Nate Hallums breaks down why your health plan is costing more and delivering less — and what SMB owners can do about it right now.
GROWTH PILLAR: Health & Wellness
WHO THIS IS FOR: SMB owners · Solopreneurs · HR advisors · Leaders building systems
WHAT THEY'LL GAIN: A clear picture of how wellness plans actually work, how to fund them without new out-of-pocket costs, and why participation rate is the number that matters most.
Most business owners are paying more for healthcare every year and getting less in return. That's not bad luck. That's a system working exactly as designed.
Nate Hallums has spent over 30 years helping businesses stop reacting to healthcare costs and start building around them. After starting his career at IBM, he built BYF Consulting and Backyard Fishing Agency around one core idea: wellness should prevent problems, not just respond to them.
In this episode, Nate breaks down the difference between major medical plans and true wellness programs, explains how mental health sits at the foundation of everything else, and walks through why GLP-1 drugs — offered at up to 90% below market price through the right plan — are changing the conversation for employers and employees alike.
He explains how companies with as few as 10 employees can use a FICA-based tax savings structure to fund wellness coverage with no new out-of-pocket cost for employer or employee. He draws a straight line from the 401K revolution of the 1970s to where tax-advantaged wellness is headed — and makes a convincing case that 20 years from now, not having one will look as strange as not having a retirement plan.
Nate also covers the difference between participatory and voluntary plans, why participation rates in the 90–95% range are achievable, how on-demand concierge care eliminates the 2–6 week wait for a doctor, and how the plan his team runs covers the whole family — including a tick bite his wife resolved over the phone in 30 minutes.
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NEXT STEPS
Bernie(00:22)
question to the listener:
Why does our healthcare cost more every year, yet help our people less? Our guest breaks down how business owners and advisors can stop overpaying for broken health plans and make smarter wellness choices that actually work. He'll explain the real options in today's healthcare marketplace, how wellness programs can reduce costs while improving employee outcomes, and how companies,
even with those as few as 10 employees, can use strategic, tax efficient wellness solutions as a true business advantage. Our guest today is BernieHelms. He's a longtime entrepreneur and wellness strategist who brings more than over 30 years of experience helping business owners, executives, and nonprofits, and faith-based
Organizations reach their goals after starting his career with a Fortune fifty company. As the force behind BYF consulting and backyard fishing agency, Bernieleads
An EHP Wellness Partnership that delivers world-class employee wellness programs while uncovering real healthcare savings for organizations as few as 10 employees and well beyond 250. His team actively supports more than 90,000 employees across state governments, professional sports franchises, and publicly traded companies. Known for his clear practical speaking style, Bernieeducates leaders and their advisors on how the healthcare marketplace really works.
What options exist and how to make smarter choices that benefit both people and the bottom line. He also he's also helped consultants and financial professionals fund their own fees through the savings of his program, create and he continues to run a results-driven marketing agency that serving both small businesses and enterprise-level clients with a sharp focus on ROI. Nate, absolute pleasure having you here today. Thank you so much for joining us. David Free Recorder saying.
Nate (02:04)
Well, one of my mentors it's always stuck with me, you can't
It's so good. you can't direct anything that's not in motion. So or you can't direct or redirect anything that's not in motion. So I have to have, even if I'm 180 degrees out of sync with where I want to go or where I figured out I want to go, if I'm not in motion, I can't do anything. If I'm inert, I can't change direction.
Bernie(02:26)
Hence being a rock as opposed to a landslide, right? Fair enough.
Nate (02:29)
There you go. I
like it. Yeah.
Bernie(02:32)
You started in a Fortune fifty company. So usually that's kind of a that's a nice safety zone. I've I've been in the corporate side, maybe not the corporate top fifty. What made you move from that space to entrepreneurship? 'Cause you know, there's kind of safety knowing there's a paycheck at the end of the day.
Nate (02:48)
Right. Right. Well, funny, you know, one of the the I worked for IBM for a number of years and and one of the guys that I went through training with, I asked him years later after I left, after we both left IBM. I said, so when did you know I was I was gonna go start my own thing? He said, When I met you. So something about me that I guess speaks to that. but I just I it was a great education.
