The Cure for Fragmented, Cobbled-Together Benefit Plans

A lot of these cobbled solutions are seeking, a, how do I drive that next top line dollar? But b, how little margin am I willing to accept in order to drive that next top line dollar? You can't operate on razor thin margins and still deliver an exceptional product and exceptional service. And that ultimately means that everyone else has to meet their marginal intentions as well. And that's where I think the wheels fall off so many times.

Hey.

Hey.

Welcome back to the broker's voice. I am excited for this one. This one's going to be a good epis. I think you're going to get a ton out of it, especially if you're in the employee benefits space. Even if you're in the commercial space. I think this is going to open your eyes and give you ideas for your employee benefit teammates. I'm excited. Today I am joined by caleb parker, chief commercial officer at angle health. Caleb, welcome to the show, man.

Yeah, thanks for having me, Andy. I appreciate it.

I've got a lot of clients working with angle today. Very pleased. I think this is going to be a good episode. You know, the thing I'll say about angle as we roll into this conversation, you said offline, you guys have 22x since 2022. That is phenomenal. And I gotta say, I gotta believe one of the reasons why is you're actually doing what you say you're going to do. And we're gonna talk about that today. But before we dive in to angle health, your background, man, but most people don't know. Before you got into this industry, which most of us do not get in by design, you actually went to culinary school. Talk about that.

Yeah, you know, it was an interesting place where I, you know, thought that's where I wanted to do. Right. Wanted to follow a passion. And unfortunately, oftentimes passions are either a, a lot of work and or b, a lot of money. And in the case of culinary, that's the case for both. Right. So, you know, ultimately made my way where. Where all lost souls find themselves over employee benefits. So, yes, you know, trying to achieve the same goals with not working every single weekend.

Dude, I gotta tell you what you just said. I look back, like, when I got in, I go, yeah, I guess I could probably define myself as a lost soul at the time.

Well, I. I'd be curious. Totally off the subject today. I assume you still probably have a passion for cooking.

Yeah, yeah.

What's your. You know, I just got back from italy and I gotta share. You know, I'm a guy in the states who Is pretty close to gluten free, dairy free. I have a lot of gut issues, man. When I was over there, bread, dairy, you name it. No impact on me, which I was both. Both was awesome and irritating at the same time. Yeah. But if you, if you're cooking for the family today, what's the go to meal?

You know, it's a great question. You know, the weather just broke here in South Carolina. Right. So, you know, we're going from, you know, that which is light and summery to that which is a little, a little hearty. So, you know, we did a, a good chili the other day with some homemade sourdough.

Right.

So, you know, it's all about, all about what's in season, but also sometimes you just gotta cook with, with what your heart tells you. So.

Yeah, soup and chili season, right? Indeed. That's awesome. That, by the way, the group we went down to Italy with was primarily a group of older women from Charleston, South Carolina. So, yeah, a lot of Southern bells.

Yeah. Let's talk about your background though, a little bit. There's one other question I have I am pretty curious on. So you also, after deciding culinary being a chef wasn't going to be your thing, you went and got a degree in finance, as did I. And I've always said if I knew I was going to get into employee benefits going out of college, I would have gotten two degrees, finance and psychology. Because I believe you have to know numbers and you got to know buyers, you got to understand people. How has your finance degree impacted what you do today?

It's both impacted and not impacted. Right. So to your point, right, you have to know numbers. I think more importantly than knowing numbers is the ability to explain them. Right. Which often is what, what you could summarize as psychology or you could summarize as economics. Right. Finance is typically, again, why does one plus one equals two. Right. And economics is much more of both a psychological aspect, a sociological aspect and what have you. And we look ultimately at employee benefits or kind of the general greater ecosystem. It truly is a supply and demand function. Now, there's a million different ways in which you would describe that, but at the end of the day, many times the numbers do lie in this space frequently. And they're also very, very difficult to predict. But when you can understand some basic supply and demand as well as risk selection, you know, you can, can make something different here, which is really what we've tried to do.

