300 - How Emotional Intelligence Can Transform Leadership in Healthcare with Ethos Benefits' Chelsea Ryckis

Welcome to Listening with Leaders. I'm Doug Noll, lawyer turned peacemaker. I teach executive leaders how to listen to emotions rather than words so that they can become the leaders everyone wants to follow. And I teach those same leaders how to be authentically present, available, and connected to their families despite being insanely busy. I have learned that we are 98% emotional and only 2% rational. Learning how to listen to emotions is, in my experience, the foundational skill of life. Stick around to the end of the show and I'll reveal how you can be on our next guest in 15 to 20 minutes. So let's get started. Chelsea Rykus, welcome to Listening with Leaders. You are the co-founder and president. Your husband's the CEO. Of a company called Ethos Benefits, and the website is ethosbenefits.com. Welcome to the show.

Thanks for having me, Doug. I'm excited to be here and to share.

I love doing Zoom calls. You got a little dog behind you.

I know. I was like, everything was perfect and quiet, and then—

Don't worry about it. I've got dogs too. It's all great.

There he is right there too. He actually, funny enough, he attends like business meetings. So our clients know and love him across the country.

So, well, there you go. Why don't we start off with a little bit about your backstory? You're based in Florida. Canada. I think you said you're in Puerto Rico right now, but tell us a little bit about yourself.

So I'm actually Canadian, and I came to the U.S. on a softball scholarship back in the day, a Division I. And my first interaction with the American healthcare system, which I now work in, uh, was when I suffered a traumatic brain injury. So my senior year of college, I was hit in the head with a softball, cleared to play too soon, and unfortunately had to defer medical school, go back to Canada, entered a brain injury rehab program for about 8 months. And despite leaving the U.S., the medical bills followed me. And so that was when I experienced what 1 in 12 Americans experience, which is crippling medical debt in the face of a very horrific injury. And it was a very difficult time in my life. And it's what really inspired me to do what I do now, which is to— I'm doing my best to disrupt the American healthcare system one employer at a time because over 180 million Americans are relying on employers for access to healthcare. And they've been told a really big lie that there's nothing they can do to control the cost. And it's simply not true. And we dispel that myth every day.

Okay. So this is an interesting topic. You're a disruptor in the healthcare business, which probably needs some serious disruption.

To say the least. Absolutely. It's a very antiquated industry. It's a huge industry, but what we're really focused on is when an employee goes to a company and they're offered an employee benefits package for attraction, retention of talent, usually that health insurance piece is one of the top decisions that talent is considering when they're looking at employment. Opportunities, right? Interestingly enough, employees are very rarely happy with their health insurance. Yet employers, it's the number 2 or number 3 expense for them, usually second only to payroll. So it's this really interesting conundrum where employers are very frustrated because they're paying so much. It's out of control. Every year it's going up. The people that they trust to bring them solutions are telling them, hey, this is just what it is. It's trend. It's COVID. It's whatever, enter excuse But really, if you were to look at the system, it's working exactly the way it was designed, which is for everybody advising employers to make more money when they pay more money. So inherently, the system has all these incentives, and that's what's driving up cost. So employers are by people that are making a lot of money off of them believing it.

And so what is your company, Ethos Benefits, that you and your husband founded? What— how does it disrupt the field?

Sure. So the number one conflict of interest when it comes to the way that employers are making decisions for their health insurance, which remember is impacting every employee and all of their families, is with a broker generally, right? They're trusting somebody to bring them options, help them consult, implement, and execute a benefits program each year. If you look at the way that traditional brokers are paid, they are paid commission, right? That means when premium increases, compensation increases, right? It's an inherent conflict of interest. Not to mention, if you think of brokers, they really are— should be considered sellers' agents. There's not— they're not buyers' agents, right? They're— they should be consulting the employer, sitting on the right— the same side of the table as them, but they're paid from insurance companies, so they're motivated by bonuses. By trips. And when you look at the language, the fine print in these contracts, they are heavily incentivized to position employers to renew as is with the existing carrier, massive bonuses. So the way that we entered the industry 10 years ago was as fiduciaries. My husband took what he learned with his securities license as a 401 advisor and said, you know what, employers are getting sued. For mismanagement of funds at a very small level in 401s, the mismanagement in health insurance plans is rampant. And soon people are going to be focusing here. And now we're seeing it. We're seeing employees suing employers every single day because of health plan decisions. So we've just essentially taken a fiduciary approach. We do not take commission. We do not take bonuses. We do not take trips. We simply work for a fee the same way that you advise you pay CPAs, attorneys, like you were like that.

Mm-hmm. And so companies hire, they engage you as a professional, and then what kind of services do you provide?