It was an opportunity to get into the boardroom and the C-suite pretty quickly and at a at a young age. And so that was a tremendous education. But I wanted to take those ideas, concepts that I learned and apply them in to smaller businesses and my own initially, and then ultimately as I learned more and more things about.
the challenges of small businesses, I wanted to start to help other businesses take advantage of the things that I'd learned. And so there's a great advantage to having that corporate experience that you can bring to the smaller business because corporate large corporations have to be more organized, have to make decisions that impact the entire enterprise. And smaller businesses a lot of times are a little bit more transactional. So to help you get into the world of strategy and out of the world of tactics,
that was that was kind of the the draw for me.
Bernie(04:01)
It's it's interesting. I and I I I totally get what you're saying. having been inside the corporate box and outside the corporate box, there's certain things you you take with you. But you you picked health care. I I mean that's that's first off, that means you recognize there was a problem. So what was the trigger for you for the from the healthcare perspective? And why healthcare?
Nate (04:18)
Yeah. Well, you know, it's been a w it's been a journey to get to to healthcare and kind of the same sort of I'll call it maturation process for myself is having gone through all of the different things that you're you try to solve problems for businesses and for business owners. But ultimately you're solving problems for people. And one of the biggest problems for people that impacts their ability to do the things that you're recommending be done.
depends on their ability to show up completely. And a lot of that is healthcare. So one of the early experiences that I had was I played football for a number of years and and car accidents, just you know, life along the way, I had neck issues. And so those had to to get addressed and I was able to get those addressed relatively it it it it took this emergency, I'll t I'll I'll put it that way.
It took this emergency, I can't turn my head sort of emergency, to make me go find a solution. And that's where a lot of employees are, a lot of people are just in general, until it gets to an extreme. We really just kind of let's keep on going. I've still got to go to the soccer game. I've still got to show up to the PTA meeting. I've still got to go to work, all those things. And and so it's easier. I always choose the easiest path as just a human.
And my easiest path is just to ignore things until they're an emergent situation. So and that's kind of applies to the whole system.
Bernie(05:40)
I I think you just described almost every dude I know. I ain't going to no I ain't going to see no doctor. now I gotta you know my arms falling off now I gotta go see the foot typical I'm being bold here. Speaking of people making decisions and and wellness, right? You know, like waiting the last minute. What still surprises you though from an organizational point of view, whether it's you know an SMB or you know, you're an enterprise level.
what what surprises you about their decision tree on on wellness?
Nate (06:06)
Well, it's a lot it's kind of like back to the individual. We only do it when we have to. And similarly with business owners, we only do it when we have to. And and our focus is making our widget, selling our smoothie, whatever our services are, our products are. We're focused on that and getting those things out the door and in somebody else's hand in exchange for for for cash. So unless it re unless it applies to that, clearly.
then I'm not really going to be focused on anything else in my business unless I have to. And so with the mandatory requirements at certain levels of employees, now I have to. So the the real creative one of the reasons I I really enjoy working with small businesses is they really have more of a sense of employee well being in general.
because one, they have more interaction with with people and maybe even their families, so that they really kind of see the whole picture and and take a little bit more holistic approach to being an employer. And so smaller businesses are actually looking for solutions. Unfortunately, there aren't a lot that are really affordable. And so it you kind of have this this kind of catch 22. As I get into a larger enterprise.
I really care less and I'm really more focused on my career and my and the things that I'm doing for the for the business. And as a whole, the business is in that is in that mode. So we have to make b larger businesses do it and the smaller businesses are more open to it, but have fewer choices.
Bernie(07:30)
So when you say wellness, usually I I think medical, right? And then the dental's not far behind and then I realize, gosh, I gotta go visit the dentist, and then I go then I got my eyes and then got my ears, you know, and God knows what else can kind of go sideways on your on your body. Mm-hmm. Is is is it just physical health or is wellness a little broader spectrum?
Nate (07:50)
It is it is a broader spectrum and and more and more studies are coming out on how someone's wellness and and if you take again there's a holistic approach, and as you're saying, we tend to think of it in on the physical body side, and and disease and and all of that. So that's really covered or should be covered by what we call your major medical plan. So if you've got Aetna, Blue Cross, Cygna, those big companies offering
major medical stuff for the for the person who has to wait for the emergency to go in and see. They're covered. And and so that where there's a whole series of questions that go around that and how we get those things installed. Wellness sits on top of that and actually should be preventative. So if healthcare is emergent and and dealing with existing maybe chronic problems, wellness should be really more of a holistic and preventative
And a lot of that starts with your mind. And because your mindset is going to impact everything else, whether it's stress levels, it's just in general call it mental health. So we had mental health challenges, both from the severe to less severe or what would be considered minor, but still more impacting than than we might ever know. And then COVID hit.