Yeah, it was a great jumping off point because I was going to say we operate in an industry where one plus one can actually equal whatever you want it to be. Right?

Yeah, very true.

We're sitting here going, no, no. One plus one equals two. And the system's going, no, no equals nine. It equals nine. Look at that. Anyways, let's talk about Angle health. Yeah. As I said, I have several clients working with Angle today. Very pleased for the few folks who might be tuning in who are not aware of what angle is. You describe it as Buka plus without the buka baggage. And I really like that. Go into that a little deeper if you can.

Yeah, definitely. So we take a big step back, right? Angle was founded by two former Palantir engineers who largely worked in the Department of Defense space as well as healthcare. They saw just how fragmented the data stacks are across large Buka players. And oftentimes you think of the frustrations that we all face in this industry with legacy incumbents is why is it so hard to just get an ID card, right? Why is it so hard to get a claims report? Why does it take three weeks to get a quote? Right? And to some extent, you know, it's like moving ultimately a container ship, right? It's very, very difficult to do. And one thing lives over here and another lives over here. And, you know, certain places are paying claims on DOS terminals. So the idea was how do we rebuild this from the ground up and ultimately vertically integrate our data stack across the risk piece, the claims paying, the underwriting, etc. And so what we sought out to do ultimately with this Buka plus concept is how do you again, give that familiarity, right? That which we are all kind of expecting, right? We often say that employees don't have bad benefits, they have bad benefits experiences. And a lot of times it's a misalignment of expectations and reality. But also, I would argue the same thing happens at the. At the broker level, at the employer buyer level. And so we've sought to, again, how do we marry both worlds of something that is consistent and familiar, right? A fully integrated data stack, the claims payer. That again, is one in the same. And how do we also bring about the things like multiple network, national network choices and PBM variety and custom plan designs, what have you, and bring it all back together and candidly in a package that just works, right? And in an industry when things so oftentimes don't work, that's really what we've sought to do rather than reinvent how people access health care, which is where 90% of our, you know, competitors that are entering this space Sit. We want to deliver, again, the familiar, but deliver it better.

I love that because that, you know, I think one of the biggest challenges brokers have in this industry is when you try to implement too much change, even if it creates a positive result financially. If the experience isn't what they thought it would be, you're gone. Yep. And I would love to hear your definition, because I love how you just said what you said. Bad benefits aren't the problem. It's a bad benefit experience. And that goes both ways. You may think you have created an amazing plan for a client, but if the employee experience sucks, the plan sucks. So talk a little bit about how you guys. What is. What is a bad experience? And then based on how you guys have designed what you do, what would be a good experience?

Yeah, you know, I think a bad experience, truth, Truthfully, again, is one that doesn't meet the expectations of whomever's using the benefits. Right. And so it's. It's not fair to say that bad benefits experiences equals a distaste for prior authorizations or, you know, a distaste for, you know, having to ultimately utilize a biosimilar instead of a brand name. A bad experience could simply be a member expected to have a copay, and now they have a deductible. Right. So simply because the way in which a provider verified eligibility and verified benefits and, you know, to that point, we often say that we can't solve everything in healthcare. Right? We can't solve what happens behind the desk at that provider's eligibility office. We can do ultimately, again, is provide a pathway for easy and consistent answers and provide quick and easy resolutions. Right. Because in the end of the day, we can only control so much. And that's, again, where we seek to deliver that elevated experience. Because in the end of the day, healthcare is difficult, Right? Well, is hard.

And I think what you guys have nailed is, you know, I've had a lot of conversations with clients and prospective clients alike in the last three to four months where it's not uncommon for them to say, man, we just lost a group. We just wrote.

Yeah.

And when I hear that, I'll instinctively ask, did you win it on a new idea? And almost every time, it's, yes. And I'll say, that's your problem. You haven't built enough trust yet. You just brought a new idea in which comes with expectations. And the only expectations that matter are the clients. And if their expectations aren't met, without the trust, you're gone.

