Ditching the Carrier Playbook for a Client-First Model | with Wes Spencer

You would come in with a 60 page found nice proposal of all of the data and stats that are relevant to you as a consultant. But that doesn't really help somebody that 99% of their day is doing something else. Shift your mindset.

Hey.

Hey. Welcome back to the Accelerate your insurance sales podcast. I'm joined here by Wesley Spencer, co founder, Simple Benefits in Grand Rapids, Michigan. Welcome Wes.

Thanks for having me.

Let's start here. So we're going to talk a lot today about what you guys are doing with the simple care team, which I think is damn cool what you guys are doing from a care navigation purpose. But let's go back to folks listening who have no idea who Wes is. You and I actually started with very similar career trajectories at Federated Insurance. But even before what what led you to even get in the insurance business?

At the end of the day graduated of Ball State. Did did a, you know, put my four years in at at the as a Cardinal at Ball State but at the end of the day senior year was approaching and really had no job prospects other than a decent GPA and hadn't spent a lot of time working looking for a career where it really was just hey, need a J O B coming out of college. So ended up going on a golf outing that had to do with our career services team at Ball State and ended up meeting who I'm sure a similar district marketing manager at Federated Insurance.

I was recruiting on the college campuses.

And ultimately we could talk for days about that. I ended up being a district marketing manager recruiting kids on college campuses. But yeah, the rest is history after that I spent three years in Indianapolis market for Federated and ultimately was promoted from a marketing it was called a marketing representative.

To a district marketing manager in Grand Rapids, Michigan.

So hence where you are now here.

We are in hall.

So when you joined Federated, did you do the nine month program or were you more of a career hire? Two weeks I did and that's what.

I give a ton of credit to Federated even still to this day. Unbelievable training development program.

Probably one of the best in the industry.

Has to be. Yeah, I mean to truly put that amount of commitment into for me at the time was a.

Freshly minted college graduate with really no industry experience other than I did a couple of internships throughout, you know, junior senior year, one of which was with an insurance carrier that strictly sold life insurance. And typically those are, hey, grab a phone book or your list of under.

Ams list of still underf friends and.

Go sell them some life insurance, make us some money as an intern and by the way, we'll pay through your licensing.

It's like okay, cool. Dude, I thought I was. I did the NML internship thing in the summer. One of my college years. One of my summer colleges. Yeah, I thought it was the greatest marketing boy in the world.

Yeah.

Write down your a hundred family and friends because we know you're not going to stay. And now we got a list of a hundred.

Eddie.

Oh by the way, make the connection.

For one of our reps so that they can sell you some life insurance and then maybe you get a cut, maybe you don't. But any yeah, we'll at least give you an internship check mark on your on whatever is needed for your college career. And I think I made minimum wage at the time was like seven bucks an hour.

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Know, I remember going back to Federated. I was a two week career hire when I really should have been nine months because I was out of college, already started my career. But I did it for like a year and a half before I came over.

They just needed somebody.

But I did the two week thing and you know my big eye opener for folks who don't know, you know Federe's headquartered in Owata, Minnesota, which is not a big town in Apple. I remember the first time going there for the two weeks and they said you got to be careful when you go out on the town because locals don't like people to work at Federated because they know how much money you make, they know you come from somewhere else and they're going to try to find a way to get you in trouble. And I'm sure you have stories of people who didn't even make it out of training because they decided to do something stupid in public. And all the time, yeah, we had some burnouts.

That'S funny you bring it up.

No, you did two weeks.

Imagine nine months where you're living, living there.

Yeah. So I would say that's the downside of it. I give again full credit to their training program. I learned so much not just in insurance which is dry and nobody really sets a life goal when they're in college to be an insurance marketing represent. No but what they did a great job was teaching overall business acumen and helping understand not, not, not through just class settings but through. What I really loved about the nine month program is at the back end of it the last three months that you'd get a plane ticket to anywhere USA and you'd be helping a federated client through.

Some issue that they had. And yeah, it wasn't even really going.

To be your territory but you were basically just fielding it in.

Why did you get a significant amount of experience of learning, meeting business owners, how they think, how they act, what's important to them, what's important to their family, what's important to their people?

It was and you need a lot of the salt of the earth people because of the industries we specialized in. My harm equipment, auto dealers, plumbing, H vac.

