EP 7 - Live Audience: Contrarian Members’ Meeting

How do you provide first-class healthcare benefits while also containing costs?

That’s the main question of this live episode, recorded with Suzanne Lutz, Laura Williams, and Santina Daily, three captive Members from very different industries and backgrounds. What they all have in common is a complete dedication to the well-being of their employees and a desire to change that relationship.

This is only a small part of the value that you can get from a ParetoHealth Members’ Meeting. If the advice here resonates with you, visit paretohealth.com to learn more.

What is 80/20 with ParetoHealth?

Health insurance, dissected. It’s a take-no-prisoners journey into the heart of health insurance co-hosted by two of its major disruptors. The Andrews (Cavenagh and Clayton of ParetoHealth) give you fresh insights and perspectives. Join them in their conversations with guests who are also transforming an antiquated industry and reshaping the way employers select and implement healthcare benefits.

[00:00:00.630] - Andrew Clayton
Hello, this is Andrew Clayton, and welcome to the 80/20 with ParetoHealth. Special episode this week as we come to you from the Bahamas in honor of Contrarian Re's 10th anniversary. Contrarian Re is our oldest captive and really our flagship captive that helped us start the entire ParetoHealth initiative.

[00:00:27.270] - Andrew Clayton
We recorded the session live at the members meetings, and so you're going to hear some live background noises and we think of it as a special dose of authenticity. Special day so joined by special guest host, Jack Longstreth, as well as Contrarian Re members, Susan Lutz, Laura Williams and Santina Daily. We appreciate everyone joining us.

[00:00:51.290] - Andrew Clayton
Would you do the honor, Jack, of introducing our guest?

[00:00:54.970] - Jack Longstreth
Yeah, now I'll turn it over to you guys. Please name, company, maybe industry, and how long you've been a member of the captive. Why don't we start there?

[00:01:01.690] - Andrew Clayton
Thanks Jack. Great introduction.

[00:01:02.890] - Jack Longstreth
Thank you very much.

[00:01:05.130] - Jack Longstreth
Go ahead.

[00:01:05.130] - Suzanne Lutz
I'm Suzanne Lutz. I am the director of human resources at a company in Lancaster, New York, a suburb of Buffalo, Sunny Buffalo. We've been in Pareto for five months, but have previous experience in a different captive for five years previous to that. Our industry is seals and gaskets. It's not glamorous, but everybody needs us. I am happy to be here and we'll talk more in a little bit.

[00:01:39.940] - Andrew Clayton
What's that expression? They say, drop the zero get with a hero.

[00:01:44.160] - Laura Williams
Good morning. I'm Laura Williams. I'm the executive director of The Arc, Ocean County Chapter located in Lakewood, New Jersey. The Arc provides services to people with developmental disabilities and their families. Been part of the captive going on three years now so excited to be here this morning.

[00:02:02.840] - Santina Daily
I'm Santina Daily, the director of human resources at Chamberlain Hrdlicka. It's a law firm in Houston, Texas, so I manage lawyers. Definitely need to be in the Bahamas. Been with the captive for four and a half years.

[00:02:21.530] - Jack Longstreth
Each of you have a different story. One of you came from a different captive, one of you came from fully insured, and one of you came from the consortium type model. Why don't we just start with why? Why did you join?

[00:02:32.450] - Suzanne Lutz
Why I joined? First of all, having experience in the fully insured world, I knew that that was not what I wanted to continue in. Having those renewal meetings every year, I mean, you thought it was a good thing if you only got a 10% increase. I said, there's got to be a better way.

[00:02:51.050] - Suzanne Lutz
Heard about a captive, was in another captive program, which I believe we were successful in. But the thing that brought me to Pareto was the emphasis on cost containment and that not everything's à la carte. These are things that are built into the program.

[00:03:09.640] - Suzanne Lutz
You do have some options to choose, but I am super excited about how we can continue to provide excellent first class healthcare while containing our cost. The big thing for me is, how am I going to get our employees engaged in doing all of that? But I'm very excited about what we can do with Pareto.

[00:03:33.210] - Jack Longstreth
Laura.