Well, and I think to add to that Andy. Right. Many of these new ideas that are brought to bear are brought to bear to drive savings. Right. Very rarely is a new idea brought to bear that says, hey, this is actually going to cost you 5% more, but is a much better experience. Right. Unfortunately, in the employer sponsored healthcare space it operates as a commodity, which means that many times our buyers are price driven first and noise driven second. Which is why solutions like reference based pricing, despite the noise, but when properly sold can be implemented. But I do think there's the idea of new ideas. In my opinion, 9 times out of 10 are brought about to solve price concerns and less brought about to solve experience solutions, et cetera, concerns.

Love that. And the only experience that matters is the employees. What I think you guys have nailed though is the fact that you operate like a level funded plan, but you still give me a lot of the access a Buka might give me. So in order for me to make a change to angle, it doesn't require a lot of changes.

Right.

And I think that's important for the audience to hear.

Yeah, yeah. I mean, I think in terms of, again, if we come back to the idea that employer sponsored healthcare is a commodity, well, you know, take any other commodity, right? A coffee, tea, spices, what have you. Right. In the end of the day, coffee is coffee. Now, you know, there's better coffee, there's worse coffee, what have you. But the experience in general is largely consistent from the actual consumption. And that's really what we believe. You know, healthcare should be the same to make that ease of transition, Right. If it's not, if it's radically different, many times that cost of that change, management is lost and that cost oftentimes isn't felt until you're 11 months into a contract and wondering how do I possibly get back to a Blue Cross contract, quite frankly.

Yeah.

Well.

And to that point, going back to the employee experience, if you implement a bunch of changes but in your head they are the right changes, they could have a positive impact on this plan and the employees and the cost once employees start complaining because it's different again now the quality of the plan is in question. Yeah, and, and what I, what I, how do I want to say this? What I love what you guys are doing is the ease with which you are making it for people to make that change away from the fully insured market. You know, when you look at the spectrum of options when it comes to financing a health plan, you've got a fully insured plan, maybe implement a health reimbursement arrangement and Then you go to level funding, partial self funding captives and then up at the end of the spectrum are people like Walmart that are their own plan. Right.

I think in the space you guys play, you guys work all the way down to five lives right up to about 150 is probably that, that sweet spot.

Yep.

There's, you walk into a 50 life group thinking you're going to implement a bunch of reference based pricing and a bunch of these outside the box ideas. The, the, the percentage of the market that is ready for that in that space is so small. Definitely you have to have that easy first step. And that's what you guys are.

Not only are we that easy first step, we're also that, that solution to the Frankenstein health plans that sit in the market. Right. Whether that be, you know, the expert broker consultant that has all of the right intentions and is building this health plan Solution with a TPA at the center and 15 mobile apps around it, or whether it be again, a number of these sort of what we call more health plan marketing organizations of kind of these cobbled together solutions that again have the best intentions but in the end of the day are so complex, the employee simply just uses their plastic ID card because that's all they know how to use. That's all they've remembered. And they had one open enrollment meeting where they were educated for an hour that their spouse didn't attend that again wants to use their plastic ID card to access the benefits they want.

Well, and let's talk about, you know, we, we talked offline about there being a lot of white label solutions out there now, right. Where they may have cobbled together a bunch of different types of solutions, white labeled it, given it a name. You said something I'd love for you to expand on. I was saying to you the, the challenge I see with that and it's frustrating because I have clients dealing with it. A lot of these white label solutions start with good intentions, of course, but then I see two problems coming in. One, sometimes the revenue becomes the North Star. So they start making bad decisions for the sake of revenue or they just can't handle the level of scale they're experiencing. And then the wheels fall off and the problem is the brokers left to pick up the pieces.

Always.

You brought in a third challenge, you see, and I'd love for you to talk about that. Cause I thought that was interesting. I did not think of it.