Yeah, so usually what we're doing is we are consulting them, learning about their culture, learning about their finances, their cash flow, learning about what works with their benefits, what doesn't work with their benefits, all about their employees, the way they like to be communicated to, their specific needs for their population, where they are in the country, all of that. And we take all of that information, and we work it into what we call an alignment proposal, which is essentially we're going to be looking at the financing of a health plan. So the way that we— that same concept of the way that we're paid, right, in alignment with the interests of the employer, we take that same concept of alignment and transparency and we apply it to the entire program. So we're only going to be hiring vendors in the health insurance plan that are transparent, that are also fiduciaries, where every single piece of of the puzzle, if you will, of the benefits puzzle, is designed where these vendors win when the employer wins. So we bring this proposal to the employer. It's generally 30 to 40% less expensive than what they're used to seeing because all we've done is eliminate the fraud, waste, and abuse. Uh, it's like this super simple concept, but when you look at the way that the healthcare supply chain works, hospitals, pharmacies, brokers, insurance carriers, they want employers to pay more. Nobody— premium is revenue to them. Nobody wakes up in the morning wanting to reduce revenue, right? So no one's going to come to an employer to reduce premium. So it's essentially about designing a program where we take that element of transparency and fiduciary and we put it throughout lower cost. And then the really cool outcome is that most of the time people assume because they've been taught this by brokers, if you are decreasing premium, you're probably decreasing benefits. Or you're increasing deductibles, you're increasing out-of-pocket. That's— it could not be further from the truth. Every plan that we design is like significantly lower deductibles than the national average, significantly lower premiums. We do free cancer treatments, free specialty drugs, free outpatient surgeries. You can do that when you eliminate all the fraud and the waste and the abuse within the plan.

I would think that you would have 1,000 million companies stampeding to your door.

And it's really interesting. So we have grown a lot over the last 10 years and this concept of transparency. It's funny because it's become a buzzword in the industry, but it really is. It's a very— the education process takes some time, but once employers, HRs and CFOs, they understand that I might love my broker, I might go golfing with them once a month, they might be my cousins, uncle, whatever. But this is a business decision and this is no other program in my company will impact the financial, emotional, and overall wellbeing of my employees more. So there's also this added layer of complexity recently where Consolidated Appropriations Act of 2021, it's a new law that it's essentially the same way that employers are fiduciaries of their 401, they're now fiduciaries of their health plan.. And they actually always have been. And this is where all these lawsuits are coming from. So Wells Fargo was just sued by their employees this year. Johnson Johnson was sued by their employees. The MLB, Aetna, like everybody is getting sued because, and get this, this is what's wild, Doug, they're getting sued for picking Blue Cross. And it's like one of those concepts in business where it's like you just assume, okay, bigger broker, better solutions, bigger carrier, more protections, better benefits. None of that thinking is going to yield good outcomes when it comes to health insurance or benefits.

Wow. So what— I don't want to get a digression off into the lawsuits, the litigation, but yeah, for sure. But basically the litigation, the basic claims that employees and their counsel are making is that you selected Blue Cross. You didn't do your due diligence to figure out what's really out there. Blue Cross is just one of the biggest and most easily available. And Blue Cross provides crap coverage that doesn't provide for my pre-existing conditions, and you're liable because you're a fiduciary on this.

So the concept of that is accurate, but it gets a little bit more specific because it's be— on these lawsuits this year at least are specifically talking about the pharmacy benefit manager within Blue Cross.

Okay.

So within a health plan, let's say it's Blue Cross United, whoever, there's 4 pieces. There's the pharmacy benefit manager. That's who's determining the prices of scripts, what's covered, what's not from a drug perspective. You've got a network, PPO, HMO, blah, blah, that kind of thing. Side note, you don't even need a network, but that's a conversation for another day, right? I have a TPA. That's who's processing the number on the back of the card, talking to your providers, right? And then you have the actual insurance piece, which is stop-loss insurance. So that is every single health plan, whether self-funded, it's Blue Cross United, every health plan is the same thing. Now, what's interesting is when Blue Cross is running everything, they pick those 4 entities. And guess what? They usually own all 4 of them. Of course, right? Yeah. So they're taking spreads off of the top and that's where that fraud, waste and abuse is coming from. When we design plans, we are marketing those 4 pieces out to hundreds of carriers, hundreds of vendors, and we're able to let capitalism work and the costs go down. Right. So what happens in these lawsuits is the Blue Cross is not incentivized because they own the PBM for— or United, all of them. Nobody's incentivized to lower the cost of drugs.. So for example, an HIV drug, the Johnson Johnson employee, it would be $10,000 to access this drug for HIV charged to the health plan when the cash pay price at Walmart, $73. Yes, there's an MS drugs, there's a whole list of them. If you were to actually read the complaint, like it's insanity. The markups are over, it's just wild. We have a lot of examples of it, but it's specifically focused on breach of fiduciary duty, lack of prudence in decision-making for the pharmacy benefit manager. How is it possible that a company with 240,000 employees is paying 10 times what a cash walk-in at Walmart would be?

