. Tell us in the comments: What is the first change you will make to your benefits strategy?Whether you're an HR professional, CFO, CEO, or just tired of rising healthcare costs, this is your call to rethink benefits strategy and finally take control.Connect with our guest today at: Linkedin: https://www.linkedin.com/in/justin-held-cebs/Website: https://www.ifebp.org/YouTube: https://www.youtube.com/user/IFEBPListen to their podcast: https://podcasts.apple.com/us/podcast/talking-benefits/id1183535454Connect with Chelsea and Donovan:Website: www.businessofbenefitspodcast.comInstagram: https://www.instagram.com/ethoseffectpodcast/Chelsea: https://www.linkedin.com/in/chelsea-ryckis-8508a192/Donovan: https://www.linkedin.com/in/donovanryckis/
If you have ever been told “you can’t access your own portal” or “don’t worry, we’ve got great PPO discounts,” this episode is for you. Today host Chelsea unpacks real stories employers have shared with me and the costly myths behind them. Names and details are changed, the situations are real. Use this as a checklist to protect your plan, your data, and your people.In this episodeThe red flag no one should ignore: being blocked from your own carrier portalNo access to your ben-admin system and why that traps you from shopping the marketAsking for compensation disclosures under CAA 2021 and getting a flat “no”Fear tactics about big carriers and how to verify before you trustSticker shock: $125 PEPM broker fees and how to benchmark what is reasonablePerks over performance: NHL boxes, steak dinners, and fiduciary duty“Broker severance” and the myth of 250 years of benefits experience“Local” vs. “large” broker labels and what actually mattersBeing told you are a “small client” and why that is never an excuseShiny value-adds vs. real cost and quality outcomesKey takeawaysIt is your plan and your data. Own the logins, the reports, the invoices.Verify before you trust. Ask for proof, not talking points.Benchmark compensation and services against outcomes, not perks.Hold every vendor accountable to frequency and severity of claims, not swag.If you are an employer, CFO, or CEO who is tired of trend increases and status quo advice, this conversation will give you a path to real savings and better outcomes. If this helped, like, subscribe, and share with a leader who needs to hear it. Tell us in the comments: What is the first change you will make to your benefits strategy?Whether you're an HR professional, CFO, CEO, or just tired of rising healthcare costs, this is your call to rethink benefits strategy and finally take control.Connect with our guest today at: Connect with Chelsea and Donovan:Website: www.businessofbenefitspodcast.comInstagram: https://www.instagram.com/ethoseffectpodcast/Chelsea: https://www.linkedin.com/in/chelsea-ryckis-8508a192/Donovan: https://www.linkedin.com/in/donovanryckis/
Welcome back to The Business of Benefits Podcast, your no BS, no sales guide to real solutions in employee benefits.Today, host Chelsea Ryckis sits down with Nelson Griswold of Next Gen Benefits to unpack the so-called “big lie” in healthcare and show employers how to take control of cost and quality. Nelson Griswold is a leading voice in employer-sponsored healthcare reform and author of Healthcare’s C-Suite Solution, Fixing American Healthcare, and Life and Death Decisions in the C-Suite. He helps CEOs and CFOs manage healthcare like a supply chain and turn overspend into free cash flow. Nelson explains why claims are not all the same, how incentives in the current system work against employers, and what it looks like to build a plan that puts your people first.In this episode you will learn:Why the 80/20 ACA rule can push premiums up, and what that means for your planHow to move from reactive renewals to a strategic, employer-controlled modelThe difference between fully insured and self funded, and why risk is often misunderstoodHow nurse navigation and quality data reduce complications and total spendPractical first steps to align incentives with an advisor who works for youWhen to use bundled, direct contracting, international pharmacy, and reference based pricingWhy better quality often equals lower cost, and how to steer members to itIf you are an employer, CFO, or CEO who is tired of trend increases and status quo advice, this conversation will give you a path to real savings and better outcomes. If this helped, like, subscribe, and share with a leader who needs to hear it. Tell us in the comments: What is the first change you will make to your benefits strategy?Whether you're an HR professional, CFO, CEO, or just tired of rising healthcare costs, this is your call to rethink benefits strategy and finally take control.Connect with our guest today at: https://www.nextgenbenefits.com/Connect with Chelsea and Donovan:Website: www.businessofbenefitspodcast.comInstagram: https://www.instagram.com/ethoseffectpodcast/Chelsea: https://www.linkedin.com/in/chelsea-ryckis-8508a192/Donovan: https://www.linkedin.com/in/donovanryckis/