Yeah, I think, you know, the third challenge that we see right. Is at the end of the day we're in A risk bearing market, Right. We're looking for individuals that are, you know, trying to solve different ways to finance healthcare. Right. And when we think about the self funded or self funded adjacent spaces, right, we insure the employer who insures the individual. But Bob, who started his plumbing company 40 years ago and grew it to 50 employees, never thought he'd be running an insurance company. Yet as soon as he signs onto that ERISA plan, he's now running an insurance company. And so ultimately, when it comes to this market where you have to finance this risk, a lot of these cobbled solutions again are seeking A, how do I drive that next top line dollar? But B, how little margin am I willing to accept in order to drive that next top line dollar? And because of that, again, while built with the best intentions, you can't operate on razor thin margins and still deliver an exceptional product and exceptional service. Especially in the case when again, you aren't the TPA many a times in these cobbled solutions, you aren't the risk bearer.

Right.

You are the architect. And that ultimately means that everyone else has to meet their marginal intentions as well. And that's where I think the wheels fall off so many times.

Yeah, well, and let's talk about this because I think there's two things you're solving right now that many advisors have when they're helping their clients make changes. One, a move from fully insured to any other financing arrangement typically comes with underwriting and apps. And, and that can be the bottleneck that keeps a group from looking. And two, to your point, when they built these Frankenstein plans, because there's a lot of advisors who like building and picking, but after five times, five clients, doing that with your administrative burden is so heavy that you just bottleneck your scale because now you're spending all your time with these plans you've built. Talk about how Angle Health has solved both the underwriting needs and the medical applications and the bottleneck that presents as well as the administrative burden often put on an advisor who wants to build the fully unbundled Frankenstein type plan.

Yeah, well, you know, from day one we engage with an advisor. You know, our intention is not necessarily how do we grow our business, right. It's how do we grow their business. And so every single quote that comes through the door a with simply a member level census, we're returning our healthcare scorecard, right? That healthcare scorecard is telling the broker everything that we see that's going on in our precision risk underwriting.

Right?

It's the conditions, the drugs and what have you that typically a broker either would a have to subscribe to a service that candidly is very expensive for underwriting, whether that be a gradient, a Milliman curve or you know, insert the next kind of great underwriting tool out there. And then they'd also have to figure out a how do I distill this information and package it up to any given client. So why we start there, Andy, ultimately is we want to see every single quote that a broker is going out to market with because we want to also give an indication of hey, don't go get those health apps, right? If this is a very poorly running group, don't spend the time to get an illustrative quote and go get a health app. On the flip side, it's a well running group, right? And it's a group that we like the risk on. Well, here's a quote that you can go sell tomorrow, right? You can go sell it tomorrow, it's firm and it's ready to be sold. And oh by the way, it can be implemented in 48 hours with digital ID cards. And oh by the way, you know, 70 to 80% of our clients renew with single digit renewals. And all that comes back to how do we simply put more margin on any given client for the average broker, if it takes three hours to market a client and you can do so in 15 minutes with us, that's significant time back. Time for your family, time for your hobbies, or time to grow your business. And that's really what we're so hell bent on is how do we deliver a higher marginal product both in working with us and the clients that we onboard together with our broker partners as well as the additional value that we can provide a broker across their book of business.

So if you're willing to share, I'd be curious because initially my head goes right to, I'm going to guess a lot of that is being supported via AI. How are you guys using AI in that process to make that so easy? Because you know, I hear as an advisor you told me, you know, within can be implemented in 48 hours. I believe quotes can be turned around in less than a week. Like this has been the bottleneck for so many advisors trying to move somebody away from fully insured plans. Where does AI come into that? Because that's gotta be a big piece of that.