That's crazy.

Yeah.

So this is really exciting.

Yeah, it's fun.

So let me ask you a broad question about yourself personally. What is it? You've been doing this now for 10 years. Obviously, your business is successful and growing. What is it that gets you up in the morning and gets you really excited to go to work?

So funny. I always thought that I really understood my why, but just recently I've really had another kind of epiphany on it. And it's this, it's what gets me up in the morning is giving people back their power. So I've just always lived by this concept, whether it was my brain injury or I've had things happen to me in my life where it's like, resilience needed to happen. Like I needed to keep going. I had— I didn't have support, didn't have whatever, and I just kept going. And I love the idea of being able to educate employers and employees every single day that you don't have to be a victim to the crappy healthcare system that we all agree on isn't delivering what it's intended to do. And through the process of education, like empowering people to take their power back one employer at a time, one, one employee decision at a time. That's what gets me really excited is the process of empowering people.

How do you out— how do you do your outreach to potential clients?

So it's been really interesting because we've produced a documentary that's going to be on streaming platforms next year. It's called It's Not Personal, It's Just Healthcare, and it's essentially an exposé skimming the surface. We skim the surface today, but it's a deep dive for employers, for HR, CFO, showing them, hey, this is where these costs are rising and this is how you can get out of the mess that you're in. And We've taken that on the road. So we've been doing premieres all across the country. We speak at conferences almost once or twice a month. We write articles, very much kind of thought leaders and education first is my personal motto. So through the process of educating, we tend to get a lot of inquiries, but the documentary has been a huge tool this year where we're just sending it to employers to watch and then they're calling us after and saying, hey, can you take a look at our program, please?

Don't worry about it.

We have situations in which employers, for whatever reason, they are tied into a relationship with their broker that they're not willing to leave, but they have come to realize their broker doesn't know how to basically take them to this next level of transparency and sustainability and premium. So we will either consult on the actual program itself and just be paid as a consultant, or we'll teach the existing broker how to do it. So there's a lot of different ways that we can help employers, but essentially it just comes down to asking every vendor that you partner with, how are you paid? When are you paid? Why are you paid? And if you can start to align those questions throughout your entire benefits program, you'll very quickly see a reduction in premium and much happier, healthier employees.

Wow. So what is it you think, Chelsea, that's unique about you that you bring to this whole project that has made it so successful?

I think having gone through the brain injury and really feeling so alone and desperate in that process and not even understanding I thought I had insurance. Wait, I have a $5,000 deductible? I'm 22 years old. What does that even mean? Not having anybody to call. We really pride ourselves in our business on our advocacy. So I have a big team of advocates that they walk every employee through the hardest moments of their life, whether it's via text message, over the phone, over email, whatever, however anybody wants to be communicated with. But we will set appointments for employees, we will negotiate hospital bills for employees, we do the types of things that brokers consider not to be profitable because they're selling a product. They're not consulting. So that's what I think is the— my background of just being so a victim to the American healthcare system and now being able to offer people a way out of that at both the financial employer level and the healthcare delivery where the employee's actually experiencing the benefits.

Wow. So you offer services, patient advocacy services.

Oh yeah.

Or so if an employer signs up with you, that would be within, of course, the scope of the engagement. But one of the services you offer is patient advocacy skills. So if an employee has a problem, that the employees can call one of your people and they'll guide them through the process and help them and that, and negotiate and navigate with them.

Absolutely. And it's not a 1-800 number, right? It's, it's truly, we get text messages all day long. Hey, I need to set an OB appointment and I'm in this zip code. Can you help me? Or I received a bill from the hospital. It doesn't look like they billed insurance properly. We'll call. I'm at the doctor's, they're saying they don't take our insurance. No problem. We give them a call. Okay. Yeah, they, we had something over the weekend where it was a 911 emergency, a text message. They're like, this employee's at the pharmacy. They're not taking our insurance. They're not taking our insurance. So one of my advocates calls and they were just spelling the lady's name wrong. Like it's stuff like that, right? Where every single day this the systems, if you think about the financing of healthcare, the insurance, meeting healthcare delivery, the actual consumption of healthcare, it's the two most complex systems I would argue in the entire world. And we expect employees, minimum wage, whatever it is, busy people, single moms, all to figure this out. No, the advocacy piece is honestly, I feel like our strategy and the multi-year strategy is huge. But none of the innovation and transparency and doing the right thing matters if people can't actually use it, right?