[00:03:33.270] - Laura Williams
We were in the fully insured model for a long time, and we go through the renewal nightmare of trying to figure it out, trying to go. I remember saying... Every year I'd say, "Bring me something different. Everything you're bringing me is my broker, is a tweak to the plan." Well, we all know what tweak to the plan was, is make the benefits worse for your employees.

[00:03:56.790] - Laura Williams
It just got worse and worse and worse as the years go by and fortunately we have a great consult relationship with Campbell Petrie, who does a great job for us. They really dragged us, kicking and screaming into the captive slowly and methodically convincing us this was the way to go. We've seen really, really good results so far.

[00:04:20.500] - Santina Daily
We were in the fully insured world, and we knew we wanted to go self-insured so we joined the consortium with the same brokers, but nothing really changed. Every year renewal would come, it would be too late to make any changes. It would be a 25% renewal every year. It was very frustrating.

[00:04:41.140] - Santina Daily
Then everyone's looking at me like, why are you not doing your job? We had, one of our partners brought Snellings Walters in, and they said, you really got to listen to this idea. At first I was not on board with switching to just another broker. Here we go again.

[00:04:59.910] - Santina Daily
But it was something different and since we've joined, we've had 0% renewals for four years. We've saved over $4 million. It's been amazing and the relationship is totally different than just another broker that they're not accountable. It's been amazing.

[00:05:22.950] - Jack Longstreth
Suzanne, you touched on it a little bit of cost containment. A big part of obviously these member meetings are learning about what other members are doing to manage their claims. One of the things you are excited about, from a cost containment perspective?

[00:05:40.670] - Suzanne Lutz
I'm excited about using the kiss card. We already have some employees taking advantage of that. Also, even on the pharmacy side, working with Smith RX to really, I mean, that's what's going to kill us are the specialty medications. But I'm really... Feel confident in what they'll do to help us save wherever we can.

[00:06:08.580] - Suzanne Lutz
Other thing that I'm excited about, we don't even have it yet, is quantum health. Because part of the education with employees is it's difficult for them to navigate. Do I call KISx Card? Is it Healthcare Bluebook? What is it that I do? But now rolling everything up into quantum and have a concierge service. One number. You call one number and they will help the employee whatever avenue they need to go.

[00:06:34.620] - Suzanne Lutz
I'm excited about cancer care, God forbid, but if we need it, it's there. Nothing more important than someone getting a devastating diagnosis. What do we do? You can't even think straight when that happens to you. But to have someone to hold your hand through that process, to me, can be lifesaving.

[00:06:53.900] - Andrew Clayton
I think it's critically important. We have so much of the industry is set up. Laurie hit it on earlier where solutions are how we push for more ownership, both financial and responsibility onto the employees. That's just simply a barrier to entry. We need to make it easier for them to access care.

[00:07:11.900] - Andrew Clayton
Healthcare can be a foreign language to to almost everyone. Ability to get them to the right point of care with the right guidance, the right coaching. It's critically important to both I think, the success of your health plan but also it's a cultural impact.

[00:07:28.340] - Andrew Clayton
You guys all have very three different workforces, so they come with their unique challenges. What are some of the areas that you're finding success and communication with your employees and getting them to understand hopefully it's a we issue, as opposed to us versus them issue?

[00:07:46.680] - Laura Williams
When you make a change like this, this is a pretty radical change. As I've heard people talking about concerns as to even moving into the captive of the destruction to the member experience. What we found is, our members were just as hard as we were of, we're going to see increases in co-pays, we're going to see all those little changes that we did to the plan or we're going to change your provider, whatever it was going to be.

[00:08:13.330] - Laura Williams
But our staff, once they realized that we were really committed to providing the best possible care. Since we moved over, we've improved our benefits two years in a row. We've tweaked our plan the other way to actually give back benefits to employees and that's been a real win.

[00:08:31.600] - Laura Williams
Yes, we do expect them to do a little more work on their end with the specialty drugs and working with Magellan and Payer Matrix to try to manage those costs. But we haven't had any resistance. People, as long as they knew we were trying to make it better, they knew how stressful the renewal process was just in general, for administratively for HR and finance.