Welcome back to The Business of Benefits Podcast – your no-BS, no-sales guide to real solutions in employee benefits.In this solo episode, host Chelsea breaks down what it really means to have a multi-year healthcare strategy for your company. Instead of reacting to renewals at the last minute and hearing the same excuses year after year, Chelsea shows you how to treat your benefits program like a true business plan—with long-term goals, measurable KPIs, and strategies that actually deliver results.You’ll hear a real client case study that has achieved five straight years of decreases by following a step-by-step benefits roadmap.Chelsea also shares:✅ What isn’t a multi-year healthcare strategy (the reactive renewal game)✅ How to build a business plan for your benefits, just like any other department✅ Why data access and employee trust are the foundation for long-term success✅ The difference between a slow, steady approach and a “shock-and-awe” strategy✅ Real savings examples—millions of dollars saved while improving employee experienceIf you’re an employer tired of rising costs, empty promises, and lack of control, this episode will show you a better way to run your healthcare plan.Whether you're an HR professional, CFO, CEO, or just tired of rising healthcare costs, this is your call to rethink benefits strategy and finally take control.Connect with Chelsea and Donovan:Website: www.businessofbenefitspodcast.comInstagram: https://www.instagram.com/ethoseffectpodcast/Chelsea: https://www.linkedin.com/in/chelsea-ryckis-8508a192/Donovan: https://www.linkedin.com/in/donovanryckis/
In this powerful episode, Donovan Ryckis sits down with Jay Gepfert, President of The Culpepper Group, to unpack what employers don't know—and what it’s costing them. With decades of experience on both the retirement and healthcare side of the fiduciary table, Jay brings the receipts on how hidden broker compensation, lack of transparency, and outdated fee structures are draining company resources and exposing employers to serious risk. You’ll hear:Why healthcare benefits need the same due diligence as retirement plansHow compensation models drive broker behavior—and what to demand insteadA real case study showing 46% savings in broker feesWhy the current healthcare system is broken—and how litigation and legislation are forcing changeWhat you need to start doing now to protect your plan, your budget, and your peopleIf you're an HR leader, CFO, or CEO who’s ready to ask the tough questions and rethink your benefits strategy—this episode is your playbook.Subscribe now and hit the bell so you never miss an episode. Because if the truth is out there... are you ready to hear it? Let us know your thoughts in the comments & don’t forget to subscribe for more no-BS insights.Whether you're an HR professional, CFO, CEO, or just tired of rising healthcare costs, this is your call to rethink benefits strategy and finally take control.Learn more about Jay's work: https://www.culpepperrfp.com/Connect with Jay Gepfert on LinkedIn: https://www.linkedin.com/in/jay-gepfert-rfps-for-retirement-health-and-welfare-plans-a418027/Connect with Chelsea and Donovan: Website: www.businessofbenefitspodcast.com Instagram: https://www.instagram.com/ethoseffectpodcast/Chelsea: https://www.linkedin.com/in/chelsea-ryckis-8508a192/Donovan: https://www.linkedin.com/in/donovanryckis/
Welcome back to The Business of Benefits Podcast! In Part 2 of our deep dive with Danielle Young of ClaimDoc, we shift focus from theory to reality — what actually happens when employees engage with a reference-based pricing (RBP) plan?We break down:The truth about provider accessHow ClaimDoc achieves a 96%+ acceptance rateFear-based tactics vs real-world outcomesHow to handle balance bills — and prevent themWhy communication before open enrollment is keyThe co-fiduciary model that protects employees and employersWhat brokers should be doing (and what to look out for)Building a proactive communication strategy that WORKSThis episode is a must-listen for HR leaders, CFOs, and employers ready to take control of their healthcare strategy and rethink everything they thought they knew about RBP.If you're tired of being sold to and want to make smart, transparent decisions for your people — you're in the right place.Learn more about ClaimDoc: https://claim-doc.comConnect with Danielle Young on LinkedIn: https://www.linkedin.com/in/danielle-young-rbp/Subscribe now and hit the bell so you never miss an episode. Because if the truth is out there... are you ready to hear it? Let us know your thoughts in the comments & don’t forget to subscribe for more no-BS insights.Whether you're an HR professional, CFO, CEO, or just tired of rising healthcare costs, this is your call to rethink benefits strategy and finally take control.Connect with Chelsea and Donovan:Website: www.businessofnbenefitspodcast.comInstagram: https://www.instagram.com/ethoseffectpodcast/Chelsea: https://www.linkedin.com/in/chelsea-ryckis Donovan: https://www.linkedin.com/in/donovanryckis/
