Cara Kirsch is vice president at SilverStone Group, a full-service resource management organization offering customized services to meet business and private clients' specific needs.

Paul Wilson: How did you get your start in the benefits industry?

I've been in benefits for 20 years. I started on the employer side in an employee benefits department. I moved to consulting, where I wrote employee benefits communication. I then started to do general health and welfare consulting before moving to UnitedHealthcare, where I did account management and sales for nine years. I was recruited by Blue Cross Blue Shield of Nebraska in 2011 to run their sales strategy. I'm from Nebraska, but was living in the Bay Area, so I decided to come back. After a couple of years, I was really burnt out and wanted to do something different. The day after I left, I got a call from SilverStone Group. It was the perfect place for me. It's been amazing.

PW: How has the industry changed since you came on board?

I think the business environment has become too focused on chasing shiny objects: “Oh my god, let's try this. How about that?” One thing I've learned is you've got to stay focused on a couple of things and do them really well.

PW: How have you seen health care reform change brokers' mindsets?

We're seeing a lot of acquisitions, and I'm not surprised. To me, in a large group market, especially self-funded, you have to have solid data, strategy and infrastructure to support clients. Those strategies typically cost a lot. Some bigger brokerages have been very aggressive here in Nebraska when it comes to acquisitions. We've done a little, but 99 percent of our growth is organic. We've seen smaller brokers who have a few large group cases say, “We've got to get out.”

PW: Based on this trend, will there be a place for smaller brokers in the years ahead?

There will always be a role for smaller firms with smaller clients, especially if it continues to be as transactional as it currently is for the 2 to 50 market. In the short-term, there's probably not going to be a mass exodus, but long-term, if I'm those small employers and I plan to grow, I'm not aligning myself with someone who can't help me as I grow.

PW: What is your impression of the carriers right now? What's next?

I think we're going to continue to see them diversify and shrink. There is going to be consolidation. I don't mean they'll shrink as far as revenue, but they're getting smarter about what markets make money and what the industry needs.

One carrier is currently really good about buying technology startups and companies that are trying to understand how people access and utilize health care. I see that continuing to evolve.

Some of the big carriers are very open to innovation—they're willing to try new things and they have plenty of money.

PW: What is the biggest challenge brokers face?

One things that's amazing to me in the consultant world is the mediocre level of service employers become comfortable with. They'll have a long relationship with a consultant who's not that great, but they won't change. I've been in situations where they really want to pick us, but they're like, “Well, nothing's really broken.” I always think, it's a top three spend item. Why wouldn't you try something different? Luckily, I've been able to convince many of them to do that, but some who really need us just don't pick us.

PW: In many ways, it's harder to be a broker than ever before. How do you stay motivated?

Whether or not employers can see through the mediocre service they're getting from brokers, the system is still broken. It's on me to make sure I'm constantly sharing knowledge about how we can push the system to change.

PW: Any examples?

I implemented my first reference-based client in January; it was really interesting. I met with them last year as a prospect and they were getting a high double-digit increase. They had 300+ employees and were faced with not even having a plan anymore. The option their broker offered was a no go, so I said, give me a chance to put a second set of eyes on the renewal and see what we can do. We won because I put a reference-based strategy in front of them. They were fully insured, and I moved them to self-funded. They only had one plan before, so we gave employees a choice, with a really robust communication strategy. We only had a short amount of time to implement it, but it did what we needed it to do. Their costs are less than their full premiums were last year.

PW: The P&C/risk management side is aligning with benefits more often these days. Where do you see this trend heading?

In the past, risk for companies has been very siloed. They'd look at their workers' comp list, retirement and wealth planning very differently than benefits. But it all works together. People who aren't able to save for their retirement often are stressed and unhealthy. If they don't have an appropriate savings account for emergencies, they're more stressed out and more likely to have an accident and become a comp claim. So we try to talk to employers about their risk holistically.

PW: What do you wish you'd know when you were younger?

I wish I'd started as a broker 15 years ago. Omaha is kind of a small town, despite being a big city—everyone knows everybody. I have worked really hard during the past three years to be visible across the state in terms of speaking and marketing and strategy, but if I'd been doing that since I was 30… It takes time. My daughter is 19. I would love for her to get interested in this profession.

PW: How can the industry start doing a better job of attracting young talent?

I think spending more time with younger people as they're getting ready to finish college, specifically those with business or finance degrees. Help them understand the opportunity that's ahead of them. Some insurance companies do a good job of recruiting those kids to come on board as sales reps, but I think young people sometimes scare consulting firms, because there's a risk they won't stay. But if you want have bench strength, you have to commit to them.

PW: Talk a little about the experience of being a woman in this industry.

I grew up in a man's world. To me, not having any female counterparts is not a big deal, because that's how my whole life has been.

It's interesting, because I don't see myself as different, but I'm often treated differently. So I have to remind male counterparts that I don't need to be treated differently.

PW: You'd like to think that wouldn't even be an issue anymore.

It still happens all the time. My perspective is if you make a contribution, you'll be treated equally. For me to make a contribution in the same way is not easy. I'm a single mom with three kids; my male counterparts are all married with stay-at-home wives. I think women are often very private about their battles because they don't want to be seen as incapable. I used to think that didn't exist, but I've experienced it in my career. It's a real thing.

PW: How do you address the challenge of work/life balance?

My perspective on this is very different than it was in 2010. You have to realize you can't have it all. When my career first started to take off, my kids were really little and I was a single mom and it was OK. But kids need their parents, and you can't outsource that job.

Now, my perspective is you can't let anyone else define or decide what it means for you. You can't apologize for the work/life balance that you need, because the things in your life that are most important are going to change. My kids will grow up and leave, and I'll only be 47 when I'm an empty nester. I'll have 20 years to kick it into overdrive, but for the next three years, my son's playing high school football and I'm not missing anything.

PW: Finish this sentence: The key to success in this industry going forward is…

Be open. Be open to ideas. Be open to crazy suggestions. Be open to changing the status quo. Be open to challenging the norm.

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