PMP - Challenges with Benefits - Oct, 2024

David Rice: [00:00:00] Welcome everyone, uh, this is our latest, uh, Series in a series of events, uh, we're hoping to keep going and have these continue to grow and being valuable to our audience. So I want to thank everybody for joining us today. For those of you don't know me, my name is David rice. I'm a senior editor of people managing people.

And today's session is going to focus on overcoming the core challenges of employee benefits. We'll be speaking with some top voices and thought leaders in this space. So I'm going to introduce them and they'll, well. I'll introduce their name and I'll let them introduce themselves. But, uh, but joining us today, we have Vaso Paramanis.

She is a former CHRO and current consultant with 125 years of experience. Welcome Vaso.

Vaso Perimenis: Thank you. It's really nice to be here.

David Rice: Awesome. Um, also joining us, we have Cara [00:01:00] Barnes. She's the founder of Good Karma Consulting. Uh, Cara, welcome. Tell us a little bit about you.

Cara Barnes: Thanks. It's really good to be here. I am a factional HR manager for small.

Nonprofits and small startups.

David Rice: Very cool. All right. And then we have, finally, Sherry Race. Uh, Sherry is the CEO and co founder of Enthea. Sherry, welcome.

Sherry Rais: Thank you. Um, I run an employee benefits company that focuses on innovative, evidence based mental health treatments.

David Rice: Awesome. And as you will all come to see that's going to be a theme of today's conversation a little bit.

So, um, well, we'll get started in just a sec. And to get us going, though, I would love to hear where everybody's joining us from. I always like this part. We get some surprising places in the attendance. So please take a second to say hi, let us know where you are in the chat. Um, and then a couple of housekeeping items.

This session is being recorded. It'll be available [00:02:00] later on for anybody who couldn't attend or is. As well for you all who could attend. Um, we may use clips of it on our website or on our social channels. Your cameras and microphones by default are off so you won't appear in the recording. The rules are simple.

Ask any questions that you have and we'll get to as many as we can toward the end of the call. If it's like super relevant to what we're talking about in a moment, I may tie it in, but for the most part, what we'll do is we'll set them aside and we'll come back to them, uh, towards the end of the call last 15 to 20 minutes.

All right. Well, with that, I out of the way, let's just get straight into it. Um, The first thing that came to mind when we talk about benefits, honestly, is burnout, right? So when we talk about benefits and we think about how people think of benefits with their job, a lot of what they're trying to get at is addressing sort of their sense of burnout.

It's one of the most common challenges organizations [00:03:00] face, and especially around creating better mental health benefits. Uh, Cara, I'd like to start with you, sort of what's happening within organizations that you're seeing, you know, as a consultant, that has made this such a pressing concern, and what are some of the signs that you may need to make this a priority?

Cara Barnes: Yeah, no, I think that's a really good question. I feel like just to start, I know that in the, in the chat box, there's like quite a few different people from all over the world. Um, I'm coming from a perspective of working with small businesses in the U S and what we're seeing, first of all, is Health insurance is getting really, really difficult to obtain at an affordable rate.

This impacts obviously the employers, but ultimately at the end of the day, it's impacting the employees. So boots on the ground, we're seeing a lot of, you know, big increases from like 10 to 40 percent increases on medical premiums alone, [00:04:00] which is obviously mental health is a big part of it. Like, What the challenges are then is can we afford benefits for employees?

That's number one. Um, and secondly, What kind of benefits are we able to do? We have to go to a basic plan because it's getting more expensive, and now these basic plans are not offering really great competitive quality benefits that are for mental health, right? That normally is the one that gets dropped.

So that's what we're seeing right now. Um, with our, our nonprofits and our small startups really struggling to find quality benefits that they could offer their people. Um, and then we're also seeing just kind of an, Um, an increase of requests for mental health benefits and more support here, especially with younger generations like millennials and, you know, Gen C, they, they're openly prioritizing health and they really expect their [00:05:00] employers to offer this type of support.

Um, and as you know, uh, mental health is also tied to physical health or situations where, um, you know, somebody pulls out their back and that's like a direct correlation to A big impact on somebody's mental health and so I think it's all tied together. And what we're, what, what's a mistake that's happening is that we're thinking, oh, we need mental, we need better mental health support or that's, or for employees are saying that, but other people are saying, no, we just need better medical benefits.

I was like, well, they're one in the same. So that's what I'm seeing so far. I don't know, Sherry and Vaso, if that's what you're also kind of like coming across. Um, but boots on the ground, that's day in, day out. Yeah. Conversations we're having.

David Rice: Yeah, I'm curious, Vasil, from your perspective, because you have a lot of experience sort of in the healthcare field, and I know that teams are often short staffed, granting every PTO request isn't always possible, right?

So [00:06:00] the burnout piece and sort of the tie to mental health there must be, must be. Must be very pronounced.

Vaso Perimenis: Yeah, it is extremely pronounced. Um, and one of the challenges, Carl, you mentioned, you know, the, um, sustainability of benefits is that there's so much strain, strain being put on expense. So when you have a finite amount of money that you can spend on benefits, where are you going to allocate that?