[00:08:55.320] - Laura Williams
But the recognition that we were making the plan better and more sustainable for the long term for employees was really an easy message once we got through that message.

[00:09:08.430] - Jack Longstreth
Santina, you've had fantastic savings since you joined your law firm. You have your unique challenges. Can you talk a little bit about what you've done from cost containment on that side?

[00:09:23.350] - Santina Daily
We implemented high deductible health plans and gave a bunch of money for their HSA, which really drove people to those options. Then we put in HealthJoy so they have everything in one place. They have price transparency for medications and for like MRIs and things like that.

[00:09:47.260] - Santina Daily
But really, it's just been education on how, these are their dollars coming out of their pocket. You shop around for TVs and everything else, why not shop around for an MRI? Why pay 3,000 when you could pay 400?

[00:10:03.740] - Jack Longstreth
We're in the Bahamas. We're at the members meeting. Can you talk a little bit about the members meeting? How has it been valuable to you, and what do you look forward to?

[00:10:13.380] - Suzanne Lutz
For me, it's been, first of all, the slide presentations and getting filling in the blanks. There's a lot to learn when you're in a captive. For me, it's getting used to a new program, but I've really enjoyed the round tables where we discuss with other folks from different parts of the country, what they're doing, what's working for them, how are we tackling, not only healthcare but other, for me, HR-related things.

[00:10:43.740] - Suzanne Lutz
It's been really beneficial. It's nice to put a face to a name and know the players in the company, and just make sure that I know everything that's available to me and what are the best things for our organization. It's been very helpful in that respect.

[00:11:02.100] - Laura Williams
I think learning from other captive members, hearing the success stories of other captives, I find it comforting when I meet people who've been in the captive for a long time.

[00:11:13.780] - Laura Williams
Part of the insecurity of making the decision to go here is it's something new, not a lot of people around you are doing it, sort of be able to talk to people one on one and hear their experiences. Hear the successes and the challenges that people face, and really have the opportunity to be committed to that.

[00:11:34.270] - Suzanne Lutz
This is a really good thing for a lot of us. When you see the success people are having, you're like, okay, I'm in the right place for the first time regarding health benefits that we've ever been in. You see that at the captive you see that everybody is... To have a group of this many people that aren't bemoaning something about being part of a membership group like this, it's really great.

[00:11:55.670] - Suzanne Lutz
You're not hearing people bad mouth or Magellan is the worst, or my consultant is terrible. There's a real, genuine support within the membership that really comes out at the membership meeting. It's great to be here.

[00:12:10.030] - Andrew Clayton
Their broker might be terrible, but their consultant's okay.

[00:12:14.990] - Santina Daily
I love the members meeting. I always get new ideas. We're considering moving from Magellan to SmithRX. Went to that meeting yesterday and just trying to figure out if that's going to be a good move. But as my colleagues have said, really the networking is where you really find value. Just finding out what other people are doing and going, could I do that at my firm or business?

[00:12:42.220] - Jack Longstreth
I'll give you an either or question. Laura, I think to your point that not every step we take is going to be perfect. They're going to be some stumbles along the way. Part of being able to share with other employers is where you can learn from others' missteps. All that's great.

[00:12:58.940] - Jack Longstreth
We also like to challenge the community and they do a great job of accepting it, which is, I'm in a place today but I need to plan for tomorrow and the day after, the day after. Do you have a misstep that you've really learned from that was beneficial in hindsight, or was just a simple misstep?

[00:13:18.110] - Jack Longstreth
Or do you have something where you're looking forward to doing in the next couple of years? Might not be the right time now, but you're excited about potentially exploring it a couple of years from now.

[00:13:28.870] - Laura Williams
I budget my maximum aggregate, which is probably been my biggest mistake. I think if I go, but I was convinced all this time that that was going to be my worst case, and you just get planning for it. I think we're going to be able to take some of those resources and look at other places to support our plan or follow through with our plan.

[00:13:52.270] - Laura Williams
I think it's just the realization that it's going to be continuous looking at opportunities to cut costs and enhance benefits for the people we employ and make sure that our guys are healthy. Doing some proactive medical stuff with our team, trying to get those thoughtful use of the medical plan, is I think, what we're looking to do that we haven't always done.

