115: Employee Benefits Tips & Tricks with Justin Miller

Welcome to DSO Secrets. I know what it's like to be an entrepreneur in the dental industry. I've had my ups and downs, just like you. There's so much opportunity to be excited about, but so few resources to get answers. From here on DSO Secrets, we get you those answers so you can change the lives you're meant to bless and achieve your personal success.

When I was working as an associate

rat at a school, I never imagined I could own these many practices with this amount of support. So thank you.

You have helped build my marketing mind

to a whole new level.

You have this natural talent, this unique ability. Happy day to you and welcome to another episode of DSO Secrets. I am Ken Kaufman, your host today, filling in for the ever illustrious Emmett Scott. I'm excited to introduce today's guest, Justin Miller. He is currently the VP of Employee Benefits at USI Insurance Services, has a business degree from Texas A and M of Commerce. Justin, thank you so much for joining the show today.

Yes, thank you very much for having me. Always great sitting down and talking with you, Ken. Thanks a lot.

Yeah. Well, we're excited to jump into this topic and I think you're going to bring some interesting perspectives and hopefully give our listeners some things to be thinking about as they try to be competitive in the marketplace and do it the right way when it comes to benefits. So, starter question. So what led you into this DSO industry and what in the world are you still doing here?

Yeah, so that's a good question. I honestly, I'm fascinated by the growth and consolidation in the industry, the strategic planning and the complexity. You know, the path that these groups are on intrigues me quite a bit. And really, you know, all those things considered, it just happens that our model just kind of fits really well into that mold. And so I enjoy it. Great.

Appreciate that. So can you walk us through in terms of, if you think about these DSO leaders that you've interacted with, all of us are trying to figure out what is the biggest bang for the buck in terms of if I've got extra dollars to spend, should I put them towards health insurance or a retirement plan or disability or life insurance and what's the most sticky in terms of employees and what will help them be the most excited about staying employed. Could you maybe walk us through this priority of benefits as you see them and what the demand is just across all of the different organizations that you have a chance to see?

Yeah, I think that, you know, in the DSO space, right there's, I think the list of wants and even needs from the employees based on who those employees are, vary greatly, right. From clinicians down to, you know, the office staff and even, you know, maybe call center employees. I would say, I would say employees and, and this is really industry agnostic, right? I would say employees, they measure the employer sponsored healthcare plan. They measure it with the coverage that they're getting against how it impacts their pocketbook. Right. The variance could be. As an example, clinicians might be very interested in putting as much money as possible into something like an hsa. Right. Other employees, you know, what's important to them might be that they have lower co pays. You know, there's differentiators in classes when it comes to disability. Long term disability for a dentist, God forbid something happened to their hands is important. Right. Other employees with short term disability, folks that have kids, you know, that's important to them. So, and a lot of times, you know, it's very hard to find that answer to your question. As a group, as a leader. One of the places that we really like to start, you know, one of the foundations that we try to create is first benchmarking your, you know, the DSOs, benchmarking these benefit plans against their peers just to make sure that we can better understand if it's actually contributing to, you know, finding and retaining talent in what is surely a competitive job market. Right.

Yeah. So let me, let's stay on this health insurance piece for a minute here and just unpack this for a second. The question that I think our listeners will care about is, is that it's possible to offer health insurance but have your employees not value it very much because maybe it's not a rich enough benefit designer program. It's also possible to spend too much on that benefit plan and design. And so what I hear you saying is there's some market data that you can pull down to say, hey, on average, this is the type of health plan, the deductibles, the CO pays and those sorts of things. Can you walk into how you think about that and how employers generally try to dissect that piece? Because for most of us, the biggest cost is the health insurance element.