And as an example, um, gene therapies. are now becoming more advanced. They're extremely, extremely millions of dollars in for gene therapy. They're very expensive. Um, we have a GLP one drugs that are extremely expensive. Um, you know, where I worked before there was a 200 percent utilization increase in GLP one drugs.

And so all this costs money. [00:07:00] Right. And so you have mental health needs, you have weight reduction and all those comorbidities that come with it, um, or they're being prescribed for, you know, um, cardiac issues and all these other, um, um, diagnoses. And you've got this very advanced kind of cutting edge therapies that are coming out.

Where are you going to spend? Your finite amount of money, mental health is absolutely critical because like in health care, you don't have the staff that, um, can provide the care to the patients, then, um, the patients suffer, right? And, and we are patients. I'm a patient, right? I can run a health, health plan, but I'm also a patient of that health plan.

And so, you know, it's just, it's getting more and more. Um, acute the challenge of sustainability is becoming more acute [00:08:00] when it comes to to the cost of benefits.

David Rice: And Sherry, you know, from your perspective, I mean, you're seeing this kind of at different stages, right? I'm curious, what are some, you know, so many people are struggling with burnout.

What are some of the kind of the root causes of that and, and how are you kind of helping folks be more creative in how they approach it?

Sherry Rais: Yeah. So the pandemic definitely intensified work pressure. Blurring the boundaries between work and personal life, especially when everyone started working from home.

Um, and then workers have been adapting to these constant changes. Some, for some people, that's hybrid models. For some people, it's rapid tech advancements, like everyone's, you know, feeling a little stressed. We all now have to use AI. Um, we're dealing with economic uncertainty just in general. And so all of this, Um, adds additional strain on employees financially and [00:09:00] mentally, um, which is why 77 percent of employees are actually reporting experiencing burnout at their current job.

Um, 75 percent of employees said they would take A low, slightly lower salary to get better benefits. So we clearly have, um, you know, a bit of a crisis on our hands, not to not to sound too exaggerated. Um, and as others pointed out, the economic cost of this in terms of absenteeism, productivity, employee turnover is costing employers quite a lot of money, uh, untreated mental health.

Not just burnout, but everything mental health related is actually costing U. S. employers 3. 7 trillion annually. And some of the things we can do are actually look at innovative and maybe evidence based solutions that get to the root cause of our mental health issues. Often what we've been doing with mental health is we've been [00:10:00] applying Band Aids.

So we will, um, take medications for years, if not decades. And, uh, probably a lot of people, uh, on this webinar can relate. Some of those medications will have side effects. Um, we'll start doing talk therapy if we have access to it, which is great, but we might, some people might stay in a rut where they're in talk therapy again for years, if not decades, and we're not actually tackling the root causes of our issues, um, Which leads to more burnout, like a snowball effect.

Um, and that's why I think it's important to look at more innovative treatments, which I think we'll talk more about.

David Rice: Yeah. Well, one of the things that was coming up, uh, across everybody is, is cost, right? Where it's costing us a ton of money and we have finite resources. And one of the issues I think that we run into, right, is there's a lack of transparency in how prices are set, specifically with the aforementioned pharmaceutical drugs.

You know, we've got, Vassily mentioned the increase in, [00:11:00] uh, certain, the use of certain types of drugs. A lot of this gets attributed to the pharmacy benefits model, right? A pharmacy benefit manager. Model. Um, what sort of needs to change, I guess, in your opinion, and Vaso, we can start with you, uh, around this because, you know, companies are able to hide their pricing very effectively, and it has a huge effect on benefits plan.

So where, I guess, if we were going to change something, where would you start

simple, right? Oh,

Vaso Perimenis: yeah, there's so

Cara Barnes: much to change.

Vaso Perimenis: I think fundamentally, at least with the, um, PBM market, what's happened is there's been this, um, terrific market concentration. And so you have CVS and Caremark, which is their, um, PBM that they own. And then you have, [00:12:00] um, Cigna, Cigna and their PBM. So you've got these insurance companies or retail pharmacies that are now getting into the PBM market.

business. Um, Cygnus is Express Scripts and Uniteds is Optum. Together they have like 96 percent market share. They fill 80 percent of the prescriptions. So think about that. CVS has a retail pharmacy. CVS also owns Aetna. Which is an insurance company. Um, and so what they, what these companies are doing is they're doing this vertical integration where they're sub optimizing a part of their business because the profit that they make by sub optimizing one part is so much greater in another part of their business that it's an overall net gain.

So as an example, CVS, Um, insurance, um, can, um, negotiate and pay, um, [00:13:00] um, insurance. They can, the, the insurance, insurers can be paid, um, uh, a certain amount for a reimburse a certain amount for drugs, but the retail pharmacy. Is paid less and that's called kind of, um, spread pricing. And so they keep the profit from that.

There are all these financial mechanisms that are behind the scenes that no one really knows about. And, and, um, there's also the rebates. I'm sure you've heard about pharmaceutical rebates and how that works. Well, one of the jobs of a pharmacy benefit manager, and maybe I'll start there, what did they do?