[00:14:18.910] - Laura Williams
But it really is just opening our eyes. I just think you spend so much time, this is the way it is. This is the way it is. It's really just opening your mind to trying to do something different and trying to figure out a different way to manage this albatross of cost that healthcare is for us.

[00:14:37.700] - Jack Longstreth
Laura, I'll go to you again. You started with Blue Cross Blue Shield as the TPA and since then you've moved to Allied. Can you talk a little bit about that transition?

[00:14:47.340] - Laura Williams
Oh, my gosh. It's been like night and day. It's so funny that you make the decision. When you talk about, I should have moved Allied as soon as we moved into the captive because the transparency that we get from Allied in terms of claim data and information there's no comparison.

[00:15:09.890] - Laura Williams
The timeliness of the data, the ability to analyze the data, to really be able to see where our pressure points are in terms of trying to figure out what our potential exposure is. Getting in front of some of those things quicker, has really helped.

[00:15:25.250] - Laura Williams
The experience for our employees has been pretty seamless. In New Jersey Blue Cross Blue Shield, is it, they really control the market. Our ability to get out of that and convince our employees to move to Allied and have a really robust network was really a positive, positive thing for us.

[00:15:45.410] - Andrew Clayton
Culture is a big part of what we're trying to help support. The culture of the employer-employee relationship. What have you guys been able to take advantage of? Or what are you're using from a messaging standpoint to try to continue to bring them into the fold?

[00:16:05.690] - Suzanne Lutz
I think it's just communication. You just have to send things out to them often and on different topics. You can't do everything at open enrollment because it's information overload. I've learned that they may be remembered one thing after they left that meeting.

[00:16:25.970] - Suzanne Lutz
We have check ins with employees. They know that our office is always open if they have benefit questions. We spend considerable amount of time when we're bringing in a new employee so that they have time at the time of hire, and then when they're eligible for their benefits, I send out any kind of flyers.

[00:16:45.410] - Suzanne Lutz
Meritain has just flooded us with all kinds of flyers that we can send out at different times. I think it's just always bringing in front and center, not to the point where we're annoying anybody, but once a month, you send out something in an e-mail blast, you put a poster up, we have things on the TV screens. I think it's just a constant communication and it's really helped us.

[00:17:07.210] - Suzanne Lutz
There was a couple other things that I was thinking of with your first question about what's been great, if you don't mind, for the move to Pareto. One of them is just around the design of the captive.

[00:17:21.050] - Suzanne Lutz
My previous experience is, it was really, really difficult to manage. There was another layer involved in getting the reporting. You really didn't know which end was up. Quite honestly, this is very buttoned up, it's my term for it. Is that we have our deductible layer and then stop loss. I don't have all kinds of calculations and all kinds of reports for the other layers.

[00:17:51.840] - Suzanne Lutz
That's been really helpful to me in trying to manage the plan. Our implementation into Pareto was excellent. I have absolutely no complaints about that at all and I think this feedback is important. The team that we worked with at Meritain was awesome. Talk to SmithRX. We knew all of the players before we even went live.

[00:18:15.960] - Suzanne Lutz
The reporting, I can actually log on to Meritain and see my own reports. I don't have to wait. Having had the experience I did, I really appreciate that everything is front and center for me and that I have the ability to look at all of my data so that we can design our wellness programs around those things that I'm getting feedback on in short order. I know I went off topic there but...

[00:18:42.600] - Jack Longstreth
No, that's great.

[00:18:44.980] - Andrew Clayton
That's great.

[00:18:44.980] - Jack Longstreth
Laura, I'll turn it over to you again, if you don't mind just on the the RX side. Since you've moved from Blue Cross, I know you've implemented some innovative programs. Can you talk a little bit about the RX side of things and how you've saved money?

[00:19:01.260] - Laura Williams
That was our most success, biggest success, I think, is moving to Magellan and using Payer Matrix, which has really helped us with our specialty drug costs. We had a number of employees on some really high cost specialty drugs. It was the thing Campbell Petrie kept pointing to when we look at the renewal process and trying to figure it out.