Yeah, this live benchmark. Right. And we do that against industry, we do that against geography and then other general employers of your size. But the data set is, it's got the obvious things in it, especially things that employees care about. Right. Deductibles out of pockets. But it also measures, you mentioned this, the actuarial value of the plan that you're offering your employees. In other words, all things considered, out of pocket, co pays, you know, deductibles, contributions, everything. How rich is this plan? You know, what percentage does this plan pay for all those things considered? And so it really peels back the curtain. You might have a plan that you think is great, that's not so great. Right. You might have a plan, a plan that is great that the employees may not appreciate because of the way it's being communicated. Right. Or some of the things that they don't understand. And so, and it also helps us understand if you're an outlier. Right. Maybe the pendulum has swung all the way to the point where you're overly insured. Right. And it might be too rich. And so it measures those, those valuations. And so that you can really peel back the curtain and understand what decision making you could take to, to define that plan.

Understood. And then obviously, the portion that an employer chooses to contribute toward the premium versus what the employer has the employee contribute toward the premium, that really comes down to that decision of what, what is the plan design? How rich are the benefits? And then as an employer, what are we going to put in versus versus them? Because at the end of the day, I think the employees care not just about the plan design, but how much is coming out of their paycheck as well. So could you comment on that perhaps?

Yeah. So, you know, the DSO organizations, I mean, the pay structures, those vary, right? You know, I would say no total cost of insurance for employers sometimes, you know, total cost of salaries, you know, as a percentage of salaries sometimes can creep up to up to 30%. Right. Especially for those employees making, you know, 25 bucks an hour or less. And so the plan could be super rich and covers a lot, but if they can't afford it, it doesn't mean much to them. And I go back to what I mentioned earlier. We don't have some type of baseline for comparison. Right. How do we know what's competitive and how do we know what direction to take? Because the truth is, the plan could be great, it could be bad. But if your employees aren't willing to, you know, participate because of the contributions, then none of that really matters.

Great. So let's move then from the health insurance topic, and I'm just going to go through the stack. The next one usually is dental insurance. And of course, we're unique in that we provide dental services to communities. And so what do you see that DSO employers are doing in terms of what they're offering is are they picking up PPO plans and then treating those patients in their Offices or having them go to any office or requiring them to exclusively come to them. What are some trends you're seeing there?

Yeah, I think it's kind of different across the board. You know, it's a little easier to control it when you have, you know, five, six, 10 practices, especially less than that. I think as you grow, so does you know, your footprint. Right. And so it makes it a little bit tougher on that dental offering even though you're in that space. It also gets a little tricky from a compliance perspective as well. Right. And so we actually have a lot of folks in the, in the DSO space. You know, they've got really great ideas. Right. When it comes to dental, obviously that makes total sense. And so it's, we just make sure that, you know, we're bouncing it off our ERISA council and checking the box, the boxes, you know, dotting the eyes. So I was to answer your question, I'd say this. There's a lot with a nationwide PPO network. Right. And sometimes that's needed based on where your employees live, you know, where your practices are and their ability to be able to get to care with ease. And then sometimes there is an HMO esque type product that comes alongside a PPO product as well and let the employees choose.

Great. I'll just layer something in here. It's something that we've thought a lot about inside of our organization and ultimately we like the idea of our employees using our product or having access to our product in the dental practices that we are supporting and hopefully having really good experiences and as a result then being willing to refer friends and be influencers in their communities and we find that. Right. Happy employees that are happy and engaged that believe in the product and how you're helping and benefiting the community. It turns out that a lot of those family and friends of the employees of the dental practices do that. And so it's something that we, we purposefully have tried to encourage our employees to use our product. Now if it's a service that can't be delivered within one of our supported dental practices, then obviously they're referred to other specialists or those sorts of things. But I just wanted to throw that out to the listeners is something to consider. Those employees can often be influencers in the community if they really believe in what you're doing and let them try it, let them actually be a patient and a customer of the dental practice in the process. Any thoughts on that or have you seen any trends around that that I

think the strategy is good, you Know, I think the best customer is, you know, comes to a business by word of mouth. I would say that, you know, I would say not only does it give the employee the experience. Right. Of the company that they're working for from the customer's perspective, but it's, it's probably quite convenient for them considering that they work for that company as well. Right. And so, yeah, I think it's a good way. It's a good measuring stick for leaders. And then along the way, like you said, it gets the word out in these communities as well.