Yeah, so. So we're an AI native company, right. It sits at our core foundation. So from, from go, so to speak, the underwriting component of it is you leveraging a number of different Algorithms that we've built to actually access these data sets. Right. And we could speak for hours about the overly homogenous approach to underwriting that sits in today's market with everybody using the same tools and everybody using the same outputs. What we've done differently here is we've looked at all of these various tooling and solutions out there and leverage them as data brokers. Right. And looking at the underlying data sets, and then we're able to ultimately, again, apply AI, which is great at taking oftentimes, you know, highly vague, vague signals and deriving conclusions from it. And that's really what our underwriters spend most of their time on. Right. A traditional NGU or carrier has underwriters that are looking at the individual quote, the individual health app, what have you. Our underwriters really spend a lot of time focused on how do we further codify our underwriting process. And that is, again, how do we further train AI to make those decisions, not only on pricing, but on risk selection. And in our, our viewpoint, those are two very different things. Pricing versus risk selection.

Yeah.

But at the end of the day, I'm going to keep coming back. It's allowing you to help advisors get things done, in some cases minutes or days, in what used to take weeks or a month completely. And that is, I was just say, the one complaint I hear, Caleb.

Yeah.

Time and time again from our clients that are trying to move a client away from the fully insured model is. Has always been everything was going well up until the point we needed underwriting and we needed medical apps, and that's where it stopped. Yep.

Yep. And it can go as well as you want. But when you have a smaller employer that's never completed health apps, the first question is, why am I telling you, Mr. Mrs. Broker, or why are my employees that have never met you, Mr. Mrs. Broker, spilling their guts quite literally. Right. On paper, for what is going on with them in a world where everybody is more concerned than ever about data privacy.

Yeah. What would you say? I'm curious, because the other thing that's very intriguing for me is, number one, you make it very easy to help advisors move clients away from the fully insured model. Again, described you describing yourself as BUCA without the BUCA baggage. BUKA plus without the BUKA baggage. There's also some cost containment built into what you guys are doing.

Of course.

Talk a little bit about that because again, smaller the group, the less options they often feel they have with it. What are some of the cost containment initiatives that we can Find inside angle health.

Yeah, so it's, it's again, kind of comes first and foremost, comes back to where does, where does AI start sort of play. Right. One of the things AI is great at again is taking a lot of sort of disjointed information and deriving conclusions from it. You know, when prior authorizations first came out or even pre certs. Right. Is the silver bullet of how do I stop a high cost claim and or how do I manage a high cost claim into a potentially lower cost outcome? Well, so many of those solutions that have come to bear in that market, again, wait till that point of prior authorization. If you're submitting for a prior auth, the last thing you want to do at that point is be told you can't go to the doctor, you can't go to the facility you want to go to. I need you to go down the street. Right. Well, ultimately what we have built is an identification model that allows us to engage much sooner. Right. Than that point of prior authorization. And where we feel that again, many times cost containment and the adjacencies break down is in the lack of trust. Right. In the end of the day, consumers don't trust their insurance because they feel that insurance is always, so to speak, in it for themselves. So building that trust on the front end is where again we first start. And then offering those solutions, such as international sourcing, access to foundational programs. You know, we're rolling out additional solutions next year around infusions and ambulatory surgery centers and more, again, giving members access to care, quote, unquote, beyond that plastic ID card, but still making it feel so very familiar. And again, a more trusting solution than simply telling the member at the time which they want to get their surgery done. You can't go where you want to go. I need you to go across the street.

Yeah, well, you talk about the, the lack of trust from the consumer. I mean, if you don't think that's a reality, go listen to a Joe Rogan podcast. I've heard him say several times, health insurance sucks. It doesn't cover anything. And he's got hundreds of millions of followers. So the lack of trust for health insurance right now, I would say is at an all time low, which is why we have to do a better job building plans that are built for the member, not for the bottom line. Yeah, so what I'd love to hear from you as we start to bring this to a wrap. Caleb, we got a lot of advisors listening in.

Who is a good fit from the Advisor side of the equation. Who would be a good fit for a program like Angle Health? If I'm a broker, what should I be looking for?

Yeah. So, you know, first and foremost, I would say, you know, we are contrary to the market perhaps of non booka solutions in that we work across the spectrum from independent solutions, independent brokers, all the way through to, you know, consulting firms. And some of that comes back to that Vuca plus sort of familiarity as we think about clients that really fit Angle. We don't have SIC code restrictions. We waive participation requirements, and we at the end of the day care about the risk of the enrolled population. And because we're able to do, again, a risk underwriting profile at the member level, which differentiates us from others.