They're kind of like, um, middlemen. Right. They're the middlemen that work with the drug companies, the manufacturers, um, the pharmacies and insurers, um, to administer, um, the, um, pharmaceutical part of a health plan. And what happens [00:14:00] is, um, They, um, because they have these other businesses, they can negotiate certain pricing.

It's like a shell game. They can move from here over here and the consumer, like if you ask what's the price of a drug, you're probably going to get 10 different answers. Because the price of the drug depends on what's negotiated. And so, that's where the lack of transparency comes in. So you have companies like Mark Cuban's Cost Plus, and what is he trying to do?

He's trying to go directly to the manufacturer for a certain amount of drugs and say, Okay, this is, let's say, the wholesale price of the drug, plus 15 percent markup, that's what you pay. Very clear on how that price is determined. But until, so what can be done until these companies change the way that they operate, there really isn't going to be much change.

And I don't know if you've heard recently, but [00:15:00] CVS is thinking about breaking up their company. And it might be because of pressure that they've gotten like the Federal Trade Commission think about a month ago, um, filed a lawsuit against all three PBMs because they're artificially inflating the cost of insulin.

And so I guess, and there's also been legislation that's been proposed for pharmacy benefit manager transparency and I think they're kind of reading the tea leaves. And they're thinking of breaking up the company into two parts. And so one part would be kind of like the retail side and the other part would be the, the insurer side.

And so, um, the, I think that's, what's fundamentally going to have to change is how these companies are structured. But as consumers, like as health plan administrators, You can also push back. There are a lot of pharmacy benefit vendors out there that aren't involved [00:16:00] in any of the rebate pricing or getting percentages of this or percentages of that.

All they do is they get an administrative fee. That's, that's where their revenue comes from and it's very clear where their revenue comes from. So do an RFP. Start looking at the standalone pharmacy benefit managers and what they can and start asking lots of questions as consumers you have to ask about transparency.

What is every single source of revenue from this contract that you're going to get PBM? Disclose it. I want to audit the plans. I want to know exactly Um, the data that you're selling, our data that you're selling to these, um, drug manufacturers, um, I wanna be able to conduct a pharmacy benefit audit every couple of years as a form of control and monitoring over this.

So there are a lot of things that, um, consumer, the consumer can do. The administrators of health plans to [00:17:00] sort of, you know, push back a bit against, um, against the, um, the PBM current. Current state.

David Rice: Yes, it gets it. You know, it's interesting. You're talking about them breaking up the company. I read earlier today that Walgreens is going to close something like 500 stores in the United States. So I'm wondering, do you think there's some sort of reading of the tea leaves going on here around the sustainability of this approach that we that we've gone this this journey that we've started with the PPMs?

Vaso Perimenis: You know, in and of themselves, PBMs are very helpful because they create the formularies, the drug formularies that insurers use, um, and their primary job originally was to keep the cost of prescription medication as low as possible. That's not a bad goal. That's not a bad mission, right? That's good. So I still think, you know, there's [00:18:00] definite value in the pharmacy benefit manager industry.

It's these vertically integrated PBMs that are creating a lot of havoc. Like there's this one drug I was reading, it's called Levac. And it's a cancer drug that went generic in 2016 and you can buy it for 55 bucks a month now that it's become generic. And CVS and I think Cigna's, um, was charging, they were charging 6, 000 a month.

Why? You know, because of these kind of financial manipulation of drug prices. I don't know how else to say it. Yeah. So, it, it's, it's a big problem. And I get that companies are in business to make profit. I understand that. Um, but who gets left out in the cold is the patient, is the consumer. Mm hmm. Of the patient.

Of these drugs. [00:19:00]

David Rice: From the perspective, and Cara, I'll turn it over to you on this one as well, like, in terms of being a plan administrator, of going out and finding these plans and trying to develop a good offering for employees that's going to help you acquire talent, where is there sort of a breaking point here?

Because a lot of this, we're talking about the expense, I guess, where do you start to prioritize and sort of reorder What it is you, you need for your employees and how do you actually identify that for your pop, your employee population?

Cara Barnes: Right. No, that's a really good question. And I mean, speaking about burnout and mental health, check on your HR employees out there.

So because there's a lot of pressure on the HR administrator to find quality benefits and their hands are often tied to what they have to offer. Right. So, uh, some of the challenges we're facing is, Because it's [00:20:00] so expensive, even with these basic plans, you can only offer one type of insurance. So like in California, you either love or hate Kaiser.

Like that's like a one type of insurance here. And because I work with small businesses, they don't have like the power of size to be able to offer multiple plans. Um, so some of the things that I do to try to like navigate through this difficult situation, like make the best out of a difficult situation is really, like Vaso was saying, is shop.

Uh, definitely get as many quotes as we, we can to see how competitive we can be. And I also look into the details of the plan. So what is the out of pocket max of each of these insurance plans? Because some of them don't even offer. Uh, coverage on some of these subscription prescriptions. So like, they're like, they only cover generic, but everything else [00:21:00] that is a higher, like brand is not even covered at all in insurance.