Very nice. All right, I want to jump to, then there's division insurance and those things, but I want to jump to the disability insurance. And you mentioned this especially for doctors and interested. If you could give a commentary on the cost to have long term disability insurance for a doctor or a dentist in this specific example, the cost to have that on an individual basis if they go out and buy it on their own versus the cost if the employer pays for it. And all dentists, for example, are covered on that program. Can you walk us through sort of the concepts of adverse selection and how the variance in cost between an individually sourced product versus an employer sourced and employer paid product?

Yeah, the biggest difference is, you know, the issuance, you know, of the policies, what they cover. You know, you would think that if you go as a group, you're going to get much better rates, right. For something like disability than you did if you went with an individual. But the truth is that's not always the case. As a matter of fact, I have clients that have individual policies for a certain line of coverage that we offer to the group that are actual individual policies. And I have other groups that it's better, the rates are better for them if we offer it to them as a group. And then of course, there's those instances where those doctors or those employees have both. Right. And so it all falls within the underwriting. Right. And it all falls within the markets that we talk to on the behalf of, of these clients. The main thing is, you know, the cost of something like disability as compared to the benefit when you need it obviously isn't that much. But what's really, really important is the details within these policies, right. Where the red tape is, where the red tape isn't. But mainly the coverage, especially for someone like, you know, a clinician or a dentist, right. It's, it's. There could be, there could be. And their compensation could, could be a lot of different things. Right. It could come from a lot of different buckets. Shares, you know, salary, whatever it might be. And it's just super important that we make sure that we have the right coverages in place should something like that happen. Does that make sense?

Yeah, it makes perfect sense. And you know, generally my experience has been if a doctor goes out, sources their own policy, and then if we tried to replicate that in terms of an employer sponsored program, it is a lot cheaper for the employer to do it. And so it's an interesting opportunity to think about the overall compensation program for an associate or even an owner doctor, and giving them some opportunities and potentially some significant cost savings around that. Okay, cool. So anything else in the benefit stack that sticks out to you, like retirement plans? Are you seeing anything else that's really in high demand from DSO groups or is it really just the health and the dental and.

And.

Yeah, anything else beyond those?

I think retirement is top of mind these days. You know, I think people are more educated today than they have been in the past. But truth is, I'm not your guy. You do not want me to take on your retirement plan. We've got other folks at USI that do that. But you know, I would say whenever it comes to, you know, benefits, you know, having a competitive, competitive plan, it's just a vital piece, you know, especially the medical benefits to being able to grow the organization because you can't do it without people. Right. And if they're choosing other practices over yours, that's just not a cycle you want to be in if you, if you can't staff it. Right, right.

That makes sense. So can you walk us through then, what are some of the key trends you see happening in employee benefits? Just overall and where, you know, where do you kind of see these trends going? And then is there anything specific that DSO leaders should be especially attuned to in terms of where employee benefits are trending?

Yeah, I must. I'll start with the immediate. Right. The pandemic has definitely left its mark on employee benefits. Right. And it certainly did a number on, you know, the DSO practices, especially last year. It's the major healthcare providers, right? The carriers, last year, they experienced a reduction in total lives covered on their plan internally at the carrier, they would call that belly buttons. Right. That's what they call them. So last summer, right, post spring, last summer, the carriers, they begin scrambling, trying to figure out and forecast not only the future costs associated with COVID 19, but also what could be a wave of elective procedures that frankly just couldn't be done during the lockdowns. Right. And so since Then I would say beginning last fall, I would say beginning last fall, we've been seeing higher than normal rate increases on these renewals for employers. And honestly, this is even for employers that are running really well from a claims perspective. The carriers have actually flat out told us, the broker consultants, that we could expect stout renewals in 2021. Right. Last year there's a lot of companies in 2020 that had good claims experience because there was a lockdown and you just couldn't access a lot of healthcare, minus the emergencies. The problem is when you Fast forward to 2021, these renewals are high this year and the carriers are not giving those employers credit for that claims experience. In 2020, not everyone had great claims experience, but there certainly was some of the most that did. And so they're treating Covid in 2020 as an outlier. And so it leaves us in a precarious spot whenever we're negotiating with these carriers. And you just got to bring a lot more to the table to get a win for employers.