[00:19:25.650] - Laura Williams
That if we could just attack this one thing, we could save money. We could definitely save money in this one area. They've been great. It's just been... When we rolled it out, you you get nervous about employees having to go without medication that's going to take a little bit longer, but their ability and willingness to really work with the employee to try to get them the medication.

[00:19:45.690] - Laura Williams
We've had success, and nobody's been denied a medication that they needed. We've been able to work through all of the issues, and the savings has been significant for our plan.

[00:19:57.450] - Jack Longstreth
Santina, I'll turn it over to you as well. Law firm, lawyers, RX side is a huge expense. Can you talk what you've done on that side of things?

[00:20:08.210] - Andrew Clayton
We're not generalizing.

[00:20:11.450] - Laura Williams
I mean, we had Magellan, and they have a lot of cost containment built in to them as well. We've had some challenges in that area, but our spend is really pretty low. It's around 20% so it hasn't been too terrible.

[00:20:32.180] - Jack Longstreth
The best sales force we have are you the members, because that obviously is so much more powerful hearing it from members than it is from us. You have people that are on the fence saying, why should I join the captive? What would you say to them?

[00:20:48.620] - Suzanne Lutz
What I say to them is that when you're fully insured, none of those companies are going to tell you you're getting a refund because you had a really good year. Why wouldn't you not do that? Mostly it's the fear of the unknown, or the president of the company, whoever it is, they're stuck in their ways. They just don't want to do it.

[00:21:10.720] - Suzanne Lutz
In this particular case, you're insulated. Why wouldn't you try it? I mean, there's so many things that you can do. I share with them. I do. I have like three people that I know that would be perfect for this and I just share with them, this is how it is for me. This is what we saved.

[00:21:33.780] - Suzanne Lutz
The best part of it is, if you're managing your costs and you're using those cost containment strategies, the money never leaves the building. You pay for the claims. But if you're running your claims good and you're using those cost containments to your point, you don't have to book your total aggregate. You can take a percentage of that. I just have to sell them and how it's worked for us.

[00:22:00.140] - Jack Longstreth
Laura, Santina?

[00:22:02.850] - Santina Daily
I think a lot of people are worried about the cost. To her point, there is a deductible stop. You're protected in that way. It's night and day. You have more information at your fingertips. You can control what you're doing. When you're fully insured, you have no control. You can't carve out a medication, you can't override something. You can't see your data real time. You can't manage your cost. But you can do all of that when you're in the captive.

[00:22:39.050] - Laura Williams
I think I just... Now that we're out of the fully insured model, it's hard for me to understand, and I can understand the frustration of being a consultant, trying to try to convince us to do it, because it really is. It's night and day. The experience is different.

[00:22:56.530] - Laura Williams
Not to belabor the points, but access to information, control. What sold me, I think, was the the immediate savings that we could do it. We had a terrible renewal. We were getting it in our fully written insurance was terrible. I think that helped push me over the edge to the next one.

[00:23:15.210] - Laura Williams
But it's the idea that, when you have a great year fully insured, it's a flat renewal and that's a great year. It's going to catch up because one of those years are going to have a terrible year and that 0% doesn't cover the 30% increase or the 27% increase that you're seeing.

[00:23:34.570] - Laura Williams
Just to have that control makes all the difference for it. For an employer like mine, we employ low income caretakers. They don't make a lot of money. Single parents who need our coverage, we want to be able to offer the best benefit package possible.

[00:23:54.880] - Laura Williams
I have a lot of like minded. There's an Arc in every county in New Jersey, and there's 700 in the in the nation. We all are like minded. We're facing those same challenges. I really have been trying to push those of us who haven't made the move to, whether it's Pareto, hopefully it's Pareto, to really look at insurance differently as a different model to get out of this fully insured making money for the Blue Cross Blue Shields of the world.

[00:24:25.280] - Andrew Clayton
Yeah, they're doing okay. They don't anybody else look out for them. A couple of of maybe quicker hitting questions. You're in the Bahamas and member meeting content aside, being outside of the four walls, was one of your favorite things that you've done or are looking forward to doing here?