We're not talking about Fortune 500 cell phones, we're talking about small businesses that had been growing in the community for decades. And you're a young dumb college student that's coming out and trying to figure out what's going on with their insurance package.

You get punched in the face pretty quick. What I'm curious. You had a lot more success than I did. I, I stayed five years and I tell people the reason I didn't make it is, you know, the incentives and everything are based off the life insurance. And I hit all my other goals. I sucked at the life insurance so I eventually moved on. What made you. Because you, you elevated to a district manager. What made you ultimately make the switch over to the independent side?

I have, I had a. Just a.

I wanted to succeed. So what, what was really great about saturated is that at the beginning of every year you had a well defined goal. Whether it was number of accounts that you sold, number of health insurance clients that you helped.

Even just number of touches that you made with your client. You had to hit certain benchmarks. So it was a really well defined business plan. And then of course on the life insurance side, which was one of the most difficult to attain was selling X amount of dollars of life insurance at the time for me it was, I think it was like 50 grand worth.

Of know what it is now there.

I heard it's over eight. It's incredible. That's a lot of light, a lot of life insurance. So I, I under and clearly from a business model standpoint, it makes sense.

Yeah, right.

That's where a lion's share of your profit is going to come from an insurance company. But yeah, it just. Out of sheer tenacity and volume, I learned to sell the small policies as needed to meet with my client. And I started in a territory that really didn't have many clients. It was east side of Indianapolis, Indiana and there was a decent customer base, but nothing that hadn't been picked clean by every prior marketing representative for any type of upsell. And at the time you're young enough and go, well if this is what I'm supposed to do, then I'm gonna do it. And yeah, made it a couple years doing that in and of itself, just trying to.

Meet the goals that were set forth. And I think if you put a decent path in front of yourself, you can attain it just out of sheer volume. But that is a grind.

It is. I remember years, I had a couple years I submitted like I don't know, 60 or 70. Right. Reports. Yeah. Where's the property casualty, aka is another term for quote. But yeah, it's, it is a. I'm curious because I know I might. When I left, I gravitated. I went to an agency. I got hired to start a benefits department for P and C agency. But I still sold both commercial and benefits. But eventually I gravitated the benefits. And you know, at Federated we sold everything. Commercial benefits, estate planning, life insurance, disability, you name it. Yeah, I gravitated to benefits because I really just felt that was an area you could educate people. What made you. Because you guys, you know, simple benefits. Today your firm is benefits only. What made you gravitate to benefits?

I think that, I don't think this, the reason we did this is because we saw that not just health insurance was broken, but the healthcare system was broken. And I have a personal passion for fixing that. And I don't care what industry you're in. From a sales standpoint, if you can't create differentiation for what you're doing, it really is just that grind of volume creates opportunity. Opportunity turns into successes, successes turn into income.

But you can, if you see a problem that can be solved. The one of the challenges that we had just even going back to Federated, it was absolutely a cookie cutter program.

So you see good health insurance, great.

Health insurance, unfortunately RIP right. No longer exists, but.

The.

The ability for a, a.

What is truly the consultant for a business to make change or make a recommendation with the insurance carrier when it absolutely makes sense, just didn't exist in that direct rider market. You have to use the riders that are available. You have to use the underwritten rates that are available. In some cases you could plead a case to get a couple points off of a renewal, but man, it got to the point where.

The underwritten rates didn't make sense and it got really frustrating because what do all of us as consultants or representatives for our clients, what we really want to do is do what's right for our client.

And so at the time, we were naive enough to think that the independent agency system has to be a better way. Right, right. Because now as an independent agent, I'm going to have the plethora of freedom to be able to sell multiple different competitive client or competitive programs for my client and for sure going to find them the best solution. And quickly entering that space, you realize that it becomes more of a.

Camp of.

Each independent agency has its primary bread producer for their agents because of.

Not just commissions, which we could talk about why commissions I don't really love, but agency bonuses and other cream that gets added to the, to the, to the revenue stream.

Biases, advice the broker's giving.

Yeah. So now I'm an independent agent, but the agency I work for loves and needs a specific insurance carrier to sell a couple more accounts or to grow that revenue a couple more points. And if you do so as an independent agent, you get a financial win. I didn't love that.