So the concern being that there's deferred care that's being pushed into futures and it may not show up in the numbers, but it's going to show up in the numbers. And the carriers or health insurance companies are trying to stay out ahead of that.

Yeah, it's not like the broker consultants, it's not like we don't recognize that. Right. We see the potential and their concern, you know, our job is that. So what we did at USI is we've got tons of actuarial folks and underwriters that we plant in our local office and we send them in the battle on our clients behalf. You know that, Ken. And what we did nationally is we came together and we underwrote, if you will, the pandemic as it relates to our clients. And we use the different geographies, we use the different infection rates. Right. The people that weren't getting elective surgeries done just to figure out, you know, actuarially, like what we feel like this pandemic means to our clients and the cost. So now that, you know, in 2021, whenever these carriers are blaming these things, you know, on these high renewals, it's just a logical conversation that we can have. So we're not saying it's not a factor, but it's very commonplace for a carrier to load it up as much as they can and then blame it on Covid. Right. And you have to have an answer for that. Right. Because you don't want to take that increase if it's not warranted.

Yeah, that makes sense. That makes sense. So some key trends then is that we're really talking about having to carefully go through your health insurance renewals because the carriers are continuing to bring rate increases even if your claims experience stayed flat or even went down relative to prior years just because of deferred care. And so many other elements that just wreaked havoc that Covid caused and wreaked havoc, havoc throughout the whole system.

I think it's easier for them to do that today than normal, especially for someone that's running well. Right. They can hide behind the COVID You know, other, other trends that you know, even started well before the pandemic. You know, you've got primary doctors that are really feeling the pressure. You know, these guys are selling out to these large health systems and hospital systems. You've got Medicare cuts on top of that. And what's really happening and has been happening for the last few years is this, this the cost is shifting to the private sector. And based on how the carriers view and give credibility to the middle market, it's the middle market that is really taking the brunt of that. And so it's this weird conundrum where the middle market needs the most resources on their side to kind of fight this good fight. But a lot of folks, a lot of brokers that have those, there's a lot that don't. And a lot of brokers that have that type of process and resources reserve those for some of the larger clients. Right. And so it's hard on a middle market companies sometimes during this renewal season.

Yeah, I get it.

That.

No, that makes a lot of sense. And you know, you and I have known each other now for a little while and you know how I generally feel about insurance brokers, employee benefit brokers specifically, meaning, like they get compensated when your rates go up. And so what's their motivation? To really negotiate in your behalf. And they want to sit there for the whole year and collect a percentage of those premiums you're paying in and get away with as little service as possible to try to make their model as profitable as possible. It's just I've always felt so misaligned with, with the mentality and walk us through, you know, how you think about that and how you guys try to combat that. And really what I'm looking for is I'm not looking for a sales pitch for Justin Miller. More as let's empower these DSO leaders that are listening in. How do they select the right person to help them get their employee benefits in place, get them set up the right way so that they're maximizing the value they're providing to their employees.