And and so that's exacerbated all of those issues and and really put a highlight, put a spotlight on mental health. So that's one of the big components of wellness is mental health, which impacts, I think everyone would agree, that that impacts your your entire life. if I'm depressed or my kids depressed, I'm
under stress because I'm having marital issues or financial issues. All those things manifest themselves into physical issues. But if I can address it on a preventative basis, have an outlet for the mental health side, I am in much better shape and so is my whole organization.
Bernie(09:39)
That's so when you do when you're talking about preventative mental health is really important. That's it's it's a forefront item because of you know anything to do with the head. If if where the head goes, the body tends to follow. even if even if you're wrestling, apparently that's that's kind of that's kind of the guide.
Nate (09:54)
Yeah.
Bernie(09:56)
do you also deal with like you know because the other things that influence good health is sleep.
Diet, exercise. Is that also part and parcel? Like do you offer i if someone is going, I I'm not doing it well, you know, pick pick a lane, right? Yeah, I'm not doing my sleep well, whatever. Is that also part of the overall package that's part and parcel?
Nate (10:17)
Yes. Yes. in fact, and you you may have you've obviously I I would I think if you watch Tv television at all, you've seen the Ozympic commercials. So yeah, weight loss, weight management, all of those things. We're the fattest country in the world. you know, all those things that we we get messaging on. how do you address it? And and they've and they've come up with this this kind of miracle set of drugs. There's you know multiple
vendors now that are providing those things. it addresses a a a major issue, and that is weight and weight control and and all of the different things that manifest themselves out of out of control weight management. So it impacts mental health, you know, it imp it impacts so many different things. and again, on a in a on a preventative basis, if I can lose weight,
Maybe I don't have the heart attack. If I can lose weight, you know, maybe I my arteries don't block up. So there's all kinds of downroad benefits in addressing that single issue. And so knowing that that was a very important item in people's lives and that it was very expensive to do, or I had to have a private coach, I had all these different things, and talk about you know putting it off.
I'll just go ahead and have my three meals and and and I'll exercise whenever I do. So in some cases, exercise really isn't the solution because they've got other metabolic issues. So we offer those those same types of drugs at about an 80 to 90 percent discount to the market if you're as part of our package, and that goes for the whole family. So that has been a very popular area.
On the financial side, because that's not covered by the, or maybe it's partially covered by the Cygna, the Yetna, the the bigger companies that are offering the major medical plans. the the fact that it's it's most of those offerings are through employers that are paying out of pocket. So there's a without getting into a lot of the detail, there's a self-insured and there's a fully insured version of healthcare.
To get those sort of benefits are generally self-insured benefits that are coming from the company, meaning that the company's writing at least part of the check, if not all of the check, for your GLP one is what is that category of drugs. So to be able to elimiBerniethat or just really, really minimize it down to almost nothing makes it the barrier to entry goes away. you we provide the access is there and we take it a step further.
We don't just say, you know, here's your pills or here's your shot and you you're on your own. We actually assign a coach to you. and that coach can be as involved as you like, can use that coach can just be a guide, or they can be a very active coach working on nutrition and exercise and all kinds of other plans for you in combination. So there's a long-term success with the GLP one plans. You know, if if you look at the bariatric
surgeries that that people have, a lot of times that's not a long term solution because I didn't change my other habits. And so this is a total holistic wellness approach that happens to use a drug to aid you to go
Bernie(13:17)
So for every dollar they s they they spend in in this, whether it's whether it's either paid by the employer or co-paid by employer or employee. So if I spend a dollar in this effort, what is the return on investment that you f I found for companies and and first off there's money, but there's also time, right? And you know, staff turnover. Like w what are the what are the ripples that are that are positive outcomes that
I've spent a dollar here, but it's like, you know, if I do training for the Olympics. If I I practice enough or I go to go to a marathon, right? If I practice enough, it's not it's not I don't die that day when I go to do the marathon. What are you finding as an ROI out of this spectrum?
Nate (13:58)
Yeah, great question. And and back to your question of why aren't people doing it? Why don't people address this area until they have to, is because it's not perceived as an ROI area. And so if you start with the the precept that your real assets are not your shop floor, they're not your inventory of of of devices or things that you're selling, your real assets are your people.