And so what we try to do is look into, okay, if the worst has happened, if somebody to get hit by a car or got cancer, what is the total maximum is that they're going to have to pay out of pocket as an employee? And so I'm very, very like. really focusing on out of pocket max. So it's OOPM. So you'll look in like the summary of benefits that you're looking at for if people are looking at their benefits right now, or shopping benefits or HR people out there looking, I would definitely take a look at that and then see, um, what the deductible is.

So like, you're just kind of zeroing in on certain plans that need to make the best of the situation. Right. So like, If I were, if an employee were to get cancer, the maximum they would have to pay for that year is X amount. And that's kind of a good way looking at it because [00:22:00] like transparency is not there.

Um, even just myself, just to give you my example, I went to go check on a headband for my son. His head's a little bit skewed or whatever. And they came back to me and said, the insurance company says that they may Or may not cover it. I was like, okay, what kind of answer is that? Like, tell me, will my insurance cover this or will it not?

And they're like, we don't know until we start it. So, but I'm still on the hook. So whether or not the insurance companies covers it, I'll still have to pay if they don't. And it's like a guessing game to whether or not they will or not. And so that's, that's the, that's a problem. And I know that I have to take that risk, but I understanding what my out of pocket maxes for that year.

Um, is key. So again, like how I navigate it is like, shop for my clients, for or for my business, for the business that we work with, and really educate the employees of like, [00:23:00] this is the situations happening, this is the how the insurance works. And then, and making them understand what these terms are. Like.

What does a copay copayment mean? What is. Like co insurance means and then giving a real life example situations of like, okay, if you're pregnant, this is how you utilize your insurance and how much it's going to cost you and this is the max you're going to get. And so that's how I can try to like combat this such a horrible part of my shitty situation of a health insurance that we are in.

to cover, you know, to, to, to help navigate them through this, right, is give them more information and explain this to them.

David Rice: I was like, kind of go out there and we started shopping around for different things, you know, kind of coming back to where we started with like the mental health challenges. Sherry, I want to kind of get into and Thea and what you all do and, and sort of the conversations that you're having with employers.

What are you finding, uh, you know, some of the biggest needs [00:24:00] are and how Are there kind of different models developing to help address some of these, these big needs around mental health?

Sherry Rais: Yeah. So what we know is that 60 percent of people with a mental health issue are treatment resistant, which means nothing that we have to offer them will work.

So just think about what that means for a second. Um, and that's a huge challenge for employers because even if they're doing all of the amazing things and adding all these new mental health offerings for up to 60 percent of people with mental health issues, it's not going to work. So that's one big challenge that we need to address.

Um, fortunately, There are treatments like Stella ganglion block, um, TMS and ketamine assisted therapy that are known to work in those cases of treatment resistance. I know the most about ketamine assisted therapy because NTS started with that as its first [00:25:00] product. And we've seen that it. Results in an 89 percent reduction in mental health symptoms.

We've actually seen an 86 percent reduction in PTSD, a 67 percent reduction in anxiety, a 65 percent reduction in depression. Um, we've also seen incredibly that 80 percent of people that do ketamine assisted therapy will do just a few sessions. So not something you do every day. And at follow up. 80 percent of them are off of their meds.

So we're actually getting to root cause healing. Um, which is to me is incredible. Um, and then has all these spillover effects in terms of boosting productivity and, uh, engagement with the team and morale. But, uh, to Vaso's point about costs. Here's an interesting thing about ketamine assisted therapy. The branded version of ketamine, Spiravato, is actually covered by insurance and the protocols for [00:26:00] Spiravato are to be on it daily.

regularly for the rest of your life. It's not something you do just a few times. It's actually something you just keep doing. And the average cost of Spirato is 45, 000 a year per patient. However, if you use branded ketamine, I mean, generic ketamine with therapy, The cost of the generic ketamine is nothing.

It's like 5 a dose. Uh, you combine it with therapy. So there's a cost of the therapy and a complete treatment cycle is about 5, 000. And what tons of data out there shows from not just Cynthia, but from all of these ketamine clinics that we see is that people only need to do that six times. Um, and they don't have to come back the next year or the year after.

So you're talking about a 45, 000 annual cost versus a 5, 000 one time cost. Um, yet the carriers are covering the branded version and not the generic version with the [00:27:00] therapy. So, um, isn't that interesting?

Cara Barnes: Say Sherry, I was like, this is like really interesting to me cause I don't know this right. And. This is a type of knowledge that should be sharing to our employees and to other businesses of like what's available to them.

Yeah.

David Rice: That was going to be my next question actually is around the education piece. Sort of what is the challenge there in terms of getting that message out there and helping people understand like the different routes that they can go because for a lot of HR folks, they've only ever dealt with certain vendors or certain types of benefits.

Sherry Rais: Mm hmm. Can I start on that?

David Rice: Yeah, yeah, yeah, please.