Yeah. And I would love to do that. And if there's, you know, I like helping people, regardless of where they go, get something that will mean something to them. Right. Whether that's us or not. And the truth is, you are partly or mostly, I would say. Right. You know, our industry is fairly broken. We definitely see it that way. We've resided ourselves in a lot of ways to becoming mailman. Right. Get the census from you, take it to the carriers, get quotes, put it on a spreadsheet back to you. Right. Pick a number on the spreadsheet and do it in a crunched amount of time and blame increases on trend or large claims. And it's funny that you mentioned that because when you and I first met, as a matter of fact, our, our relationship spawned from that comment that you made that our all brokers were created equal. And you'll remember that that did not offend me. I actually laughed and I said, you know what, we're on the same page. You're actually 95%. Right. And the truth is, 10 years ago, if a broker had a good set of golf clubs and they had a good relationship with the carrier, they could really do right by their client. And that's just not the landscape that we find ourselves in today. And the truth is, most people have the best intentions in our industry. We just find ourselves in a much more complex landscape when it comes to, you know, representing our clients. Like you said earlier, DSO leaders are on the hunt for the best plan for their employees. Right. A competitive plan for their employees at the lowest cost. And I would argue that the answer to that question or that issue really lies within the process that you take to arrive at that endpoint. Right. The goal of the carriers is actually the complete opposite. Right. They want less coverage for the highest amount of cost. Right. And so procuring insurance, as you just alluded to, procuring insurance for executives and DSOs, you know, any executive at this point has become quite frustrating to getting that employee benefits plan for their employees. And the problem is it comes with, it's one of their largest spends as an employer in a lot of cases. And it comes with the least amount of transparency. And so what's needed, you know, in this process and a lot of things that we try to bring to the table. And the truth is I sound kind of biased, but the number one defense you have against this is your broker, consultant. It's almost the only wedge that you have between carriers and employers. And so what's needed is the resources that it takes to be able to create some predictability, transparency, work, product. Right. That is independent from any carrier data, anything that you would get from the carrier as a baseline for comparison so that These employers, right, CFOs, CEOs, owners, can create, they can create a decision path for themselves and feel good about it. Right. And keep that cost down as low as possible, obviously.

Yeah, that makes a lot of sense and I appreciate you being willing to go down that road. And even you entertaining my comment that was probably a little over aggressive, but just entertaining. I appreciate that. It seems like, because all of this is really a math game and there's some projections and some guesswork about, hey, what may happen in the future, but it's a math game. And what I hear you saying is, and what you're recommending to the DSO leaders that are listening in is get somebody on their side who's willing to do the math game on their own and come up with their own projections, their own numbers of what should happen, you know, logical, actuarial, sound, hopefully.

Right.

And get those numbers and then that's how you go and you win the math game with the carrier. I think that's what I heard you say. But if you need to unpack something there, I'd be happy to have you do it.

Yeah, sure. I have two points on that. You're absolutely right. You hit the nail on the head as far as the cost goes. There's a lot of other things that need to be looked at. But you know, the cost is a big part of it. Right. And the renewal calculations that are being put out by carriers today are much more complex than they used to be. Right. And I am in the industry. Right. And I'm very familiar with it. But you know, I cannot underwrite it personally for you and tell you exactly what the numbers should be. You know, I can go through some of these workups that come from the carrier and poke holes in it, but we need a real life number aside from that carrier underwriting that was not done by them that we can compare it to so that we can have a logical conversation otherwise. Right. The carrier just wants, you know, they're much more complex and it all happens to do with the math behind it, like you said. And so let's say they want a 15, 20% increase. Right. Well, if we don't have those resources, if we don't have an independent study of what that cost should be. That was done, you know, even six months before the renewal, prior, independent of the carrier. The only leverage that we really have as brokers at that point. Right? And like a traditional model is pound our fist and tell the carriers that, you know, it's just not good enough. And that renewal already had that padding in it, you know, when it was sent out initially. So they'll take, okay, four or five, six points off of it because these guys are upset or they're going to go to the market, you know, one of those two levers. And all the while it might, it might have been. It should have been a zero. Right? It might, should have been a negative renewal. It happens all the time. And you know, what we always say is, you know, we're not, we're not in it to save you money every single year. We're not saying that's going to happen. We're just going to bring the transparency to the table and tell you what the cost should be. It might be more, it might be less. Right. But at least you have an understanding. When I talk to CFOs, they don't care if the increase is 40% or if it's a 40% decrease. They want to understand how we arrived at that number. Right. With that, with that carrier. And I think that's important. And my second point is this. You know, I talk to a lot of executives, and when I look at it from a DSO lens, here's what I see, right? The DSOs, where they are today, or at least where they'll be tomorrow, looks a lot different than where they were when they started, right? It looks differently than the beginning of their journey. And what I see is these executives are finding themselves at a fork in the road when it comes to employee benefits, Right? We can go left and take the relationship road, or we can go right and take the stewardship road. So to answer your question, yes, whoever it is, just make sure that there's a process attached to one of your larger spins to break it apart so that you can understand it and make good decisions from it. Right? We're just trying to decide how to trade risk with the carrier and then how to finance it and then making sure that's the right number.