They happen to move those things through your business. But you're if you address your real asset in a in a way that's the most productive, least cost, but gets you to this whole person showing up because you're paying the whole salary, then that alone is just conceptually is a is a higher ROI. But there have been studies done. Johnson and Johnson did a study.
it's a little dated now, but I think I think it was through 2011. they said over the prior 10 years they had generated or received resulted in a quarter of a billion dollars worth of higher productivity, greater throughput, all the different things you might measure on a normal basis with your business, but not necessarily think about it in terms of the wellness of your employees.
GE did a study and they said dollar for dollar, there was a almost four to one return on investment for every dollar that I spent. So hard cost, hard benefits, and these are for plans that actually cost out of pocket. And I know we'll talk about how we can make that not an out of pocket cost, but for people that are writing checks, spending money, the big companies.
have to force themselves to go through those sort of measurements to see what it is there's been if there's if it's a big budget item, where are they getting a a rate of return on it? And because their biggest cost is people, if I can make those people more more productive in whatever way I'm doing that, not just using AI in my business, how about you know providing a better solution for the individual that's working on the shop floor behind that cubicle.
Bernie(15:52)
So if I'm in business and I'm starting up and I'm I got a crew of people in here and and like you like you like you said, you know, if I have this coverage, you know, something goes sideways for them in their particular instance, not not not through any fault of their own. I can help address it and they'll stay stay with me. How do I shop for that? How do I shop for the right size, the right product?
'Cause you know, at the end of the day, if I live in the downtown somewhere, you know, a a smart car, you know, tiny little thing might be an ideal thing, but it's not a back forty, you know, a four by four, you know, going through the bush. so how do I find the right vehicle for what what's happening around me? How how do how does someone scope that out and make a choice?
Nate (16:31)
Yeah, great question. And it's you know, it can be a you know multi-layered, complex a question. Hopefully you have a good advisor who can help you navigate those things. And you know, as we talked about earlier, actually taking advantage of the plans that you invest in are always always critical. So I would look at at talking to my employees to find out what their major challenges are.
You know, do you have are there mental health care issues that we need to address for you and your family? Are there weight issues for you to address for you and your family? what can your family afford as a deductible? so what's ended up happening in terms of structure, and you know, this year has been one of the biggest increases that people have seen on their premiums, and what
A lot of companies are, I had a $3,000 deductible that I had to meet last year, but and so for us to keep the same plan at a at just a 15% increase in cost, both to you and to me as the employer, we're gonna make that a five thousand dollar deductible this year. I talked to a company the other other day. They have a ten thousand dollar deductible. You see, you think I'm gonna go use my plan if I have a ten thousand dollar deductible, but they the employer has met.
The obligation, the legal obligation of providing care, making it available and accessible. So interviewing your employees and finding out what their needs are will help you tailor some of the plans. And some of them can be very modest. if I can just get to 90% of what is available through a Aetna or a Kaiser or those sort of companies, then I've I've serviced.
you know, maybe 90% of the needs of my employers, of my employees. And then maybe we try to figure out something else where you're able to, as an employee, save money on a tax deductible manner so that you can meet the the meet the other 10%. So and that can also help on the deductible side. So it's really just understanding your market and your market are your is your employee base.
And so going into that and getting a is as much of a defined solution before you even talk to anybody, a product provider, I think you're you're much further down the road than than most people are when they just say, Okay, you know, my Bob, my cousin is a health insurance guy. I'll just talk to him and we'll see. And so you end up in a situation where if all I have is a is a hammer, you must be a nail, kind of sales, right? So
Bernie(18:55)
Yeah. Ow. are there I I I totally get that. Are there certain verticals that, you know, this is an easy fit and there are other verticals that the premium is going to be higher? kind of what I'm thinking of is if you know, if you're a white collar worker, you know, you're working in an accounting firm or you're you know developing code for SaaS platforms, you know, stuff like that versus
I'm a lumberjack and I'm okay and I cut down logs for a living, right? yeah, two different two different areas. If you're a lumberjack, you might not need to have the you know the workout per se. you might have to work on a few other things, right? Your your like your your body joints, et cetera, and your musculature. Are there particular verticals that you know not not not buy or beware, but you might meet you might meet a more expensive need because of the nature of the what you do?