Sherry Rais: Um, and care. This is hopefully not to be taken the wrong way. Um, because I was reading the latest report saying that 73 percent of employees feel they don't Understand their [00:28:00] company's benefits. Um, and half of them say the benefits are just not communicated to them.

Well, whether they are, they aren't, it's up for debate. Maybe they don't pay attention. I

Cara Barnes: understand. No offense there. That is 100 percent true.

Sherry Rais: There is a challenge in, in, um, Communication and one of the things like I've seen because I'm on that end of I'm trying to, uh, to educate when I start working with employers, is that.

There, unfortunately, is not a one size fits all approach. So some people like print materials, some people like apps, some people like digital, some people want a webinar, some people want a workshop, and, you know, in, especially in smaller organizations, with large organizations, you can kind of do a little bit for everyone, but in smaller organizations, and we have a lot of small businesses in the US, it becomes impossible to do something that works for everyone.

And so I have a lot of empathy for how [00:29:00] Difficult, that is. Um, maybe we should do benefits ads at the Super Bowl or something so people understand how it works. I don't know. It's like,

Cara Barnes: it's like financial literacy should be the same for health insurance literacy. 100%. And like really talking through for and I think what's the benefit of being in a small business is because when the when the business is small, you can have those one on one conversations like that are specific to an employee situation to help navigate through it.

But I agree, like it is hard to get the communication out because I mean, if you talk to any other HR person, they'll probably like, I already told them, you know, like we did the webinar, we did the newsletters, we did the one on one, we did the, like, they are struggling and they're ha they're doing everything that they can to get that information out, but it's not necessarily employees fault.

It's not the HR fault. It's, [00:30:00] This is difficult to understand. Like HR, like health benefits is. It's so complex and almost purposely so that even if we were to explain this over and over again, it's hard to wrap your mind around these concepts and these, these topics, right? Like.

Vaso Perimenis: Totally agree with that. And I would go one step further and say a lot of HR professionals don't fully understand this.

The detail you really go down the rabbit trail, like you could say the copay is this, you know, the out of pocket maximize that's easy. But when you go down into deep detail on in the claims and how things are adjudicated, it is very difficult to understand the other, um, aspect of information consumption is a lot of workers are overwhelmed with data and information coming at them.

Every from everywhere, not [00:31:00] just their personal lives, but their work and it's very difficult, particularly in health care to take the time when you're working so many shifts, long shifts, shake the time to review everything and absorb it. It is. And you can, you can, like you said, in person webinars, one on one calls.

It doesn't work, and I don't think it's the fault of necessarily the communication plan. I think it's just The consumer of the information is just kind of tapped out, you know,

Cara Barnes: oh yeah, I've seen people zone out.

Vaso Perimenis: Yeah,

Cara Barnes: because like, what is like, what's

Vaso Perimenis: the difference between, okay, what is an out of pocket maximum?

What's a, what's, what's a copay? What's, what's a coinsurance? That's the difference. It's like these financial terms, and we expect You know, average people to understand all of them, and they're just, uh, financial [00:32:00] mechanisms, right, to, you know, move money instead of it being in a higher premium, you know, you have, you know, it's like, kind of like, um, you're shuffling things around, but it's very difficult to understand how it all works together.

Yeah. And we, we've made it difficult. As a country and the way that our system is set up, it's just, it's become very, very, very difficult. And the other challenge is a lot of companies don't put enough resources in HR. Right? Like you had a dedicated communications team that that's all they did. That might help, but if you're expecting a benefits team that's responsible for answering day to day questions, running reports, negotiating with doing all this work and to be able to communicate because some of them are not communication experts, but we expect that of them.

That's unfair too. Right? Yeah. And so you've got to think about where you're putting the resources and [00:33:00] where. The greatest value is, and if you really want employees to understand, you also need to make an investment to do everything you can to, um, to create a communication plan and the words that are used so that the information, which is very difficult information, can have a chance of being understood.

Yeah,

David Rice: this conversation has me thinking about my last, uh, visit and I got the explanation of benefits letter, you know, afterwards, and I thought I need an explanation of the explanation. I didn't understand why.

Cara Barnes: I would say to like there, there are solutions to and then I, I like being, I think for HR, here's like some advice for like for HR people who are administrators is to.

Expose yourself more into different types of alternative benefits because our medical systems not working. And I think [00:34:00] looking at Sherry's company as well is something that's going to be like top of my list of of looking into, but it's also like a holistic approach that you need to start. How do we navigate through these benefits?

Like the four of us here are not going to be able to change the situation anytime soon in the near future. It's, it's like, think, I mean, what's the saying goes think, um, globally, but act locally. So like, what can we do in the meantime? I think that when the meantime is like encourage leaders to prioritize health, like reduce workload, because, you know, maybe even offer some additional like stipend that is dedicated to going to see a therapist that's outside of network.

Um, These are kind of areas that are like kind of low hanging fruit that you can do as a small business owner, as an employer, as a leader. [00:35:00] Uh, even simple as like putting in your calendar, making your calendar open, stating, you know, picking up kids or mental health day and like openly making that okay. Um, like one of the things I do for my team is whether or not it's like strategic or not.