So, wow. So this show is called Listening with Leaders, and as I told you before we recorded, I'm a lawyer turned peacemaker and teach a unique set of listening skills, and that's why I'm always interested in listening skills. You obviously are a good listener. Where did that come from?

I think my mom. Yeah, it's funny, I was like, there's got to be some big business coaching I've hired A lot of coaches over the years have poured into our leadership and our development, but my mom has just always been such a great example of what it means to be a listener. And I'll be honest, early on in my leadership journey, I didn't listen to listen. I listened to solve the problem that I wanted to solve, which I think a lot of young leaders do, and just fueled by pure passion and grit. And then you get to a point in your career where it's okay, I really need to take a step back. For me, this was about 6 years ago. Take a step back and reevaluate, like, how am I showing up for others every single day? Because ultimately I can grow the most successful benefits agency that's doing the right thing in this country. But if— but what's more important to me is like the people that I'm doing it with, and I need to listen and understand and be able to motivate them every single day. And you can't educate and empower people to not be victims and think differently if they don't feel like you're truly listening and you truly care. So I I think, um, the last thing I'll say about this story is just presence is the biggest gift that you can give others, whether it's your team, your employees, your— the people you serve, your clients, your partners, your husband. Being present is the— is, for me, it's equal to listening, if that makes sense.

I think it's— I think they were one and the same.

Yes, exactly.

And it's so hard Unless you're trained, unless you're taught, or you learned it at the feet of your mother, really, unless you're taught how to be present, it's a skill that has to be learned and mastered. Listening to validate other people, I call it listening other people into existence. That's a skill. It's not something you just intuit how to do. In fact, what I teach is so counterintuitive and counternormative, you would never figure it out on your own. Yet to your point, when people feel heard and validated, And they feel loyal and they— there's trust and intimacy and all these beautiful connections that occur that we wanna have happen because one person has taken the time to listen to another person.

That's it. And it starts— for me, it starts with having hyper-awareness around the thoughts or the physiological responses that I get in a, in an interaction, right? Whether it's with my husband, who's my business partner, or a client or a prospect, it's being hyper-aware of, oh, that didn't feel good. What is it about the— what's the brutal truth in this situation that is not allowing me to really listen and understand them? Why am I putting my spin, my story, my lens on this situation? Like, my background, my experience isn't— doesn't actually matter. Like, what's reality? And learning how to remove— it's almost like removing these sunglasses, right? That's— for me, I have to literally visualize this sometimes so that I can listen.

Exactly. Yeah. So two things happen. One, people often don't listen, or they try to problem solve if they are not present because they're focusing on their own unconscious anxiety around the situation. So learning how to become aware of and manage your own anxiety becomes extremely important. Second thing is that understanding how to listen to emotions. The emotions come in 7 layers, starting at anger and ending with abandonment at the bottom.. And when you can put these emotions into this matrix, they become accessible because it's structured data. I teach people that emotions are data, just like numbers in a spreadsheet. And once we understand that it's data, then, and we can organize it, then all of a sudden, to your point, you're watching somebody, they seem discomforted, they seem unhappy or upset or something's not right. It's very simple to just access the database and say, oh, You're really frustrated. You feel disrespected. You're anxious and concerned and worried and you're sad and you feel unloved. And you just go through the layers and, and it becomes a very simple process to be able to be with people in a very safe, present way. And the other thing is that we all experience the same emotions. Yeah, we all do. I did a webinar last week or a week, the week before Thanksgiving, and I took a statement I think I did 3 statements, one around abortion, one around gun control, one around immigration. And so Cousin A says at the Thanksgiving dinner, I can't believe that the government has taken away my rights as a woman to control my own body. And Cousin B says, wait a minute, what about the unborn baby? It's murder, right? Classic statement. So then I, in the webinar, I say, all right, what are the emotions that Cousin A are experiencing? Anxiety, frustration, anger, disgust, disrespect, not being heard, not being appreciated. Great. Now what are the emotions that Cousin B are feeling? Exactly. Angry, frustrated, disrespected, not being heard, unappreciated, being anxious and concerned. Exactly the same emotions, right?

It's funny when you're in an argument, or— and I wouldn't even say argument, but just any type of conflict, right? It's the— each of us are usually experiencing the exact same thing.

Yes.