That was one of my big eye openers. Moving to the right in its side. It was like, holy cow, I got all these choices now. Right. But at the end of the day it was easy to get lulled into. But I'm going to sell so many Humana policies right now because if I can sell 10 more, I get to.

Go on their trip and have that pretty good trip. And for me, it wasn't about me going on a trip. It was being able to tell my wife, hey, honey, guess where we get to go?

Yeah, it's because I. Yeah, yeah.

Is that what's.

Was I giving the client the best?

Oh, I'm not doing the right thing for my client. I just tried to earn a trip for my bride and I to anywhere.

So what you, you brought up the problem, the passion, you know, you and your co founder, Jay Ofield, what would you say you guys are really passionate about solving right now?

Yeah.

You guys are here in the western Michigan market. What fires you guys up?

Yeah. So again, we exclusively do health insurance for employers, private employers that are looking for ways to.

Fund a benefit program for their employees, families. And just like any other insurance broker over the past couple decades.

The deliverable to the employer was hey, there's either going to be an increase in cost or we make it a net neutral and increase your employees patient responsibility at the time of the claim or some blend therein. And nobody was talking about the actual cost of healthcare and if that was appropriate for the services rendered. And in any other market the appropriate price for a service rendered is.

Here in the US it's determined by competition and there's just.

And it's clearly stated before you purchase it.

Yeah, there's just not a lot of transparency to begin with. And I know we've gone through several.

Regulatory changes to try and fix that, but.

Just with any regulation the industry will find its way to.

Respond. Yeah. And so our way of truly fixing that and what I'm passionate about is it's literally at the case level. So if a member needs a shoulder surgery or a knee surgery and our team can help that member understand their choice and create competition amongst healthcare providers.

Not for competition, but for allowing that member to understand their best choice because they're. We don't get involved in the quality of healthcare, but we certainly get involved in what is the list price and what is the net price of what this service is going to be required to pay at the end of the day. And that net price is going to be split amongst the employee and their, their family in either deductible or coinsurance or some form of a co pay and then the remainder is going to be paid by the employer. Even if you're fully insured, that net payment is going to result in a premium increase at some future state. So we looked at it as.

If the cost of healthcare is the problem and we're in a state that's actually pretty darn competitive.

You told me that the provider charge is pretty fair compared to other parts of the country.

Yeah, but that's all relative.

And.

My argument is if there's no competition, what does the introduction of competition look like? And if there is a willing care provider to do it at a lower amount, why are we not considering that? Take imaging for example. It's a pretty routine process. I believe there's 40 million MRIs done across the country. So we're not talking about anything that's ultra complicated or specific. This is a.

Taking the picture to find out and support a diagnosis. Those can vary. Even in the state of Michigan that has low rates, that maybe other states are going to be frustrated with this number, but it's going to cost 2 to $3,000 at a hospital, probably much more in other states. But we have independent MRI facilities that can do it for less than a thousand, less than 500 in some cases. So why in the world are we not incentivizing the members of our health plans that are ultimately paying for this to consider that there is options? The typical path is I talk to my primary care. My primary care refers me to a specialist. If that specialist needs a mri, they refer to the hospital's Ecosystems MRI facility. And that's where we have a problem. That MRI is going to cost triple or maybe four or five times what it should for the exact same.

Picture.

Yeah.

Well.

And to that point, if that primary care doctor is owned and works for a big healthcare facility, you know that one where you're getting referred to.

And that's what we've seen. I'm sure every other state has seen this as well. But in Michigan it's been. It's become incredibly.

Well, you said you know, and you're in a market. I thought this was interesting. You told me offline. I want to make sure I repeat this correctly. Can you say 60% of the employer market's controlled by Blue Cross?

Yeah.

Out of every 10 employee holds the Blue Cross logo on that cover.

Yeah. Recent article in Cranes the Heat. They do a good job of really shedding a light on what the fight is that's occurring here.

It's not a new fight. Hospitals think that they're not getting paid enough. Insurance carriers think that they're paying too much.

Each carrier is involved in that conversation. All the hospitals are involved in that conversation. But the thing that's critically important in Michigan is that the consolidation of hospitals has unbelievably increased to the point I think I have to look up the number. But it's like a substantial 40% consolidation.