Welcome to The Business of Benefits Podcast — the no BS, no sales guide to transforming your health benefits. In this explosive Part 1 of our two-part series, Chelsea Ryckis sits down with Danielle Young of ClaimDoc and host of Claim Talk to unpack one of the most misunderstood and feared concepts in healthcare: reference-based pricing (RBP). What is RBP? How does it really work?And is it as scary as traditional brokers and carriers make it seem? Danielle breaks it down with real-world examples, industry insights, and straight talk on what’s broken in the system and how employers can take back control. From inflated hospital bills to unfair renewal hikes, this conversation is a must-listen for HR leaders, CFOs, and any employer ready to challenge the status quo.Tune in now to learn:What reference-based pricing actually is (in plain English)How RBP can save employers 25–30% in year oneWhy fully insured employers are getting screwed tooHow to prepare your team and employees for a successful RBP rolloutWhy the right advisor makes all the differenceDon’t miss Part 2, where we dive into the employee experience and debunk the fear tactics around RBP.Subscribe now and hit the bell so you never miss an episode. Because if the truth is out there... are you ready to hear it?Whether you're an HR professional, CFO, CEO, or just tired of rising healthcare costs, this is your call to rethink benefits strategy and finally take control.Connect with Chelsea and Donovan:Website: www.businessofnbenefitspodcast.comInstagram: https://www.instagram.com/ethoseffectpodcast/Chelsea: https://www.linkedin.com/in/chelsea-ryckis Donovan: https://www.linkedin.com/in/donovanryckis/Connect with today's guest Danielle Young at: https://www.linkedin.com/in/rbpdanielleyoung
Today’s episode of The Business of Benefits is a masterclass in bold HR leadership. Meet Stephanie Koch, Director of HR at Hendry Marine, who shares how she went from sitting silently in renewal meetings to transforming her company’s healthcare strategy — saving nearly $24 million in the process.Host Chelsea Ryckis and Stephanie dive deep into:Why most companies are stuck in “spreadsheet” healthcareWhat reference-based pricing really means (and how it changed everything)How Stephanie turned HR into a profit centerThe truth behind working with legacy brokersWhy data access, transparency, and courage are key to real changeThe ROI of onsite primary care clinics — and the lives it’s savingWhether you're an HR professional, CFO, CEO, or just tired of rising healthcare costs, this is your call to rethink benefits strategy and finally take control.Connect with Chelsea and Donovan:Website: www.ethoseffectpodcast.comInstagram: https://www.instagram.com/ethoseffectpodcast/Chelsea: https://www.linkedin.com/in/chelsea-ryckis Donovan: https://www.linkedin.com/in/donovanryckis/
In this no-nonsense episode of The Business of Benefits, host Chelsea Ryckis dives into the critical but often misunderstood world of Third Party Administrators (TPAs) with industry veteran Eugene Starks. This episode offers employers and consultants a candid breakdown of why the TPA is arguably the most important player in a health plan—acting as the “quarterback” responsible for claims processing, eligibility management, vendor coordination, and plan integrity.Eugene brings over two decades of insider expertise to the table, explaining:The core functions of a TPA—including paying claims, managing eligibility, and building plan logicWhat questions employers should ask when selecting a TPA (e.g., claim turnaround time, fee transparency, ownership structure, and scalability)Red flags to look for in TPA contracts—like hidden fees, clawback charges, or outsourced claim processingHow TPAs interact with other key components like PBMs, stop-loss providers, and networksThe importance of employee communication and education in plan success, especially when using point solutions or reference-based pricingThey also tackle a hot debate: should the consultant or the TPA be the “true quarterback”? The takeaway—collaboration is key. Success lies in choosing the right consultant who partners effectively with the right TPA, ensuring strategic alignment, smart cost-containment, and a great member experience.Don’t be distracted by lower admin fees—value, transparency, and execution matter more. If you're ready to rethink how benefits should actually work, this episode is your playbook. Connect with Chelsea and Donovan:Website: www.ethoseffectpodcast.comInstagram: https://www.instagram.com/ethoseffectpodcast/Chelsea: https://www.linkedin.com/in/chelsea-ryckis Donovan: https://www.linkedin.com/in/donovanryckis/
