Leading An All-Female Insurance Agency | with Maggi Quinn

This video features an in-depth conversation with Maggi Quinn, SVP of Consulting at Intrepid Benefits, exploring her journey into the health insurance industry, the unique operational model of her all-female agency, and innovative strategies in employer-sponsored healthcare. Hosted by Spencer of the "Self-Funded" podcast, the discussion centers on how Intrepid Benefits provides fiduciary services to employer-sponsored plans, emphasizing a shift from fully-insured to self-funded arrangements to achieve greater impact and cost savings for employers and better care for employees. Maggi shares personal anecdotes about her career progression, the challenges and rewards of consulting, and the importance of building strong, trusting relationships with clients.

A significant portion of the discussion highlights Intrepid's distinctive approach to talent acquisition and development. The agency intentionally hires individuals without prior industry experience, preferring a "clean slate" to train them in their specific methodologies and culture, rather than "unwinding" pre-existing industry knowledge. They utilize tools like the Culture Index to screen for personality traits, avoiding profiles that are "slower to think, slower to act, and not proactive." This rigorous focus on culture fit and a structured immersion training process allows them to quickly bring new hires up to speed in the complex world of benefits, fostering a team that is deeply connected and passionate about their work.

The conversation further delves into the strategic advantages of self-funded healthcare, particularly for small to mid-market employers (50-500 lives), and the role of benefits captives like Paro Health. Maggi expresses her passion for moving employers into these alternative funding arrangements, where consultants can truly make a strategic impact beyond simply shopping for rates. The most exciting and innovative areas for Intrepid currently revolve around pharmacy spend, including a cutting-edge DNA sequencing strategy for personalized medication management (pharmacogenetics/genomics) and the carving out of specialty pharmacy benefits. These approaches aim to provide significant cost savings for employers while delivering invaluable, life-changing benefits to employees, such as access to expensive medications at no out-of-pocket cost.

Key Takeaways:

• Strategic Shift to Self-Funding: Employers are increasingly being priced out of fully-insured markets, making a move to self-funded or captive arrangements not just an option, but a necessity for sustainable healthcare benefits. This shift empowers consultants to deliver tangible value and strategic impact.
• "Clean Slate" Hiring & Culture Focus: Intrepid Benefits successfully hires and trains individuals without prior industry experience, believing it's easier to teach complex benefit concepts from scratch than to retrain those with ingrained industry perspectives. Culture fit, screened partly through tools like the Culture Index, is paramount.
• Operational Efficiency Through Specialization: Intrepid maintains a "well-oiled machine" by staying in its lane (benefits, not payroll or HR), segmenting its client base (e.g., core group, mid-market, self-funded), and developing specialized teams. This allows for repeatable processes and scalable growth with complex solutions.
• Relationship-Driven Sales Philosophy: The agency prioritizes building deep, trusting, and long-lasting client relationships, often embracing a "slow sale" approach. They are willing to turn away business if there isn't a mutual cultural fit, believing that engaged clients who appreciate the relationship yield better long-term outcomes.
• Pharmacy as a Pivotal Cost-Saving Area: Pharmacy spend is identified as the most exciting and impactful area for innovation in employer-sponsored healthcare. Significant savings can be achieved by unbundling and carving out pharmacy benefits, especially specialty medications.
• Personalized Medication Management via DNA Sequencing (Pharmacogenetics): Intrepid is implementing a DNA sequencing strategy that provides employees with personalized information on how their DNA interacts with various medications. This precision medicine approach can optimize drug efficacy, minimize side effects, and eliminate trial-and-error prescribing, offering an invaluable, lifelong gift to employees.
• Specialty Pharmacy Carve-Outs and Patient Assistance: Partnering with specialized firms (like Smith) for specialty pharmacy carve-outs can lead to dramatic cost reductions for high-cost drugs, often leveraging patient assistance programs to bring employee and employer costs down to zero for multi-million dollar annual medications.
• Employers as a Lever for Health Improvement: Employers represent the most significant opportunity to facilitate access to better healthcare and improve the health outcomes of individuals. By offering innovative benefits, they can empower employees to make informed health decisions.
• Simplifying Healthcare Communication: The industry needs to do a better job of simplifying complex healthcare jargon and concepts. Consultants should use analogies and terms that everyone understands to foster better engagement and comprehension among employers and employees.
• Value of Advisor Networks: Being part of networks like "True" provides invaluable access to training, knowledge, and expertise from peers across the industry, fostering a collaborative environment and enhancing the capabilities of individual agencies.
• Optimistic Outlook for Healthcare Reform: Despite current challenges, there is growing optimism for a "course correction" in the U.S. healthcare system, with a strong belief that innovative models and solutions will continue to emerge and gain traction in the coming years.

Tools/Resources Mentioned:

• Culture Index: A behavioral assessment tool used for screening job candidates to ensure cultural fit and identify desired personality traits.
• Spring Buck: A tool mentioned for generating annual reports and focusing on key areas of pharmacy spend and stop-loss breaches.
• Paro Health: Described as the largest benefits captive in the United States, used by Intrepid Benefits to help employers transition to self-funded models.
• Smith: A partner specializing in specialty pharmacy solutions and patient assistance programs.
• True (Network of Advisors): A network of advisors, led by Scott Smith, that provides training, knowledge sharing, and cultural alignment for independent agencies.

Key Concepts:

• Self-Funded Healthcare: An arrangement where an employer directly pays for employees' healthcare costs rather than paying premiums to an insurance carrier. This allows for greater control over plan design and potential cost savings.
• Fully-Insured Healthcare: The traditional model where an employer pays a fixed premium to an insurance carrier, which then covers employees' healthcare costs.
• Level-Funded Healthcare: A hybrid model that combines elements of self-funding and fully-insured plans, often used by smaller employers to gain some of the advantages of self-funding with more predictable monthly costs.
• Benefits Captive: A group of employers that pool their resources to self-insure their health benefits, sharing risk and gaining greater control over costs and plan design.
• Pharmacogenetics/Genomics: The study of how an individual's genetic makeup affects their response to drugs, used to personalize medication management and optimize treatment.
• Specialty Pharmacy Carve-Out: Separating the management and purchasing of high-cost specialty medications from the main pharmacy benefit manager (PBM) to achieve better pricing and utilization controls.
• Stop-Loss Insurance: Insurance purchased by self-funded employers to protect against catastrophic claims that exceed a certain threshold.
• Fiduciary Services: Services provided by a third party (like Intrepid Benefits) that act in the best interest of the employer and employee benefit plan, ensuring fair and reasonable charges.

Examples/Case Studies:

• Hemophilic Drug Cost Reduction: A specific example was shared where a hemophilic drug's annual cost was projected to increase from $1.8 million to $2.4 million. Through intervention with a specialty pharmacy partner, the cost was reduced to $850,000, and further patient assistance brought the employee and employer cost down to zero.
• "Selling Beer at a Falcons Game" Analogy: Clayton (from Paro) challenged Maggi, stating she "couldn't sell beer at a Falcons game" if she struggled to sell the captive, motivating her to successfully close her first Paro case after two to three years.
• All-Female Agency Dynamic: Intrepid Benefits, an all-female agency, has both won and lost business due to its dynamic, including a school that declined to work with them because they felt male employees wouldn't be comfortable calling an all-female agency.