Uh, but I do always talk about. No Fridays or no meetings for me because I don't have child care. And so if we were to meet, like, you're going to see Marcus in the video, right? Like, like openly talking about these things, because otherwise I'll get burnt out and otherwise my mental health will be. Um, affected, right?

Like, and then, and making that visible to my employees and to others so that they understand that that it's okay. You know, if you can't make certain meetings because you're taught, you're, you're really spread thin, um, or if you're being, you're constantly asking those things and, and like, how's your workload?

Like, how are you handling it? [00:36:00] Like constant communication that way. I think that's like one way of trying to navigate through such a difficult situation with benefits. And mental health.

David Rice: Absolutely. Well, um, we've got like about 20 minutes left. I'm going to kind of open it up to some questions from the audience.

Um, I know that in the next 10 to 15 minutes, one of the things that will start to happen is some folks will have to jump further calls or things like that. Uh, so before we do that, I just want to, um, You know, mentioned that if you're loving what you see here in this session, and the content that we're doing to join us for the next 1, we're going to be talking with Dr.

V. J. pending core of the behavioral science on the behavioral science of performance during constant disruption. Next Tuesday, you can find out more about it and our S. and P. using the link that Michael's going to post into the chat. We'd love to see there to keep us in mind for more things going forward.

But a question did [00:37:00] come to the chat that I wanted to ask, and it was about what do you all think about providing nutrition and fitness benefits to address employees root causes of illnesses? I'll just open it up and feel free.

Vaso Perimenis: Yeah, hugely important. Um, so in my, um, years of being in healthcare and in HR for the same amount of time, um, we had onsite gyms and when there weren't onsite gyms, we also offered, uh, paid YMCA memberships, um, so that, um, uh, those who are interested could work out and Um, we also because we have dietitians would offer classes on nutrition, um, particularly nutrition specific to perhaps a condition that, that you may have.

And so it was a little bit easier in healthcare, you know, because we have the, you know, the experts, the [00:38:00] experts there, but that's all very important. Part of managing health, right? Your holistic approach to managing health. It's not all about medication. It's not all about, um, whatever else, the methods that we use that you have to think about what you eat and how you eat and when you work out and the importance of all of that working together to improve, to improve your health.

So at least in healthcare, in that industry, Um, historically we have, um, provided these, these types of programs or benefits, um, to, to employees.

David Rice: Yeah, I know it's a few folks that I know who use the nutrition. It's like they're diabetic, so it's definitely a huge benefit for them. That's, you know, a significant portion of the population is kind of in and around that. So that's, uh, [00:39:00] it's definitely a big one.

Vaso Perimenis: Yeah, the, and I'll add one more thing for the GLP 1 drugs that are used, well, initially used for weight loss, now used for other diagnoses.

Um, uh, there, There was at least historically this, it was kind of like a open season, right? Your provider prescribes it, you take it, you start losing weight all as well, super expensive. And if you go off of it, you'll probably put the weight on again. So where I worked, um, we, uh, had a bariatric, um, clinic and so we changed it so that if you want to get a prescription, the prescription, um, would have to be accompanied by, um, diet.

And, um, weight loss programs. So it wasn't just the medication alone, it was the medication coupled with, in order for it to be reimbursed through the health plan. So that puts more, [00:40:00] uh, more accountability on the, on the patient, on the consumer of that, to not just rely on, on the drug, right? To rely on behavior change related to diet and, and exercise.

David Rice: Thank you.

Kind of go to the next one. If there's no one, nobody wants to add anything. Uh, this one said, uh, I'm running a consultancy and I have some clients who might be open to lesser known therapies. So search, they want to shop around and others who might see some stigma attached to things, or just would want to.

Would be hesitant to go away from anything that's traditional. Um, how, what advice do you have for approaching those conversations? Um, Sherry or Kyle, you can talk to them.

Sherry Rais: I'd love to jump in. Um, I promise I didn't ask someone to ask that question, but what a great question

to ask.

Sherry Rais: Um, [00:41:00] so, Juan, whoever asked that question, please contact me.

And we could have a longer conversation offline. I'd really be happy to help. And I can put my email in the chat, but at a high level, what we've been doing when talking to even the more conservative employers, traditional employers, where there's a lot of You know, stigma around some of these innovative novel treatments is talk a lot about costs.

So for example, we, um, did an, uh, case, an analysis with a health economist from UC Berkeley, and we were able to show that we can save employers up to 86 percent of their current spend just by introducing ketamine assisted therapy. So that's huge. Um, and so again, when talking to these. So when I'm talking to more conservative or maybe more traditional employers, I focus a lot more on costs when I'm talking to non [00:42:00] conservative employers or also something that's really useful is, um, stories.

So if you know anyone who, for whom some of these innovative treatments have had a big impact, I'll just say one of mine quickly. The reason I'm even in this space, I was in a very different place. Um, I was on the front line of work, um, working on the front lines and some of the world's poorest countries and, um, uh, close friend of mine was very suicidal and tried to take her life twice and I did not want to lose her and I found these treatments and saw that it saved her life and wanted to have, um, To make that accessible for others.