Where just from 40% less options than.

They'Re used from 2019. So we're six years later and now we've got consolidated down to a very small list. That creates leverage for the hospital systems and leverage in the pricing of a given service.

So.

That tells me there is even a greater need for transparency and competition amongst. If we have a smaller subset of available providers, we at least have to make them compete. Otherwise we're getting to a point where we're going to have collusion.

Well, and it. What amazes me is when you look at any market, let alone Michigan, even if you're a consumer and you just understand principles of everyday life.

Right.

And you go, all right, so now my options for healthcare providers is greatly limited. And when I say limited, it's not actually the number of locations.

It's.

They're all owned by the same people.

Correct.

And now my. I'm in a market where one carrier own 60% of market share.

Yeah.

That should tell the typical consumer something's not right.

To make that assumption.

But it still amazes me, even today with this happening at scale, that most consumers are still even. And I say consumers, you're talking CFOs, HR directors who are making these decisions about their. Diane, they're unaware of this.

They're absolutely put in a bad spot. Because think about who their advisor is. What goes back to the conversation overrides.

Bonuses and everything else going on.

So if, if I am an independent agent consulting to a cfo and my agency boss just told me our pony that we're going to ride this year is ABC Insurance Company.

Who. Who's my boss?

Correct. Who's writing your check?

Is it my client or. Or is it.

An unfortunate circumstance of having limited access? And I'm not going to buck the trend. We.

Have built simple to never have that problem. And it sounds altruistic, but I genuinely believe that, that it's going to fix.

Well, let's talk about that. I mean, you guys are doing some pretty cool things here. And it's funny, you talk. I don't know how the Michigan market works, but you know, there's still markets out there where brokers get paid a percentage of premature. And again, if you just think of that from a holistic view, that doesn't make sense. So I'm relying on you to give me good advice. You're my bro, but you're making a percentage of every dollar I spend on health insurance.

Yeah.

So what do I make when I get a 10% increase? Oh, you get a 10% pay. Rates.

Nailed it.

On top of that, you're getting paid by the carrier who's raising the rates. I used to ask clients, would you trust your accountant if they got paid by the irs?

No.

It's a fascinating question.

Right. But that's how we get. We still get paid in this industry. Right. So let's talk about simple. So I'm going to put this up here. It's simple with a Y, not S, I, M, P, L, E, no E at the end.

Correct. Yeah.

I was curious what's behind the name? What, what was the, what was the.

You know, it's, it's just as is any other young company trying to start off. It's funny. We, we understand the word simple. We wanted to be in our different. We wanted to be able to say hey, make this recognizable.

But at the end of the day our job is to simplify the decision for either a member who's having a healthcare decision. Where do I go for healthcare? Where do I buy this prescription or where do I fill this prescription? Where. But same with an HR director, same with a cfo. How do I make this decision?

With simplicity.

And transparency so that it's not.

Overly complicated. I, I've been through and even at Federated and I can imagine you remember these days you would come in with a 60 page.

Found nice proposal of all of the data and stats that are relevant to you as a consultant. But that doesn't really help somebody that 99% of their day is doing something else.

I need that data. And we have great actuaries, we have analytics tools that are unbelievable with AI innovation right now. We have more real time data on what is happening with any given group than they ever have before and it's going to escalate exponentially.

But I think the point you're making is a lot of that data helps us look good.

We look.

Yeah. Does it actually help that it's the, the end user make a confident decision.

You can baffle them with BS is what I say.

And the numbers you can make numbers say any.

It's, it's fascinating how much in any one given situation we can have the exact same carriers with three different brokers. Their numbers are different than my numbers and it never should be that way. It should be accurate. It should be the exact same for each one. So our job, especially for the decision makers is just to make the, make the overall 10,000 foot view vividly clear.

What I think you guys have done a good job with with the simple.

Care approach which is.

Yeah, I'm going to talk about.

Well that's the second part of simplicity.

When we're going to hit there because here's, here's where I come. Remember when the fad in our industry was health and wellness. Oh boy. The wellness programs, the 10,000 step programs, the smoking cessation program. You know what I think we've all learned? Guess what? People have health insurance to use it. So why not help them buy what they're already going to use at a better rate?

You got it.