This week's episode dives deep into real-world strategies for transforming health plans—rooted in fiduciary responsibility, transparency, and measurable outcomes. In this powerful episode, the team sits down with Bryan Orr, CEO of Kalos Services, live from the 2025 Florida Health Care Alliance conference. Bryan shares how he radically redesigned his company’s health plan—cutting costs by 42% below national benchmarks while slashing employee cost share by more than half.With 10 kids and a 400-person team, Bryan had every reason to care deeply about healthcare outcomes. His story is a masterclass in bold leadership, data-driven decisions, and building trust from the top down. Listeners will hear how Kalos implemented direct primary care, reference-based pricing, pharmacy cost control, and transparent network replacements—all while maintaining employee satisfaction and dramatically improving access to care.From free baby deliveries to $80,000 skin grafts reduced to $2,000, this episode proves what’s possible when employers stop playing defense and start demanding better.If you're an employer, HR leader, or benefit advisor tired of double-digit premium increases and vague justifications, this episode is your wake-up call—and a roadmap for action.Key Topics:Fiduciary-driven health plan designTransparent pricing and plan accountabilityDirect primary care and local care accessEmployee communication and leadership trustReal-world savings and improved outcomesConnect with Chelsea and Donovan:Website: www.ethoseffectpodcast.comInstagram: https://www.instagram.com/ethoseffectpodcast/Chelsea: https://www.linkedin.com/in/chelsea-ryckis Donovan: https://www.linkedin.com/in/donovanryckis/
In this high-impact episode of The Business of Benefits Podcast, we're cutting through the legal jargon and post-lunch drowsiness to bring you the most engaging conversation you’ll ever hear on fiduciary compliance. Hosts Chelsea and Donovan Ryckis pull back the curtain on what it really means to be a fiduciary under ERISA, especially in today’s healthcare landscape, where misaligned incentives are costing employers and employees big.Chelsea shares her personal journey from NCAA athlete to healthcare advocate after a traumatic brain injury exposed the broken realities of the American health system. Donovan breaks down the parallels between fiduciary standards in financial services and the gaping lack of those same protections in health benefits—until now.From health plan lawsuits and PBM fraud to RxDC reporting and compensation disclosure, this episode arms employers with the truth, the data, and the questions you must start asking.You’ll learn:What fiduciary duty actually looks like in practice (and in court)Why the Consolidated Appropriations Act of 2021 is a game-changer for employer-sponsored plansHow to identify and eliminate conflicts of interest across your benefit ecosystemWhat brokers aren’t telling you—and why that mattersPractical steps you can take today to realign incentives and protect your peopleStick around for the debut of special guest Bryan Orr, whose real-world results show what’s possible when employers take back control.If you’re ready to rethink your role, reclaim your data, and radically improve your health plan decisions, this one’s for you.Connect with Chelsea and Donovan:Website: www.ethoseffectpodcast.comInstagram: https://www.instagram.com/ethoseffectpodcast/Chelsea: https://www.linkedin.com/in/chelsea-ryckis Donovan: https://www.linkedin.com/in/donovanryckis/
If you've ever felt confused or frankly, duped by your pharmacy benefit manager (PBM), this episode is your wake-up call. Chelsea Ryckis sits down with the “PBM Princess” herself, Rachel Strauss, a 20+ year industry veteran and fierce advocate for transparency, to pull back the curtain on one of the most misunderstood (and most expensive) parts of your health plan.You’ll learn:- The origin story of PBMs and how it all went sideways - The real story behind rebates and why “pass-through” doesn’t always mean what you think - How vertical integration and offshore contracts allow PBMs to hide profits in plain sight - 40 ways PBMs make money (and how to spot the red flags in your contract) - Actionable strategies like international sourcing, manufacturer assistance, and 340B pricing that can drastically reduce costs without impacting employee experience Whether you’re a CFO, HR leader, or CEO, this episode is packed with no-BS insights to help you finally take control of your pharmacy spend. Plus, don’t miss Rachel’s exclusive giveaway: the top 10 questions to ask your broker if you're serious about cutting costs.Connect with Rachel: https://www.linkedin.com/in/rachelmstrauss/Connect with Chelsea and Donovan:Website: www.ethoseffectpodcast.comInstagram: https://www.instagram.com/ethoseffectpodcast/Chelsea: https://www.linkedin.com/in/chelsea-ryckis Donovan: https://www.linkedin.com/in/donovanryckis/
Are you ready to finally break free from the traditional HR rut and discover the game-changing strategies shaping the future of human resources? In this special episode we are joined by Andy Najjar, COO of FutureSolve and host of The Strategic HR Show.From redefining the path from HR manager to CHRO, to exploring innovative perks like Uber credits and unlimited PTO, this episode dives deep into what makes HR strategic, and how modern HR leaders can earn and keep their seat at the executive table. Andy shares real-world stories about saving millions on benefits, leveraging automation and AI for HR efficiency, and the untapped power of creative total rewards programs. Plus, the team tackles pressing topics like HR fatigue, upskilling, M&A people-risk, and the critical role of aligning culture beyond the written handbook.Tune in to learn how to think like a CHRO, benchmark your current programs, use technology to lighten your load, and create a workplace where people truly thrive. This episode is your no-nonsense guide to elevating HR from compliance taskmaster to strategic business driver so you and your people can win, together.Connect with Andy: https://www.linkedin.com/in/andynajjarConnect with Chelsea and Donovan:Website: www.ethoseffectpodcast.comInstagram: https://www.instagram.com/ethoseffectpodcast/Chelsea: https://www.linkedin.com/in/chelsea-ryckis Donovan: https://www.linkedin.com/in/donovanryckis/