So I think combining, um, combining like good facts and good data with personal stories is a great way to approach even people with a lot of stigma. Um, and I'm happy. I could talk about that one all day. So I'll put my email. Yes,

Cara Barnes: I was going to say, like, [00:43:00] we're dealing with you and I will need to connect after it's because I'm like this other consultant who asked the question, have, it's like a number one topic that continues to comes up, you know, like, even with the, even if we had the best benefits, even like the top tier benefits right medical, it still doesn't.

address the situation, like the problem or a problem. Like, even if we had all the money in the world and can give you this top tier, like your quote that you were saying earlier is that 60 percent of it doesn't actually work. Yeah. There's like, and it's not just therapy. It's like, it's like a combined effort into helping our employees.

Right. It's. We are struggling like it is a is is a really tough conversation to have and more and more I'm seeing of People just quitting with no other job available because they're so burnt out We're having to [00:44:00] help them apply for SDI and thankfully I'm in the state of California So a lot of our clients have access to those types of services benefits to the state, but very little, even like at 60, 70 percent of their wages, they have to take time off.

And, you know, people are living paycheck to paycheck right now with the cost of living. And so even that is too hard for them. Um, so I love this. I love that approach on talking about cost. Because it's not just the cost of the benefits, but like, what is, what is the cost of not doing anything?

Sherry Rais: It's too high.

The cost of not doing it is too high.

Cara Barnes: It's too high. We're drowning, right? So I'm like, I don't care how out there it is. I'll try anything now. You know what I mean? To like, try to get us back into really getting real help for people.

Sherry Rais: And we didn't even talk about it. You touched on it now, like workers coffin disability.

Claims the number one source of disability claims and [00:45:00] workers comp is mental health. And so, yeah, um, yeah, we it's it's really sad.

Cara Barnes: It's really sad. It's it's something that's happening right now. And, um, I'm seeing it in real, like, day to day with my with employees that were helping and supporting, um, which makes it really hard for Even employers and small business owners who want to provide that support and just can't.

Yeah. So at least there's one solution. We could try to talk to Sherry. I

David Rice: don't know. Yeah. You all had talked earlier about the education, the insurance literacy piece, and I thought that was really great. Cause we can, we talk about like on the website, right? We have all this stuff about helping folks with financial literacy and it is, it's become this like big normalized thing that you're going to do something around financial literacy.

Right.

Cara Barnes: Right.

David Rice: But if I was to try to do this around [00:46:00] insurance, right. What resources should I be looking for out of the gate and what are some internal stakeholders I should be looking for to partner with if I wanted to do that?

Vaso Perimenis: I think a great, uh, internal stakeholder, um, is your marketing, uh, internal communications and marketing team. If your organization has one because they have, um, real talent with messaging and coming up, helping you craft that communication, um, plan. And so, um, at least historically for me, we've leaned very heavily on that team to assist with a lot of like the, the, the big messaging.

Um, and then just using different mediums to, like you were saying earlier, you know, some people like Writing everything in writing. Some people like little video. Some people like, um, [00:47:00] you know, in person, uh, one on one. And so mapping out all the various ways that you can, um, communicate, uh, with employees is also helpful.

Cara Barnes: As I say, you could talk to a benefits broker, David, and then have them give you that information. And like, maybe their deck, their orientation deck that they normally do. Most of the time, like, companies have, like, a benefits orientation call that, they're really great, um, but then sometimes employees kind of, like, zone out on it, on, but I do, I do agree, I don't know, like, Cher was saying too, like, stories do help, like, I like giving stories and real life scenarios of, like, okay, here's a plan, and, like, real scenario, you need to get, like, Okay.

Bye. Bye. Um, a knee reconstruction [00:48:00] surgery, that's like a typical surgery or whatever, or you have like a number one thing people are talking about is autoimmune disease, like autoimmune disease is so big right now. So how do we navigate the system if you have autoimmune disease, which prescriptions are available for you?

So like real talk of like a real life example that somebody would actually. Be dealing with, uh, and then walk them through and venture. And so it's not enough to talk about the terms, but I like to put it in like. a story, an example for them and then walking them through it. All

David Rice: right. Um, another one's coming here. It says, uh, how are you tracking the efficacy of benefits and benefit plans and determining which specific acts aspects of the plan are the biggest contributors to the overall health and happiness of employees?

Cara Barnes: That's such a good question. I have

Sherry Rais: some, Oh, go ahead.

Please

Vaso Perimenis: go, Sherry. [00:49:00]

Sherry Rais: I have, we have some things that we're looking at. We are still very much in startup mode, so I would love, you know, So your feedback on this, but we've been looking, of course, at utilization. Um, we do anonymous surveys. We do symptom rating scores. Um, we, um, then if we can with larger employers, it's harder with smaller employers, but with larger employers, um, We can usually put agreements in place to analyze their claims data over time to ultimately see like, is are we reducing spend?