And still provide high quality care. And I think that's what you guys have done and recognized is okay, people are going to use it. Let's help them find the right care at the right price. So let's talk a little bit about what you guys have done. Not only are you guys offering health insurance and advising around the insurance piece of it, but you guys have actually brought a care navigation team in house to help members find the right care.

Well.

You got it. And when I say it's the second part of simplicity, I can simplify the decision for a key decision maker in a group to choose an alternative plan. Because either the existing fully insured program is way high priced or the alternatives even from those ASC arrangements are. Anybody can say, hey, let's just go self funded.

Cool.

Now what, what does that really mean? It could mean going self funded with Blue Cross Blue Shield and using an ASC program. It can be using your local hmo, it can be an independent agency, it could be anywhere of.

Probably 8 to 10 different vendors that could influence each member. That's actually not simple, that's complex. We realized early on if we're going to create these types of programs, we have to make it really simple for the member to use because that disruption, albeit a cost savings, may not end up as a net win for the employer. Because what. Let's go back. Why do I buy an employee benefits package for my employees? It's to attract and retain talent. If that employee's perception is not a net positive, then it's not attracting and it's not retaining my talent. So we have to make this super simple and a net positive financially for the employee so that, so that they can move on with their life for their, for their spouse to use. It has to be simple. And we have, and we've gone through several iterations of using third party advocacy programs. Everybody knows them, we don't need to name names, but they're usually based in some form of aggregate state in some form of partnership with a tpa. And then the data flows from the TPA.

Aggregated in a way that's digestible for a call center. The call center then is willing to take inbound calls from members.

Cool.

What's the efficacy of that? It's pretty light.

What we were doing was, I wouldn't call it so innovative. It was just so high touch that when we're trying to make a member understand their choices of care provider A, B or C, what comes along with that? Well, I've now got to schedule a different appointment I have to understand what the billing is. If I have imaging or other medical records, those have to transfer from care provider A who initially started this process likely referred me in house to some type of hospital ecosystem, pull it out of that and get it to the recommended care provider. That either is a lower cost or what we're doing for the past five, six years is there's a genuine incentive for the employee to choose care provider B.

It's still scary for that member to make that change without having some type of real human interaction to make all of those transitions happen. So we built that, we built a team that understands that and has developed relationships not only with the third party administrators direct so that we have the data, but also with the care providers so that at the end of the day we know exactly what records to pull, how to schedule appointments, how to make it as easy as possible for the member and then coordinate it back into a genuine incentive like the 0 deductible or no call that.

That's the final piece of it. Right. If you guys have put a middleman in between the consumer provider healthcare facilities.

Yeah.

Just to make sure there's an added human touch to help make sure that member is getting the right care at the right place. Right.

Talk about incentive. That's the other piece I don't think we talk about enough. And I think you brought up something that's important for people to understand. Like.

Words are one thing, actions are another. I see a lot of advisors in our industry a great game and, and, but I also see they implement, they're implementing some of these strategies and they're working but then they're still giving fire.

It's because the implementation and the.

The service that goes along with what they're doing is not where it should be. And you brought up something earlier that I wanted to come back to is your benefits are only as good as your employees perceptions. You may think you have an amazing benefit program, but if your employees don't think so, you have crappy benefits. Talk about the incentives. What you guys are doing through simple.

Yeah.

To really incent that employee to make that outreach to your team to get that help they need. Yeah.

I want to hit on one thing that you talked about because I think it's a dirty word in our industry is middleman.

It's a really good point. And I would also agree that yes, we are a middleman. Real person, whatever you want to call.

It.

It'S the measurement of the value of that middleman that's important.

Yes.

Period.

There's A lot of middlemen in this.

Nine and zero goodness, zero value. I mean, we all can talk for days about pharmacy benefit managers and really what value do they provide? Or is it actually a disadvantage to be partnered with a pharmacy benefit manager because they not only are not getting you discounts, they're buying and making markups and creating spread and frankly cost sharings with other middlemen to glean revenue. So.

I don't, I don't take offense to that middleman because I think there is absolutely a need for help in this industry because most folks, like I said, 99% of their day do not think about this.

Well, and maybe a better way to say it, how I said it was, it's a different version of what we might refer to as middleman because you only have one goal. It's to help the consumer and you. And you have no missing, you have.