Nate (19:44)
Yes. And a lot of times that shows up. So all of this is risk management, right? So it's all insurance in any form is is a form of risk management. So I'm trying to offload the cost of that $100,000 heart attack or operation to an insurance company when one of my 150 employees has to have that. And so we invest with with companies that will take on that risk. So how do we shift the risk or how do we manage it?
within our own organization. And and a lot of times the the differential is more in workers' comp than it is in the healthcare. the way the the difference in in industries impacts healthcare, a lot of times is your what they call your experience rating. So when you have to, and again going back to we don't do things until we have to. So
You're more likely to have to tap the health network as a lumberjack or as a construction worker or a roofer than you are if you're sitting at a desk. So when you have to do that, that experience rating goes up. That in that increases the the premium on a on a per worker basis. And so I I think about that and and then as a an additional fail-safe or kind of actuarial support.
workers comp comes in and says, we'll also pay the employee, we'll also pay some of the healthcare cost. And so those are are two kind of hand-in-glove operations that you need to try to figure out how to optimize and reduce your risk and out of pocket as a as an employer. Of course for the employee. And and how do you keep your costs down on the other side on the people that you're paying for to for that coverage. So
To answer your question, it's our program and I guess any healthcare program is really industry agnostic. you just have different experiences based on the risk of the work that's being done.
Bernie(21:34)
Fair enough. So
Something looks good on paper. Does that mean it's gonna work well? And you know, is it you know, you've stepped into the into the breach and you've on the floor's not here and you like in one of those cartoons on Saturday from years ago, all of a sudden you just dropped. Are there any indicators someone should be mindful of that you know it looks good on paper, but
Nate (21:55)
Well, in the broadest sense, they're what educate owners, executives need to educate themselves on what is available out there and kind of the pros and cons. And so not that that any one solution is going to be right for everybody, but it may be right for you with the with the right amount of tailoring. But the broad categories of wellness, and again, wellness sits on top of a major medical plan, are participatory and voluntary.
So wellness became this catchphrase and and and policy attempt or direction, I don't know, maybe 20 years ago. And and so all the leading edge companies had it. Now, if you know, if you're a company of a hundred or more and you don't have a wellness plan, who are you? The the issue, so my wife works for a major hospital here in the Cincinnati area.
And I had some issues before I was involved with our our current program. And I had to look, hunt, peck, call, search for solutions. They were there, but nobody there was no access, particularly for the family member, to be able to find the resources that I need to address what was turning into they call it a frozen shoulder issue.
So I found some decent resources, but it was a lot of work and a lot of time on my part to get there. And had I not been in so much pain, I wouldn't have put in the effort. And so that is a voluntary plan or what they call a health contingent plan. the best plans that I have seen are participatory plans. So if you're engaged and involved, and the provider has to do a number of things to help this thing cat be be in that category.
But if you are engaged almost automatically in the plan, then and that plan delivery is more active or proactive, then that to me is a better solution. Just because of the human nature that we've already experienced, just because of our whole orientation to healthcare. for me to access the plan, for me to be that more.
fully involved, engaged employee, and to be present, not taking time off to go do the different things that I might have to do on to address my medical issues, then to me, that is a more productive solution for the person, the individual employee, as well as the employer. And there's some other financial benefits that come along with that as well.
Bernie(24:12)
You're mentioning about funding, like you know, who's who's paying who's who's dropping the dime, so to speak, for this. You also mentioned there there might be some tax breaks or some other type of breaks. how does that take shape? How does that happen?
Nate (24:24)
Yeah, well, the encouragement from the government. So the government bears a lot of cost when we're underinsured, because hospitals just by their charter have to take you in. And so and and because most people will wait, particularly if they're not insured, they know they don't have a solution, it's almost all emergent care. And so
the powers that be have been struggling with this for a long time. but so creating a an incentive for businesses. So let me give you an example. If you go back to the mid-70s, you're probably too young for this business. But if you go back to the mid-70s, we were emerging from a defined benefit world, and we were moving into a self-funded retirement world because
an affordability issue, right? We we couldn't afford any more and we were too reliant on the investment managers to allow us to afford fully funding retirement plans for all of our employees. And so the government said, let's incentivize it employers to provide an avenue for self-funding. And if we give them enough time, then the market will take care of a lot of the the self funding options. At least they'll have whatever they saved over that period of time.