Um, and then the softer KPIs or outcomes that are sometimes hard to measure or again, if anyone has ideas, I'd love to know. Um, I want to be able to work with H. R. Leaders to see, um, has, you know, number of sick days gone down. [00:50:00] Um, I haven't been able to get this data any yet from any employers, but this is something I'm very curious about.

Like, are people showing up to work more often? Um, because 62 percent of missed work days are due to mental health. So that's something I really care about, but haven't been able to get the data for yet.

Cara Barnes: Right. I like that. I like that approach. Um, I I'm surprised that people wouldn't want to give that to you.

Like I would say, I feel like that's it's

Sherry Rais: hard to track. Well,

Vaso Perimenis: yeah, that's the problem. Yeah. There's not a consistent tracking or identification of a day as a, as a sick day, especially if you use like a PTO method. Yeah. And you don't really know the reason. Our startups,

Cara Barnes: we do unlimited PTO, which. Yeah, it's so hard to track.

Yeah. Like, yeah, you put his idea whoever came up with it, but though unlimited PTO, we don't know. And we can't ask right we can ask. Yeah. It's a sicker as a PTO or whatever. [00:51:00] Um, they combine it. So that makes sense. I don't, some of my nonprofits I have, they're very, very diligent in tracking. Yeah. Smaller companies.

I would imagine

Sherry Rais: better on that. Yeah.

Cara Barnes: Yeah. And we know, like we have that people data of like, well, like, you know, you, you've had like a 40 percent turnover last year. Yeah. You know, like that's kind of like what I go in there with some of my business. I'm like, we need to work on a lot of things. Cause you know, high turnover, people are calling sick.

People are quitting without jobs because of the exit interviews that we're doing. And so then we do another kind of survey after we're done with the client and see that data, like has it significantly changed, but yeah, it is hard to know. And for me, again, I go back to individuals and because we work with smaller businesses.

I like to see if like individuals are getting better, if individuals are actually getting the support that they need and we didn't touch on [00:52:00] it and it's probably another panel but, you know, neurodiversity is also something that isn't touched on often and getting people support who are neurodivergent.

and uh, you know, changing how we kind of like manage and lead people is, you know, we could spend hours talking about that too.

Vaso Perimenis: Yeah. So, um, so, uh, the, uh, health plan, um, not from prior employer, but for the one before utilized a population health approach, because the employees are patients, right? Of the healthcare organization.

And so there was a team of nurses dedicated to acting as coaches and like navigators to reach out, um, to, uh, Employees and, um, help them as much as possible with whatever they need in navigation or understanding [00:53:00] the diagnosis, reaching out to the to the provider if they needed something else, you know, so that was also very helpful.

But in terms of the benefits that are offered every few years, it would be very helpful to conduct a voice of the customer survey where you ask you for the current. Um, uh. offerings, ask about satisfaction and importance of that benefit, because you'll find that you're offering benefits. Sometimes they're voluntary.

And so there is a, isn't a direct cost to the employer, but there's always an administrative cost. Nobody's really using or interested in. So make sure you're listening to the employees, to your employees about what's important to them, because that will change.

Cara Barnes: You

Vaso Perimenis: can't assume that, you know, their needs remain, Stagnant.

David Rice: Absolutely. Well, I want to give everyone a chance to ask one last question. We've only got [00:54:00] a couple of minutes left. So, um, if there's any questions anybody wants to get in before we go, please pop those in the chat right now and we'll get to it before we all log off. But, uh, I guess I kind of want to leave us on this.

Um, well, benefits obviously encompasses a lot and, um, When we talk about things like PTO, you just mentioned the unlimited PTO, which I also cannot stand, you know, when we develop policies around that, and we think about mental health, and we think about overall physical health. What are you kind of doing culturally to drive to help because we have this problem with people not taking it, right?

So culturally, what are you trying to do to, I guess, help people take that time and ensure that they're at least getting their time off and their time away from work, which is a key benefit that we look for when we go looking for a job.

Cara Barnes: I mean, I'll just [00:55:00] start. I feel like it has something to do with trust.

When, when we find that people are not taking their PTOs. Or taking time off is that they're afraid they're gonna lose their job or they're not gonna keep up or there's just there's fear behind it. Um, and so that starts at the top. It starts with the leaders encouraging that and then not like bombarding them with work when they get back.

Uh, yeah, it is a problem. We're seeing it and it's a lot of because everybody's overworked. And so they're like, I can't even possibly take time off because when I get back, it's I'm paying for it for that. It's even worse. Or, yeah,

Sherry Rais: okay,

David Rice: all right, well, if nobody else has anything else to add. We'll go ahead and we'll sign off.

I didn't see any more questions come through. So I want to thank everybody for joining us today. We [00:56:00] do love your feedback on these events. So please, uh, Michael just our, uh, he's our administrator here. Uh, he's, uh, just popped a link in the chat for a feedback form. If you could please, uh, just let us know what you thought of today's events and how we can continue to make these things better.

We always love to hear your thoughts. Um, And I want to thank Sherry, Cara, and Vaso for joining us today. It was a lovely chat. I like talking about this one. This was, uh, this was cool.

Cara Barnes: Thank you. Thank you.