The alignment of, it's the alignment of the incentives. So the way that we get paid carte blanche, we get a fixed fee from our clients. So we get a fixed fee for our consulting, which is.

Value is subjective. Right? Is my consulting for you as an employer valuable? That's subjective. Are services that we provide from a simple care standpoint, it's a fixed fee. The employer pays it on behalf of their employees. So I am now your representative to help you. I am not getting paid by any other source. I am here to help your employees. That paradigm in and of itself changes everything Right now. We have to have a willing employer that sees the value in providing that.

Our clients see the value now. Okay? So the incentive when we make a change to try and use alternative choice programs for a given member, you're bucking the system of what was built for, for a health insurance or a healthcare provider healthcare ecosystem to keep the chain moving. Primary care to specialist to mri imaging center to a facility that's owned by the hospital, ultimately to get a surgical procedure performed. And all of that flows into one hospital ecosystem. That's current state and that's honestly how the industry has progressed over the last 20 years. Nowhere along the line is there anybody to stop and pump the brakes and say, is that MRI better sourced somewhere else?

There truly isn't. In that current model, that's where we step in. Same way with a surgical center, same way with choosing a specialist, even a early onset second opinion, free of charge, paid for by the health plan to make sure this path of care is actually the right path of care. The plans that we create have these incentives for the employees to pump the brakes and Go. Hold on a second. Is it the correct path of care? So free second opinion. And then if that second opinion either confirms it or let's say that the second opinion confirms it's the appropriate path of care, then within the plan, think about the difference between.

Well, we use the example of an mri. Why in the world would I have the exact same benefit for the member that went and had the exact same picture taken, but one costs 350 and the other costs 3500?

There should be an incentive for the member to choose 350 over 3500. And so that's what we've built into these plans is if you choose three 50s to date, it's still wave your.

Cost share out of pocket. Wave.

Right now, there's no denied the choice.

To go paid 350 or 3500, which by the way, my plan is paying primarily.

Yep.

But if I.

It depends on your patient responsibility. If you got a really low deductible, it might. But to your point, today's oversust, they.

Probably got a 2,500, $3,000 deductible plus. But if I choose a 350, I don't pay anything out of pocket. Sounds like a good set on me.

Yeah. So now, okay, first of all, we have to alert the member that this option even exists. Yep. Second of all, we have to convince that member to understand that that choice is not. There's no different than making a choice between buying a Chevy or a Ford. Right. It's we, you have choice. And by the way, you have this opportunity to have it for free. Or you can have your deductible and coinsurance apply. That's where our team steps in. And just make sure that the employee is really educated because they just unfortunately don't get that from the care provider side and it's truly lackluster from the plan side. Every plan, every carrier has developed some form of an app. But the adoption rate of even downloading the app is in the.

But why that doesn't work. You're still requiring the member to do all the work.

Consumers are going to do the work to become better consumers, especially of healthcare. It's not going to happen.

And genuinely, we learned that early on too. You know.

We went into this with all the right.

Motivation, but in the first couple of years we're like, why is we have a zero deductible plan that we've built? Why in the world is nobody engaging with this? And it was purely because, well, it was two things the care providers had no idea. To the best of their ability. They were probably doing what they were either told to do by their hospital ecosystem or they were just comfortable with the referrals that they were making before to a given care provider or to a given pharmacy for sourcing a medication.

What we learned very quickly is that we need to have that integration with the third party administrator so that we have real time reports starting with like prior authorizations. So anytime you're going to have a major surgery or a major, even something like an mri that's high cost and potentially high volume, prior authorization is required, which essentially means that the doctor has to ask the insurance company, are you going to pay for this or not? Will those reports come to a third party administrator for any of our clients? We've partnered with third party administrators that will give us a real time feed of those PAs, those prior authorizations so that then our simplifier team can do daily calls to the members to let them know that, hey, you have an opportunity here to get this for free. Did you know?

And it's because you're reaching out to the member, you're not hoping the member.

Does something about it.

Talk a little bit. You gave an example in one of your webinars. I don't know if you can recall it. It was an entry. Oh, where it was same doctor. Yeah, but two different locations. Talk about that a bit. Because when we're talking about different healthcare facilities charge different prices, that's even true when a doctor, the same doctor provides the same service at two different facilities.