Our answer is, you know, everyone could be a fit. Um, and we are so easy to quote. Simply quote it. Right? Simply submit a quote whether you have no intention of ever selling it. We're gonna give you a health scorecard. And perhaps at some point, right, as long as we're at the dance and we're, you know, available, some point, we'll probably dance together. And so to that we just ask, give us. Give us a shot. And don't even give us a shot with the intention of, hey, give us a shot to sell it. Let us show you again what makes us different. And let that start in the quoting experience.

Yeah, that's a good way to go. Go in with the assumption they're happy with what they already have. But give us a look and we'll see how it goes from there. You know, we're recording this on Halloween. It'll probably go out. When people are listening to this right now, it's probably early November, maybe the second week of November. Given the speed with which you can turn stuff around, we know we have a lot of January 1st renewals. I'm an advisor listening in. And let's say it's November 10th. Between November 10th and November 15th. Do I still have time to put something together here with you?

You have plenty of time. We'll take. We'll take our last January 1st group on November. On January 10th.

Repeat that.

So we will take our last January 1st group on January 10th.

Interesting.

And again, we have the ability to do that because we can turn quotes in minutes. We can install groups and hours. So as long as the expectations. Again, this does come back to expectations. I have no magic way of taking a group on January 10th and giving them a plastic ID card 10 days prior. Right. But can we get them installed? Can we get rates. Can we get digital ID cards? We can do all of that. And we have, and we will.

And I'm going to make a sales pitch for you as a former advisor. Guys, this does not mean you send them your bad risk. Terrible, terrible loss ratio. Hail Mary, can you help me? This is for the clients who are ready to move forward and have a good risk. Don't be sending them your crap and hoping he creates magic out of it because I know what you're thinking. So that's amazing. January 10th. You can still submit all the way up to January 10th. Wow. So there is still plenty of time.

If you're listening to this right now and you've got some clients renewal, client renewals that are just ugly right now. Which, by the way, Caleb, I'm hearing that across the board fully insured unapologetic renewal increases that carriers are just hammering people.

Yeah, yeah. We see it every single day in the conversations we have. But I would also add to that, Andy, that despite again, all of the high renewals out there in the market and every risk bearer always says, hey, give me your good risk groups. Truly look at us as an opportunity as well for a health care budget reset. Right. We will come in undercurrent on good risk groups. We will provide that opportunity to get out of a risk pool, to get out of trend renewals. And so to that point, again, give us a shot and I think you'll be happy with the results.

Yeah. That was awesome. This was a great conversation. Caleb. If, if, if there is an advisor tuning in, who's saying, all right, I didn't realize I didn't know much about angle health until this conversation. What would be the easiest ways to reach out to you or reach out to angle health if they've got a client or two they want to get a quote from?

Definitely easiest way by all means is is our website. There's a contact form on there. We have an email address. That's simple sales saleshealth.com and I'm personally available@calebclebanglehealth.com so reach out are happy to get people where they need to go.

Great, man. I wanted to have you on because like I said, we coach enough people who are having a challenge right now moving people off fully insured. They want to but just the path to that can be difficult due to underwriting or medical apps and stuff like that. So you guys have made it not only easy from that standpoint, but the speed with which you turn to numbers around, that's another thing I'M hearing a lot from advisors is just it takes so long to get quotes these days. You guys can turn those around really fast. So that's why I wanted to have you on. If you're listening in and you are that kind of advisor right now that benefits advisors trying to find other, you know, give your clients other solutions. Check Engle Health out. Caleb, thank you.

Appreciate it. Thank you.

Everybody else, continue to have a good renewal season. Stay sane. And like I said, if you've got a few clients that you think are performing better than their carrier is telling them, go to Angle Health and get some numbers quick. Be good.