And it's like the, the need to be right oftentimes is— needs to be dropped, right? I always imagine a rope, and especially when in a business partnership and you're pulling one way, pulling the other way, and it's just drop it, drop the rope. And guess what happens when you drop the rope? You can just— let's focus on the facts, let's focus on reality, and let's agree that we're both feeling hurt or unheard or disrespected or whatever it is.

Exactly.

And from here, where do we go?

Exactly. De-escalate, then problem solve.

Yes.

And you're right. Too many people fight to be right.

And, oh yeah.

And you let, you're right. You just let it go. Let's not be right. Let's listen to each other. And then figure out how to make, then, then figure out how to make things right between us or figure out how to solve the problem or how to move forward.

It's funny, like even with years of executive coaching and therapy and all the things, I still, today I'm on a walk with my husband and, uh, we made an agreement to stop some of the vendor partnerships that we have next year in marketing. And they were ones that I had agreed to the year before. They were my babies and some of them worked, some of them didn't. Classic business life. And I just, I felt like a child, like my, I was aware of my emotions, but I was just like, I wanted to defend my decisions even though they weren't good decisions. And I'm sitting there and I'm like, man, you've done so much work and you still, I still found myself saying things that were out of alignment just to be right or just to make my ego feel a little bit better about maybe hiring one too many people for this one project last year, whatever it was, right? And it took me almost an hour to be like, okay, you were reacting this way. What's the brutal truth of the situation? The brutal truth of the situation is he's right and you're offended by it. And then just work through all these steps, and then I got myself to a place. But it's funny because some days I can do that in a minute, and other days it takes me an hour. I'm like, man.

So the trick is to pay attention what's going on with emotions. He did something that triggered you. Yeah. So you felt disrespected, you didn't feel heard, you felt invisible, you felt unappreciated and unsupported.

Yeah.

You felt worried and concerned, and you felt a little angry and frustrated, and that caused the trigger. But if you go deeper, you felt a little guilty and embarrassed because of his decisions, and you also felt sad and unhappy and a little disconnected from your husband over this. And at the end of the day, you were feeling abandoned and rejected and unloved and unlovable.

Accurate.

And that's what's going on.

Yeah.

Happens in every single conversation.

Literally every single one. And then I got myself to the point where it's okay, it was, it's a decision, it's not you. And there's that whole thing, right? Boundaries. And I don't know if you deal with a lot of people like this, but having my own sense of worth and self outside of my business, like I absolutely, I've poured different, we have different identities and our identi—

all our identi— identities identify who we are. The fewer identities we have, the more we're gonna be defensive and reactive. The more identities we have, the more resiliency we have.

Exactly. You pour your entire life into this cause of bringing better healthcare to the 181 million Americans who rely on employers for it. And sometimes when things happen in the business, you have to remind yourself, and we serve hundreds of employers across the nation. We have thousands and thousands of employees within our book of business. We've got an amazing team. And yet still I make it about me. And it's just, it's this classic founder conundrum, if you will. But yeah, something I'm working on.

Right. If we didn't have something to work on, life would not be It'd be boring, right?

And healthcare is a pretty big challenge. I think I've picked a lot of good ones.

Exactly. Chelsea, I've got one more question for you and then I'll let you go. Sure. What's one thing about yourself that we would never know about unless you revealed it to us?

Hmm. I have a twin brother in Canada and a younger sister, and my parents own a roofing business and I grew up working for them.

Wow. You're on the roof pounding nails into the roof?

So my brother was, my twin brother. I was more on the ground picking up the scraps, throwing them in.

Oh, okay.

And then when I got a little bit older, I was doing like flyer drop-offs and mailboxes sales really early on.

Okay. You grew up in a small entrepreneurial family and that set the stage for doing what you're doing today. Thank you so much for your time today, Chelsea. It's been wonderful talking to you.

You too, Doug. Thanks.

You're welcome. Doug Noll here. Thank you so much for listening to Listening with Leaders. If you are a successful executive leader who would like to be on this program, please visit podcast.dougnull.com/podcast. If you got something out of this interview, would you please share this episode on social media? Just do a quick screenshot with your phone and text it to a friend or post it on the socials. If you know someone that would be a great guest, tag them on the social media to let them know about the show and include the hashtag #ListeningWithLeaders. I love seeing your posts and guest suggestions. We are regularly putting out new episodes and content. To make sure you don't miss any episodes, go ahead and subscribe. Your thumbs up ratings and reviews go a long way to help promote the show and mean a lot to me me and my team. Want to know more? Go to my website, DougNoll.com, or follow me on LinkedIn, Facebook, and Instagram. That's @DouglasEnoll. Thanks for listening, and we'll see you on the next show.