87. Health & Welfare Plan Practices Part 1: Tactics or Tricks - Dirty or Dumb?

Every year the IRS puts out a memo called the "Dirty Dozen": a list of legal tax structures and processes that people are abusing. They're legitimate tools used the wrong way, and the memo flags them so people can get their house in order and know where the IRS plans to focus enforcement.

Donovan Ryckis applied the same concept to benefits. Twelve tactics Ethos is seeing in the market that are legitimate on paper but get abused in practice. This isn't happening everywhere, but almost any plan sponsor could probably find one or two of these in their plan, if not a lot more.

This is Part 1, tactics 12 through 7, with Donovan Ryckis (Co-Founder & CEO), Chelsea Ryckis (Founder & President) and Patrick Ansara (Director of Client Operations). Every tactic gets the same treatment: the tell, the damage in dollars, an honest look at whether there's a fair explanation, the fix, and then the verdict. Is it dirty, or is it just dumb?

What's covered: PMPM instead of PEPM, one letter that multiplies your fees 2.4 times. Contracts that quietly stop matching the proposal. Undisclosed equity between advisors and the carriers they recommend, and the 408 disclosure you're entitled to. PBM collectives, including a reprice study that came back $1.4 million better on a $9 million claim spend. Captives used as a broker's easy button. And the controlled market check, where you go to market and somehow land on the incumbent every year.

Built for mid-market and large-market plan sponsors. Part 2 counts down tactics 6 through 1.

Time Stamps

00:00 – Cold open

00:38 – Welcome to The Business of Benefits

01:01 – Where the benefits Dirty Dozen came from

02:31 – Meet Patrick Ansara

03:31 – How we grade each tactic: dirty or dumb?

04:25 – Tactic 12: PMPM instead of PEPM

11:54 – Tactic 11: The contract doesn't match the proposal

22:56 – Tactic 10: Undisclosed equity and ownership interests

30:36 – Tactic 9: PBM purchasing collectives and coalitions

37:42 – A word from Fiduciary in a Box

38:30 – Tactic 8: Captives as the broker's easy button

48:21 – Tactic 7: The controlled market check

1:03:09 – What's coming in Part 2

1:03:51 – This isn't broker bashing

1:05:43 – An industry that pays well for mediocrity

1:06:58 – Final thoughts

Ethos Benefits: https://ethosbenefits.com

Podcast: https://businessofbenefitspodcast.com

Apple Podcasts: https://podcasts.apple.com/us/podcast/the-business-of-benefits-podcast/id1724134305

LinkedIn: https://www.linkedin.com/company/ethosbenefits

Donovan Ryckis: https://www.linkedin.com/in/donovanryckis/

Chelsea Ryckis: https://www.linkedin.com/in/chelsea-ryckis-8508a192/

Patrick Ansara: https://www.linkedin.com/in/patrickansara/

FROM OUR SPONSOR
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SHRM
Ethos Benefits is recognized by SHRM to offer professional development credits (PDCs) for SHRM-CP® or SHRM-SCP® recertification activities.

HRCI
Ethos Benefits is approved to offer HRCI® recertification credits for this program. This program has been approved for 0.5 - 1 HR (General) recertification credit(s) toward aPHR®, PHR®, SPHR®, and GPHR® certification.