Could your company be blindsided by an ERISA lawsuit? Join us as we sit down with Jen Berman from MCQ Consulting, who gives us the scoop on a groundbreaking case involving JP Morgan. Unlike previous lawsuits that focused on HR and finance executives, this one takes aim at the board of directors, setting a precedent that could reverberate through companies big and small. Jen unpacks why this case carries more weight and how it impacts employers, particularly those with fewer than 10,000 employees. Her expert insights offer a roadmap for safeguarding your organization against such legal headaches.The episode navigates the complicated world of fiduciary duty and ERISA compliance, especially within the healthcare industry. We chat about the essentials of proving harm and the indispensable role that documenting decision-making processes plays in shielding your company from legal trouble. Jen dispels myths surrounding fiduciary responsibilities, asserting that ERISA principles are more than just legal requirements—they're best practices for any organization. Don't miss out on these valuable perspectives that could arm you against the mounting challenges in benefits compliance.Connect with Jennifer:https://www.linkedin.com/in/jennifer-spiegel-berman-b834b15/Connect with Chelsea and Donovan:Website: www.ethoseffectpodcast.comInstagram: https://www.instagram.com/ethoseffectpodcast/
Are you tired of skyrocketing healthcare costs and feeling like there’s nothing you can do about it? In this special episode of The Business of Benefits Podcast, we flip the script on traditional benefits planning. CEO of Ethos Benefits, Don Minrakis, sits down with Bryan Orr, President of Kalos Services and host of the HVAC School Podcast, to dive deep into how Kalos transformed its healthcare strategy—saving money while improving employee benefits. From slashing insurance premiums by 40% to eliminating unnecessary costs and navigating a broken system, this conversation is packed with real-world strategies and eye-opening insights. If you're an employer looking for practical ways to cut costs without cutting care, this episode is a must-listen. We also break down the hidden truths behind insurance pricing, pharmacy benefit managers, and hospital billing practices—exposing how businesses are often overcharged without even realizing it. Learn how Kalos Services leveraged transparency, direct primary care, and strategic cost controls to take back control of their healthcare expenses while enhancing coverage for their employees. Tune in now to learn how to take control of your healthcare plan, empower your employees, and break free from the insurance trap!Don’t forget to subscribe, leave a review, and share your thoughts!Connect with Chelsea and Donovan:Website: https://businessofbenefitspodcast.com/Instagram: https://www.instagram.com/ethoseffectpodcast/Chelsea: https://www.linkedin.com/in/chelsea-whalley-8508a192/Donovan: https://www.linkedin.com/in/donovanryckis/----------------------------------------Podcast Produced by Hi Hello LabsWebsite: https://www.hihellolabs.com/
In this episode of The Business of Benefits, host Chelsea Ryckis dives into a crucial topic for HR professionals, CFOs, and employers—how to indemnify the risk of your fiduciary committee. If you're involved in employee benefits decisions, you’re likely acting as a fiduciary under ERISA, which means you have a legal and ethical responsibility to act in the best interest of your employees. Joining Chelsea is professional liability expert Paul Hacker, who breaks down the essential insurances every fiduciary committee should have, including fiduciary insurance, directors & officers coverage, cyber insurance, errors & omissions, and fidelity bonds. With recent lawsuits personally naming HR executives and financial officers, it’s never been more critical to ensure you and your team are protected. Tune in as we unpack what these policies cover, how they’re priced, and why even fully insured plans aren’t exempt from fiduciary liability. Don’t leave yourself exposed—get the insights you need to safeguard your role and your company. Listen now and make sure your fiduciary committee is covered!Connect with Chelsea and Donovan:Website: www.ethoseffectpodcast.comInstagram: https://www.instagram.com/ethoseffectpodcast/Chelsea: https://www.linkedin.com/in/chelsea-whalley-8508a192/Donovan: https://www.linkedin.com/in/donovanryckis/----------------------------------------Podcast Produced by Hi Hello LabsWebsite: https://www.hihellolabs.com/