Yeah, it, it actually happens more often than you think because these.

If it's an independent care provider, doctor, specialist.

They may be credentialed, which means they can perform surgeries at a given facility or they might be at multiple facilities. So if they're credentialed at the hospital and it's just easy access for them and they've got other patients scheduled there, that hospital charge is likely going to be 40ish percent more than if it was performed at a ASC, an ambulatory surgical center, or a specialty surgical center. And when we're talking about ear tubes for a kid, we're not talking about highly complex surgery here. It's just you need a facility for the operation that's usually done within 15 minutes, an hour, in an hour. So if you have an ent, your care provider that is credentialed at multiple locations, we've had.

A lion's share of our time where we can go to the patient and say, hey, Dr. XYZ has you scheduled at the local hospital.

It's only because they're scheduled on Monday, Wednesday, Friday at those hospitals. Would you be willing to go on a Tuesday to this facility? Same doctor? Same doctor, same support staff, just at a different facility. And it's a third of the cost. It's unbelievable. So why not give the patient again the benefit of a zero deductible if they choose that path? We're talking like ear tubes can vary wildly. Tens of thousands versus 1500 bucks. Yep.

That's, I mean, that's, I think that's why I've been impressed with what you guys are doing is, you know, you're at the end of the day, let's call you a health insurance agency. Right. But you guys at break, you bring such an additional level to the advice you're given. Number one, you can help them design better health insurance plans. You're bringing a care navigation team with it that's going to help ensure your members get the right care when they need the help, save money. That plan's going to incent them with zero cost access. Oh, by the way, I heard you say you do this all through consulting fees, not commissions paid by a health insurance company. Yeah. Which advisor is sitting on the right.

Side of the table with you?

I think that's something I wish more employers would hear.

Your model.

Your model versus where what the typical broker is today is getting paid by the carrier, bonuses by the carrier, overrides it. Whose trust, Whose advice would you trust? And you guys, here's how we know it's working. You guys are getting intrigue from companies with as many as 35,000 lives.

Yeah. Yeah. And what's even more fascinating, this year has been the first year where we're working frankly with other competing agencies to help. Yeah.

And now bringing this to the market to other advisors.

Yes.

It really does come from. I genuinely mean this. It's a. We need to fix this.

Yeah.

Because our current state is not sustainable. So it's not just us at simple that is going, going to resolve this. It's, it's local employers and along with the, you know, if we can help, that's great. If they're, if their existing agent wants to learn how to do this, we're genuinely happy to help because this is, this is not gonna stop. We have to fix this to have a long term, long term sustainable program.

Well, that's what's made you guys successful. You said it at the beginning. Yeah. You're passionate about this. I think what separates most insurance, the best insurance Professionals from the rest is they have a passion behind what they do. I'll be honest, a lot of advisors in the insurance industry are here to make money. They actually really don't like what they sell. They're here to make money. You guys have a passion for fixing a problem, which is why you guys are having so much success.

Mel, we got a great team. Yep. You know, we just actually just last night we had a full team get together and it is so cool to see a group of people that are also. We're walking the same path with that same passion. And I don't think it's that hard to have this passion. If you, if you really think about it, most folks think the healthcare system is broken and when we're on the right side of it with our team and our conversations we had last night and the stories that we're telling, man.

It'S rewarding beyond making money.

And I think that's the key. I think a lot of advisors in the health insurance game will say they are passionate, but at the end of the day it is about making money. So they will put aside the passion for more money. You guys don't sacrifice that.

Yeah, well, we built it so that we can't.

There's no adverse or perverse incentive. The way that we structure our client engagement. So.

It'S a non. It's just a non issue. Yeah. For the way that we work on.

All right, I'm gonna put you on Spy. You're gonna get to let. Get to know Wes a little bit here or both it. So you had said at the beginning, back, way back in your federated days that you know, one of the reasons you wanted to go. You left is you wanted to keep growing outside of business. What are you doing right now as far as habits, rituals, anything you do on a daily basis that.

Oh.

Ensures you continue to grow.

Yeah. You know, it's, it's consistent learning I think is.

Critically important. You're a big part of that. Genuinely, you're a big part of that. Just to understand what others are doing across the country. Geez. Outside of day to day, what's Wes.