[00:24:43.790] - Laura Williams
You mean, besides lemon drops with Jack?

[00:24:47.950] - Andrew Clayton
Post lemon drops with Jack, yeah.

[00:24:49.830] - Suzanne Lutz
It was just fun. Everything was fun. The meals were great with everyone. Enjoyed last night. Did the lazy river. Loved being on the beach, all of it, all of it.

[00:25:04.360] - Laura Williams
They say it's better in the Bahamas, right? We took full advantage of everything that this meeting has offered in terms of fun in the sun, for sure.

[00:25:15.080] - Santina Daily
Yeah, I've enjoyed just the downtime. We went on the cat and ran yesterday. Watched Billy hit it big on the blackjack table. It's been fun.

[00:25:26.480] - Andrew Clayton
Speaking of Billy, and we've mentioned or we mentioned and discuss your consultants a couple of times. You guys know our, especially my viewpoint of a broker versus a consultant, if you could describe your broker in a word or two, what would you say? Understanding is in the morning so Irish flu might be eligible. But what else would say?

[00:25:48.400] - Suzanne Lutz
Chandra understands our business. I can't say one word. She understands our business. She understands our needs. Full disclosure, she presented Pareto to us when you were brand new, and I opted not to because I had another thing going at the time.

[00:26:08.230] - Suzanne Lutz
But I never want to have to do that again. I mean, we shed the tears during that partying of ways, but we're in the saddle again. She persevered. Pareto has grown. It's a whole different company. Great company. The growth is outstanding. It's just outstanding. To me, that's a testament to you doing something right. I appreciate. She's there every step of the way, and I appreciate her.

[00:26:40.910] - Andrew Clayton
I think of a large part of our growth is members like yourselves who are invested and committed and committed, not only to your path, but the community. But I think it's also our commitment to working with consultant partners and not with brokers.

[00:26:58.990] - Laura Williams
Tenacious would be my word. These guys were so tenacious. Adam will tell you, it took him four years to get a meeting with us. I don't believe that. Adam forgets how many calls you get from brokers to try to get your business around renewal time.

[00:27:23.130] - Laura Williams
But they offered us a different way to do things and explained it and helped us go as slowly as we felt we needed to in the beginning and now I feel like we're on a trajectory to really do some great things for our health benefits. Their willingness to go at our pace has been tremendous. Adam and Dan, I can't say enough good things about those guys. They've really helped us and I really feel lucky to have them in our corner.

[00:27:55.590] - Santina Daily
Billy and Tarin, the whole Snellings Walters team. I mean, they have my heart. They're accountable, they're responsive. They have integrity. They are the most amazing people. I just really enjoy working with them. They become friends. I know if I have a problem, I can count on them. They're going to make me look good, which is what I need them to do.

[00:28:22.630] - Santina Daily
I know that we're in this boat together. We're trying to save money for the plan, and I know that's their goal. It's my goal. We're working on it together. I just know they have my back.

[00:28:34.550] - Andrew Clayton
And high EQ. This is sometimes a fun question. If you're talking to an uninitiated, a lay person who maybe doesn't spend your day in insurance or and health care, how do you describe the captive? Have fun with it.

[00:28:56.550] - Suzanne Lutz
For me, I try not to get into the weeds. They don't need to know that part. They just know, this is your insurance cards. We've done destruction disruption report, there is none. If anybody ask you who your insurance company is, just say it's Aetna. If you have a question, call me or call the number on the back of the card.

[00:29:22.790] - Suzanne Lutz
The other things are around the cost containment. But I think people don't need to understand, employees don't need to understand how the captive works. They don't care. They just want their insurance. Just showing them that they can go to see their doctor, they have choices that's the biggest thing. They have choices, and they're free to ask questions, that helps.

[00:29:50.500] - Andrew Clayton
How about from the perspective of another employer, maybe, or an individual at a cocktail party and maybe not the employee. How would you to describe the captive to them?

[00:30:00.260] - Laura Williams
You can take their work, [crosstalk 00:30:04] talking about insurance at a cocktail party? Okay, I get it. I just try to explain the difference between really, basically on the fully insured side versus the self-insured side really is the difference. We have a number of... I have colleagues who have been in self-insured programs but not with the captive.