It's a really helpful perspective. You know, right now there's heavy competition for labor. I would almost say there's a war for labor, especially in the, let's call it 15 to $25 an hour range. You mentioned the $25 hour number before anything specifically. You're seeing employers do with their employee benefits. We see wages going up and signing bonus offers. And I know a lot of DSO leaders are very concerned about this because they're struggling to find the right talent. And sometimes it's front office, sometimes it's back office dental assistants, and a lot of times it's hygienists. Also, there seems to be a real shortage relative to demand. Is there anything that you're seeing people do with employee benefits to try to create a little bit more competitive edge with bringing employees in?

Yeah, sure. Well, it helps, like I said earlier, if you kind of know the, you know, know where everyone sits, or I guess I should say where you sit amongst your peers. Right. I think that's very helpful in order to be competitive. But at the end of the day, the employee wants just, just like the, the employer wants from the carrier, lots of coverage, smaller costs. That's what the employee wants from the employer. And they want to get as much coverage as they can for the smallest amount of cost. And so there's a lot of creative ways that you can do that. Right. It can be deductibles, you know, it could be co pays. There's a lot of wellness. I mean there's, there's, there's tons that you could do with wellness to impact the employees, offset their premiums, but still not lose a lot of money as the employer when it comes to. And all the while, right, you're creating a culture that will help you retain and find people. You're also creating a healthier employee population for claims that might happen down the future. You can get creative with HRAs, HSAs. Right. And then the benefit offering itself. For sure. Yeah, I love that. That might be the deal breaker, that might be the tiebreaker.

Yeah, that's a great point because especially in the DSO space, we are service organizations. Most of our cost is going to employees more than any other cost that we have. In fact, I regularly say 60% of every dollar that leaves a DSO or a supported dental practice is going to an employee or paying for some statutory tax or benefit associated with those employees. And that's a very big number. So it's interesting to think about. You can actually gain a competitive advantage from a cultural perspective with the way you position your employee benefits. Because culture is the number one way you can drive the best return on. That's 60 cents of every dollar that leaves your organization. Because culture is about getting people aligned with your mission and how you want to take care of and treat patients. Culture is about how your employees feel about their experience and how they communicate and behave and interact within the workplace. We've even found our culture sometimes ends up reaching into people's homes where some of the principles and things they learn inside our organization, they implement with their families and share with others and create better cultures and environments than they had come from in first place. So it's a really interesting thing to think that ultimately, how can you tie your employee benefits program into your overall culture? In our organization we have a pillar called health and balance and that we've got very specific definitions of what that means and why it's important to us. But employee benefits is a big, big element of that and it's why we choose to spend money in those areas. All that just creates alignment and wins hearts and minds to your mission. And then all of a sudden they're taking a job with you that's a dollar an hour less than the one across the street because they see the intangibles and they can feel it. And hopefully as employers, we get better and better at communicating those. Anything to touch on there?