Doing if he's not. That she solved in the world of health.

So I'm blessed with four beautiful children and an awesome wife. We, we have a 14 year old and three 11 year olds. So triplets back in. Yeah. Back in 2013 we had.

Three beautiful children born at four and a half pounds and today they're now 11 years old. Two of them just got their first braces. So if You're. If you really want to know what I'm doing off hours, it's, it's managing kids and kids sports at this point back. Honestly, a lot of my passion came from around that time when we had three kids at one time in September of 2013. And at the time we had a. Just over a two year old. And they were. Thank God it was a, it was a healthy pregnancy. We basically made it to Heidi, my wife. I didn't. She, she did a great job.

I was just there giving high fives, just cheering on.

Cheering her on. Yeah. But, you know, made it to decently full term. But my, my daughter Penny, who is one of the, the triplets. So there's a. My boy Gage. And then Penny and Maya are identical twins within the triplet group, which is crazy, crazy dynamic. But then Penny was born with a congenital heart issue with a hole in her heart. Vsd that required.

Medical intervention. At the time, you know, we, as you're in the nicu, you spent about two weeks in the NICU just because they were born at a lower birth weight. But Penny was not making progress and you know, she spent about a month in the nicu and ultimately the diagnosis was vsd. And you have really one of two choices. Wait for it to, to, to close up. Heal. Heal itself. And that for us did not happen. So around 18 months of. Of age, we had a consult with a local hospital and cardiologist unit.

They, they recommended immediate surgery literally within a week of when we had this concert.

18 months.

And that's a heavy burden for any parent.

You know, when you, when you hear that and you're in the consult room and Penny was with us because she had just got done having the echo and we're, we're in the room and the cardiologist said, yeah, it's time. When can we schedule you? Let's, let's get her going. Let's, let's fix this issue right now.

You know, you're kind of in shock. Yeah. You don't have time to make that decision. You're just.

Yeah, you're in shock between stars. So consult wraps up. We walk out of the room, we're walking down the hall, and I feel, I wish I remember this nurse's name, but she, she stopped us and she said, heidi west, you could have went all in. Yeah, I'm sure it could have went fine. There is a reason.

That she stopped and said, don't, don't have that here.

To this day, I don't know what that reason is, but I know that it worked. The recommendation I am.

Truly grateful for is we're at a good spot.

Well.

And it tells you how messed up the healthcare system is. Here's a woman being paid by that hospital telling, you don't have pet surgery here. Right. And you want to hear how hospital runs? Ask the nurses.

Got it. You got it. And what's even, you know, think about. At no point in time was I thinking about the cost of this. No. Not once did it ever cross my mind. I was help me fix my daughter, period. That was. I don't. I don't care what it costs.

Like, that's.

That's the true.

They don't have. Most people don't have that.

Yeah.

They don't even know where to turn.

No. And guys built the program you built. If we can build a program that has that from a financial standpoint, boy, does that take a ton of burden off of.

Yeah.

You know, making a truly heavy decision like that.

Thanks for sharing. You know, we'll wrap here. That's. That's a powerful way to wrap.

If I.

If there is. Sorry. No, no, no, that's great. If there's another employer. There is an employer in western southwestern Michigan, Indiana, where you guys do a lot of your business or you talked about brokers. You work with brokers now who are like, man, how do I get part of this move? What would be the easiest way to get in touch with you?

Yeah, I would, I would just hit us up@simplebenefits.com or you can hit me@wesimplebenefits.com and.

And that's simple. S, Y M, P L.

So thank you, Andy. This is awesome, man. Thank you for taking time to do that.

Oh, I appreciate you taking time with me, man.

All right, everybody be good.

That's all we got for this episode of the accelerate your insurance sales podcast. One of the most valuable things you can do to help us and other new potential listeners find ourselves show is for you to rate the show and leave a review. So as a special bonus for you, if you leave us a review, take a screenshot of your review and send it to me as a DM to my LinkedIn profile. I will send you a free copy of our LinkedIn Diamond Playbook, our proven four step strategy to grow your business on LinkedIn. So go right now, leave us a review, screenshot it and send me a DM on LinkedIn. Also, please share this podcast with anyone you think would enjoy it. That's it for now.