So they made 401ks tax advantaged. And so meaning that I can deduct whatever I put in into my 401k and I don't have to pay tax on that on that money until I take it out. So similar concept. so and so fast forward 2026. If if you have more than two employees and you don't have a 401k, who are you? So now let's look at it.
you know, in in in terms of of healthcare and wellness. So I can deduct my my healthcare premiums, but that's money out of pocket. and those that money keeps going up and up and up, both for the employer and the employee. And so what can I what can I do to help address the stress of the whole system? And so let me at least make wellness a for more affordable by allowing it to be deductible.
So now we put that right up there with the deductibility of of your major medical plan. but it now it's it's can I afford that? Yeah, I get a deduction, but maybe I'm not in the highest tax bracket, and maybe that's not benefiting me as an individual as much as I would like, even though I would like to have access to those benefits. So they went a step further. And this is 13, 14, 15 years ago that these
The structure and the laws and and all of the rules of these plans were put in place, but people really didn't take advantage of them. Or smaller businesses with grid advisors took advantage of them, I'll put it that way. So now the process is I can send all of the services that I want to provide to my employees, to human and health health and human services, HHS, and they will say the value of your service is.
$1,000, $2,000, whatever the number is. In our case, it's $2,200. And so you can, that's the amount you can deduct. So the 20, so even though that's not your cost, which is what we got to deduct on the medical side, that's not your cost, that's the value. So let's let's deduct that value off of your paycheck. And and then that generates a a tax saving, a real tax savings.
Particularly if it's off of FICA savings, right? So I remember when I first met FICA, I was like, who is this guy? FICA, it's taking all my money, right? So I want I want to reduce my this my payment to FICA. And that savings then creates what I call a benefits bank or you know, this debit card, however you want to look at it, that allows me to spend those tax savings on wellness.
So the plan has to have all of its ducks in a row. It's got to be compliant to all the different things that you have to have in place. But if you do all those things, Health and Human Services gives you that value, you're able to deduct it. I still have this affordability problem because it's it's out of my paycheck and even though I did this the tax savings. So they created a way for us to put it back in. If if the wellness plan does its job, delivers the value that we said that it was worth.
And they can demonstrate that, then we'll let you put that back into the paycheck. So there's a way for your paycheck to look exactly the same, nothing out of pocket for the employee, nothing out of pocket for the employer. They just have to say yes to the structure. And now I have I've created a currency to pay for my wellness. I don't take change my take-home pay.
And as long as I focus on on a plan that has all of their ducks in a row and they can I can check all that out and their compliance is is all set, I get the best of both worlds. So I believe that that sort of tax advantage wellness is going to be like the 401k was. Twenty years from now, we're gonna look back and say, hey, if you don't have a tax advantage wellness plan, who are you?
And the momentum has already started to to you know, particularly with this last year, having the increases that we've had on healthcare, it's just unsustainable. And so there has to be a better solution and maybe a supplemental solution that does a number of things, not only provides a financial piece, but really addresses this holistic approach to providing health and wellness to the employees.
Bernie(29:22)
Well, company sets up a plan. Everything is running smooth. You know, the it's cost effective. the staff are covered, you know, everybody's everybody's smiling. How often do you revisit? Do you do you review if if the company merges, if the company scales would be the obvious triggers, but how often if you know if nothing drastic changes, how often do you revisit? Is is it
Population age dependent, you know, all of a sudden, you know, your workforce never left because they the this is the best place ever. And they're here now, you know, year twenty and they're still cruising, but you know, the body, the body goes, Yes, and year twenty, you know, twenty years downstream. It's yeah, we're gonna shift the gears a little bit. How often do you revisit the the establishment to make sure it's at peak?
Nate (30:05)
Well, personally, you know, for my clients, I'm constantly looking at getting feedback from, you know, the person that's answering the phone or the middle manager who doesn't really nobody's really paying much attention to other than the people right around them. I want to see how our plan is impacting their lives. And there's some phenomenal stories, almost you might say even life-saving stories.
particularly with this GLP1 stuff, because our plan is available for the whole family, there's been stories about kids and particularly teenagers being able to access the mental health care, the these weight loss drugs.
Those are probably the two biggest areas where I get just these impactful stories. But as a part of our requirement, this is the ducks in a row on the on the provider side, part of our requirement is being able to provide immediate on-demand reporting on what the activity is within your organization. And one of the things that we do is we say, if you weren't able to access this service, what would you have done?
