Be the hero: A Q&A with Suzannah Gill

Suzannah Gill is a benefits strategy consultant at EPIC Insurance Brokers & Consultants, where she focuses on understanding her clients’ businesses and works with them to craft solutions to control their health care costs, enhance their benefit offering, and improve their ability to attract and retain top talent.

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

I started out as an employee benefits and ERISA attorney. Around the time that health care reform was cast, it became evident that there was a lot of confusion in the industry and that things were about to change. I wanted to be in on the ground floor when it came to shaping that change, and I felt like I could more effectively do that on the consulting/brokerage side.

So, I moved to a small brokerage firm in Atlanta, and then I went to Mercer and worked there for a few years and learned a lot. Most recently, I’ve been at EPIC, which I really think of as my home. We focus on growing middle-market clients. I think they have such a need for help and they’re willing to be innovative and drive change. It’s an exciting group of clients to work with.

PW: In what ways has your career path shaped your mindset as a broker?

Certainly as an attorney, I understand the importance of the compliance piece. Because employers are managing employee dollars, I think it’s really important that we take that fiduciary responsibility seriously.

Related: Fiduciary responsibility: Hot potato or hot topic?

During my time at Mercer, I learned the importance of actuarial calculations, budgeting and working with Fortune 500 companies. I also learned a lot about self-funding and how it gives an employer access to data and a control that they don’t have in a fully insured environment.

And now I’m bringing that knowledge to the mid-market, to help those employers become self-funded. At EPIC, I’ve enjoyed the entrepreneurial environment where I can craft solutions that are very customized for each specific client’s needs.

PW: Many of these strategies are becoming available to smaller companies. Where do you see that trend heading?

I think the driver of more companies looking at self-funding was health care reform. Moving to a self-funded platform enabled them to avoid some state insurance fees and to have more control over their plan design, because they weren’t subject to some of the plan design requirement of health care reform.

But now, it’s the understanding that in order to have control over your health plan, you need to understand your population and have access to your data. Self-funding gives you a level of transparency and control that you wouldn’t otherwise have. We have data analytics tools that were very expensive in the past and only accessible to large companies, but now they’re at a price point that makes them available for every employer. With that data, we can decide what strategies we’re going to implement.

PW: What exciting cost-saving strategies are you seeing right now?

There’s no silver bullet or one-size-fits-all solution. It’s important that we’re very thoughtful and don’t go in with our mind already made up. That’s what makes it challenging; I can’t just say, “I’ve got the answer for you.” You have to study the data and understand the employer’s appetite for change and disruption, and their willingness to communicate with employees about why they’re changing.

With that caveat, one of the best solutions I’m seeing is implementing a health care concierge. I think we’ve done a disservice in our industry by saying we’re going to add a HDHP and that’s going to make employees become better consumers. The health care system is very complicated. If you or your child gets a diagnosis, it’s scary. Your first idea isn’t, “I’m going to use this transparency tool to go somewhere other than where my doctor told me to go.” But if we can provide employees with a nurse who helps guide them through the system, makes sure they’re going to a center of excellence, that they’ve had a second opinion to make sure the care is appropriate, that’s a win-win.

A second one I think is a no-brainer is partnering with a transparent pharmacy benefit manager. What fees are they charging? How are they sourcing to make sure they’re getting the prescription in the most cost-effective manner for the employee and the plan?

The end goal is always figuring out how we can make the plan more robust and help it work better for employees.

PW: What challenges do you face as an innovator?

There are a lot of great new innovations out there; more than I could ever take advantage of for my clients. Keeping up with them, vetting them, and understanding what would be the right situation for each client is a lot of work.

The second thing is educating employers that they have the ability to gain control. For so long, we’ve told them that they can’t peek behind the curtain. But we’re in this exciting time in our industry now where they have the opportunity to take control and have some transparency into the system, to manage their claims spend and to start dealing with the supply chain issue. It’s a matter of educating them that not only are there options out there, but other employers are already successfully implementing them.

The old model is easy. It’s super expensive, and your health care costs are going to go up year after year, but it’s really easy. Doing this innovative stuff is complicated. There could be some bumps in the road. It’s new, sometimes scary, and I definitely have more gray hair from doing this than if I was just using the old model.

That’s why everyone isn’t doing this stuff yet— there is risk and a learning curve and you have to have a client who’s willing to join you on the journey.

PW: What are your favorite things about your job?

This is the most exciting time to be in this industry. There are so many things we can do to reduce health care costs. I’m excited every day to completely flip the narrative. Instead of “how terrible will this renewal be?” it’s “what are we going to do to make the benefits even better?”

I believe America is the most innovative country there is, and yet we’re paying much more for our health care and getting worse care and worse outcomes. The group with the most incentive to change that is employers, because they’re bearing the brunt of health care costs. They’re the test labs right now; they’re the ones who are out there trying this new stuff. The things I’m doing with my clients are ultimately going to help make our health care system work better as a whole. I love the fact that I get to part of this testing environment, this lab where we get to come up with ways to make this better for everybody.

This isn’t just the “stodgy old insurance business” anymore. I was talking to a broker the other day and she said, “I get to be the hero. I get to tell my clients, ‘We just saved a million dollars. What are you going to do with the savings?’” How great is that?

PW: What is your opinion of the latest series of mergers and new entrants into the health care space?

I’m very optimistic for the Amazon, Berkshire, J.P. Morgan partnership. I think they have great incentive to change and the technology and power to get some good minds involved. I wish them great success; I think they’re the right team to do it.

As far as the mergers between retail chains like Walmart or CVS and the insurance carriers, I like the idea of having access to a doctor at a convenient location. If I could have a primary care visit at my local CVS that’s three minutes from my house, I think that’s a great thing. If we can make care more accessible for people, that would be a positive.

PW: What are your favorite sources of inspiration and innovation?

I have a lot of respect for the people who’ve been in this industry before me. When I look at the older generation, there is so much I can learn from them. I have benefited so much from the values and other things they’ve taught me. As much as the industry is changing, there are some business principles that never change. Those are things that people who’ve been in the business for a while can teach us. I’ve really benefited from taking the time to learn from others and not assuming I always have the best answer or that technology is going to solve everything.

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

Embracing innovation and change.