Can't put a price on that. Yeah, I was just gonna say you can't put a price on that. Right. My population health director that we have here at US High said something to me one time that's really stuck with me. She said that a really poor benefits plan communicated well is more successful than a very rich benefit plan that is communicated to the employees poorly. Right. That matters. And the wellness piece matters to them. It reaches their home. USI's wellness program includes the spouses. And so my wife is on that training as well. So. Yeah, you're absolutely right. And if you can help integrate that into your culture, that's a more productive employee all the way around, for sure.

Outstanding. Well, we're starting to run out of time, Justin, so we're going to jump to our lightning round. The listeners really like this. Seven questions, quick hitters, and then we'll do a wrap up. What are you currently working on?

My professional life from June to November is crazy swamp right now. I'm actually doing three different M&A transactions with three different clients with a merger as a cherry on top and the joys of trying to integrate three different companies that have different carriers, they have different plans, renewal dates and payroll contributions. So I know that sounds like fun to all the listeners and they would totally want to go into insurance after hearing that.

Yeah, that's right. What are you most proud of?

Oh, that would be my wife and two children. Hands down for sure. The entire reason why I get up every morning and go to battle. No doubt. Love it.

Favorite sports team?

Favorite sports team would be the Dallas Mavericks and the Caddo Mills Foxes. Go Foxes. One game away from state last year.

All right, Very nice. Favorite hobby?

So I'm a big freshwater fisherman and believe it or not, I actually also play a lot of competitive cornhole.

Very nice. Are you going to be on ESPN someday?

I have friends that are, but I am just not as good as them. So I don't know that you'll see me anytime soon. No.

All right. Okay. Favorite app on your phone.

Probably the. The YouVersion Bible app.

Oh, that's great. That's great. And favorite spreadsheet function.

Okay, are you ready for this? My favorite spreadsheet function is Control F. So I can find what I want. Right. Spreadsheets are a big part of my life. But just if I'm being honest, I rarely create them because not good at it.

All right. Control F. There. There will be more people listening in that are probably going to start using that now to find whatever they need. Perfect. Awesome. All right. Any last parting advice you have for these emerging group dental practices?

Yeah, I would say this. You know, as a growing business, I've talked to a lot of executives and owners and leaders who have a magnifying glass on many aspects of their business. Right. Trying to figure out the best for accounting and all other things. And what I see a lot of times is that unfortunately, sometimes is not the case with employee benefits and what they're spending on employee benefits. And I think it's because, you know, they've just, you know, the market itself, Right. And especially the middle market has just been conditioned with employee benefits to think that, you know, it is what it is and the cost is just always going to go up. And so my challenge would be to find someone that can help you to find that transparency and that predictability that we talked about earlier. Right. Because after all, it's one of the things that touches your employees lives the most in your business. So that's what I would say.

Outstanding. And if our listeners want to reach out, get ahold of you, what would you recommend as the best ways? Besides, you're in the DSO Secrets group, so they can just type in Justin Miller there. Hit you on a comment. We can get some discussions going in. Any other ways for them to reach out to you?

Yeah, I'll float my email out there. It's justin.millersi.com and then of course, you can always search, you know, Justin Miller USI, something like that on LinkedIn. You'll find me that way as well.

Outstanding. Well, Justin, we can't thank you enough for joining the show today.

Yeah, I really appreciate you having me. It was a lot of fun.

Yeah, it was a great time. Couple of my key takeaways, Actually, I'm just going to share my main takeaway. As DSO leaders, our job is to create amazing cultures. And as we create these amazing cultures, weaving into that your story for employee benefits is a critical element of the cultures we're creating and the overall experience we're creating for employees. So finding the right advisor that's going to help you spending time with your team, understanding what they care about, what's most important, and driving the dollars that you have to invest in these things that are the most important to your employees is going to reap massive, massive benefits over time in terms of how you build your culture, how you drive turnover down and your employee retention rates up and ultimately create the best experiences for the patients that all of these employees are interacting with. So those are some of my key takeaways from today. Many, many thanks to you for joining today. This is a wrap on all things employee benefits and DSOs with Justin Miller. Happy day.

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