[00:30:30.720] - Laura Williams
They don't share that risk. They haven't been able to work so they have the bad year they still have a terrible year. It's really not helping. But being part of the captive is we're sharing that risk among other like minded members. I feel like in the Pareto cult up here, saying. By saying all the things that -

[00:30:50.430] - Andrew Clayton
Your participation was not random.

[00:30:54.350] - Laura Williams
I do feel the the advantage of the captive is sharing and pooling that risk amongst like minded members. That we're not alone in it. We're not facing that catastrophic illness with an employee, and it's going to rock our boat for for the next several years. We're sharing that and grant it. We may see those times and we may have to absorb it from other members at some point.

[00:31:24.040] - Laura Williams
But I think that the reducing the overall risk and sharing the risk is what I try to explain. Fully insured or self-insured, and then the benefit of just being sharing that catastrophic risk.

[00:31:41.680] - Santina Daily
The captive is like a group of like minded individuals that are trying to contain their cost. If you have a bad claim, it goes through that before it hits your stop loss carrier so you have a little bit of a barrier there to even that rate going up.

[00:32:01.440] - Santina Daily
Even if you do have a bad year, only your stop loss premiums are going to go up, not all of your whole, fully insured renewal. You have that protection and it also can only go up 30%, which is also not even 30% of the whole amount. There's a lot of protection there.

[00:32:24.440] - Andrew Clayton
Let's... A test to see who's paying attention. There was a dashing young gentleman who gave a dynamic speech yesterday morning in reference that the captive is larger than some Fortune 25 companies. Can you remember the names of some of those companies that Contrarian or Magellan?

[00:32:45.030] - Santina Daily
Apple.

[00:32:45.030] - Laura Williams
Yeah, Apple. Let's see.

[00:32:45.030] - Andrew Clayton
I knew the Apple was going to say that.

[00:32:46.190] - Laura Williams
Did you say the big insurance companies like Blue Cross?

[00:32:48.230] - Andrew Clayton
I did. Not the... Signa.

[00:32:48.650] - Laura Williams
Signa.

[00:32:48.960] - Andrew Clayton
Humana

[00:32:52.790] - Laura Williams
[crosstalk 00:32:52] You said the insurance companies.

[00:32:54.350] - Andrew Clayton
All state. Yeah, all state. Philip 66, Chevron, ExxonMobil. If you want to be a Fortune 100 employer, get into gas or insurance. But the the buying power of the community that you've been able to help build is out there and significant. Anything we missed that you guys want to hit on?

[00:33:16.040] - Suzanne Lutz
Yes. I have since joining Pareto talked to two other companies, and I'm going to meet with them personally, with our consultant. I've gone as far as to invite our human resource work group in our area outside the city, come to our office to get a presentation on captive.

[00:33:41.320] - Suzanne Lutz
Employers are just like the employees. I mean, employees just want to show their insurance card and pay their co-pay, well, so do the employers. So you've got to find the people who are willing to listen to something and understand that it's really going to... It insulates you from those bad years but it provides you an opportunity to save a boatload of money.

[00:34:03.210] - Andrew Clayton
Thank you guys very much for participating. We really appreciate you taking the time not only to come and be with us. Obviously we're focused in celebrating the 10 year, but your commitment to the community and the next 10 years, we really appreciate it.

[00:34:16.770] - Andrew Clayton
Santina, Laura, Suzanne, thank you so much, really appreciate it.

[00:34:19.250] - Laura Williams
Well, thanks for having us. Thank you.

[00:34:23.750] - Andrew Clayton
Of course.

[00:34:23.930] - Jack Longstreth
Thank you.

[00:34:31.360] - Speaker 1
Thanks for listening to today's episode of 80/20 with ParetoHealth. We love hearing from you. If you have a question or an episode suggestion, please drop us an email at [e-mail]. That's [e-mail]. Dive deeper into 80/20 by visiting us at paretohealth.com/podcast. Lastly, make sure you follow us on Apple podcasts, Google podcasts or Spotify so you don't miss an episode