The most common answer is nothing. And so when I talk about productivity, when I talk about emergent care, all of those things go through the roof if I had done nothing. So so now that I'm able to address it, so I'm able to report on that, we meet that requirement, the management knows what's happening. There, it's a you know, feedback. so the other favorite saying that I have is feedback makes the world go round.
So feedback by having that kind of instantaneous or on demand reporting and then from a regulatory standpoint, having you know, the consistent reporting to the folks that you need to report to. that's all great information and great insight for the management and for us to be able to look at what activities, what's accelerating in terms of usage, what's declining, why is it declining? Can we do a better job? Can we provide a better solution?
Because we believe the need hasn't necessarily gone away, but we want to investigate that and make sure those are those are the cases, that's the case. So reporting almost by requirement is on a monthly basis. And so looking at it from as a provider, and I'm your individual advisor, then I'm more, I don't know if I'm more or less active than than other advisors, but I'm always interested in that feedback loop.
Bernie(32:19)
So we talked about companies, you know, whether you're you know a a few staff or or many staff, what happens if because you're you're located in the US and so you're obviously doing coverage in the continental US?
Nate (32:33)
Right.
Bernie(32:34)
is it unique say if a company has a footprint, let's say in New York and there's a footprint in California and another footprint in Texas, how do you do you how do you manage that? Or even better yet,
They're international and buddy's going over to you know pick a country and you know he's they got staff there. Do you provide how do you manage that type of coverage?
Nate (32:54)
Yeah, well, for the international stuff, because our plan wouldn't say depends, but produces these FICA savings, the the people that are, you know, so FICA is a US based or driven driven process. So so those tax advantages would happen only for the US employees. You can, it's not an expensive item, but we wanted to make it as as inexpensive as possible.
And so zero is probably is good. and and then going for your overseas or out-of-country employees, they can purchase the plan. and it's about $160 a month. And because of the savings that are happening for the US-based employees, so it's it's there's no challenge for us to be anywhere in the US and with this thing called the internet, we're able to actually communicate with those folks and and have conversations like this.
To be able to make sure we're on top of things and and everything's getting addressed, reporting, all that stuff is education reporting and everything is as happening, happening properly. But for the internet, because of the savings in the US, a lot of times what companies will do, I have a client that has I guess about 40% of their employees are in Canada. And so they have taken the savings that they received. We haven't even talked about the f the employer savings.
So they'll take the savings that they've received over there and and fund the the benefit because they've seen so much value for it in the US. They'll fund the benefit for the non-domestic or international workers. And those savings for the employee or sorry, the employer are as much as but well, so the guaranteed minimum savings.
Is about $640 a year. That's pure pure FICA. Because we impact so many other elements of the whole healthcare business, I'll call it, workers comp goes down. your increase of your healthcare, your major medical, the the big names that you think about at Blue Cross and all that, those go down because your experience rating.
goes down. We talked a little bit about that. We can actually, as a wellness provider, be your as a participatory wellness provider, we can be your primary care provider as well. In fact, we provide people have looked at us as a concierge style, and there are people out there that are paying $1,000 a month to have more or more, to have on demand medical care.
Because they didn't want to wait the two or three weeks it takes or six weeks it takes to get to their normal provider. So they're paying out of pocket for this concierge style. Well, we provide that as part of our service. In fact, we we prefer it because it helps us demonstrate to the to the government our tax advantage because we're providing these these elements of care. So we can be your primary care doctor. And a lot of times you go to your primary care doctor to get a referral to the specialist that you need.
And then that specialist gives you a referral to the technician that does the diagnostics for you. And so six weeks later, you might have a solution. but it took all that time, and those were all three points of contact with your network that increases your experience rating. So if you talk to us and we refer you directly to either the specialist or the technician, you've eliminated at least one, if not two touches to your system.
That you get charged for. Not necessarily, well, it I was gonna say not necessarily out of pocket, but it is out of pocket because you have copays on each of those. So I didn't have to leave work. I didn't have, you know, I didn't have to. There's an environmental impact of me leaving work and driving to wherever. Then I didn't have to, I didn't have to wait. And that's probably of the overall advantage if you said what.
Will employees say to me if they say, Nate, we have your plan in place. What's the biggest thing that's that's impacted you as an employee? Access to care.
So we provide a bridge and immediate, almost on demand access to care to primary care. And I'm not I'm not talking about people who have said, well, we have telehealth. Well, you're generally talking to a fellow or a resident or someone like that, or maybe it's a newly licensed doctor. In our case, their tenure plus experience, board certified, they're already making a half million dollars a year or more.
They are seasoned doctors and they can be, you can have the same person every time you call in if you like. if you want, you know, less than a four-hour response or less than a one-day response, then you might take whoever's whoever's up and available. But I get that primary care three in the morning. in our household, I'm in tick country. my wife had a tick bite. we weren't quite sure. And so
she called up if she was gonna it was gonna take, you know, three or four days, maybe a week, to get into her doctor. And because it was an it was, you know, more emergent, it was only three or four days to a week versus the two weeks it would normally have taken. So so she would have taken off work, done her copay, and by then I already have Lyme disease. So they said.
Take a picture. We took a picture. We sh actually we showed it to them on the phone. they prescribed whatever it was that she had to take. And and they even said even offered a location of the of the fulfillment of that that pharmaceutical. And it was all done within 30 minutes. So that access to care is has been the greatest thing, and then all the ripple effects that that has.
Bernie(37:59)
Pretty good. So here's here's kind of a a play on word question. If wellness plans were fishing gear, which ones are all bait and no hook?
Nate (38:06)
Mm. Well, you know, I hate to cast dispersions on on any sort of you know.
Decision that people are making, I just would say do your homework and make sure you are getting what is being presented. And so in our case, I I was talking about the the financial benefits to the employer. We can demonstrate to you, walk you through how those financial benefits are going to happen. and we do that by taking, we take a holistic approach on the proposal.
And we look at your workers' comp, we look at your major medical, we look at all the deductibles, we look at all the family elements. Are you married? How many kids do you have? What age are they? there's no you know pre-existing conditions filtered or you know, screening or anything like that. But we just if we know, then we can do a much better job on the proposal, which will show you truer savings. So in those industries you asked about that maybe have higher impacts.
on on the healthcare system and and why they might do that. So if I'm gonna save in workers' comp, we'll include that in in your estimate of your savings. So there are companies that are saving $2,500, $3,000 a year every single year, starting day one from the time they put their plan in place. So make sure that whatever you're being told can actually happen.
and and is being is being delivered to their existing client base. And one of the things that is such a key
Indicator is the participation. So earlier we talked about participatory versus voluntary or health contingent plans. So when we look at participation, and I've I've gotten you know inquiries based on just this alone. There are people that get paid based on the participation percentage in the in various plans and wellness plans in particular. and so I had a manager, senior level manager at a bank.
And when I said, well, we're our participation's in the 90, 95% range. And he just he pulled me aside after the meeting. He's like, How do you do that? We actually pay our people to use our our wellness plan. And we're still only at 30%. And most of the most of the world is at 20. And and so I just, yeah, we walked, we walked through the the the process. And so when you look at at the benefits of the plan and how well
adopted it is if you have participation rates that are high, you know there's something good with the plan because people aren't going to keep coming back and keep using it at that level if they're not satisfied.
Bernie(40:30)
Nate, if if someone's listening to this podcast and they go, yeah, you know what? I'm gonna give him a call. How do they reach you? How do they get a hold of you?
Nate (40:38)
Well, easiest way, I mean, I'll just give you my number here, but I'll give you all my other stuff as well. my number is is five one three. I'm in the Cincinnati area, so five one three two seven three seven seven eight nine. Five one three two seven three seventy seven eighty nine. So BernieHollems, I'm on LinkedIn. I will provide you so solution health dot info. Solutionhealth.info is my website.
but all kinds of different ways to to to reach me. LinkedIn is great. I'm on there all the time. And if you're a business owner and you're not on LinkedIn, I'll tell you about LinkedIn when we talk and how that might benefit you. But it's a great way to reach me.
Bernie(41:15)
Nate, I want say thank you so much for sharing your information, sharing your knowledge and sharing the value, you know, making sure people are covered. You know, yes, the government will mandate something, but you know, if you do more than the bare minimum, you have better results. And to you, the NACRA business listeners, want to say thank you for your time. So Bernieyou know, has been with the Fortune 50 company.
And he saw firsthand how confusing and wasteful healthcare systems were failing both employers and employees. And basically that drove his experience to build a wellness solution that helps serve you, serve you better. So you got a question? Reach out to Nate.