Be a beacon: A Q&A with Tom DiLiegro
Tom DiLiegro is a consultant and the owner of Benefits Advisors of Charleston, focusing on the needs of small business owners.
Paul Wilson: How did you get your start in the benefits industry?
I went to business school, but I always had an eye on health care. After college, I decided to merge my interests in health care science with my newfound business knowledge. At that time, in Massachusetts (where I’m from), they were doing their 2006 state reform and I was reading the Wall Street Journal and said, “There it is. That’s exactly what I want to do.”
After a couple of years working at a TPA, my first job in the business, I had to learn through trial and error that health care and benefits isn’t just about the money. And then the practical knowledge I learned from being on the ground and learning from employers combined with working with Kevin Trokey and Wendy Keneipp at Q4. They introduced me to people like Simon Senek and Patrick Lencioni, Jim Collins’ “Good to Great” and “How the Mighty Fall.” I learned it’s about the people. You have to have the financial part, but we’re dealing with people. That should be the focus in any part of society, not just in business.
PW: What prompted you to start your own agency?
One specific instance. I’ll be the first to admit, it might not have been totally fair, but it was a trigger point for me. I was working through our broker channel and we had a legitimate opportunity to help a small 30-person HVAC company with our solution. The broker said, “Nah, I know this is the best way to go, but I make more money by doing this other option, so I’m going to do that.” I remember slamming the phone down and saying, “This is such BS. How do you do that and live with yourself?” At that point, I thought, “I can do this better.” That was my trigger.
PW: What prompted you to focus on small businesses, an area often overlooked or disregarded by many brokers?
Small businesses are the backbone of the economy, so I think everyone wants to help them, but there’s often just not enough meat on the bone. They get overlooked and are viewed as a lot of work for low margins: “You might as well do the 200 person group; it’s the same amount of work as a 20 person group but you get paid a lot more.” From a business perspective, I get it, but there are just so many small employers that need as much help as the bigger groups.
I just came from an employer group with 25 employees up in Durham and the guy was just done. He looked at his insurance costs every month, he looked at the benefits he was providing and said, “This is stupid.” He went out looking for something different, and thankfully, there are things available that can bring value and make benefits a benefit again and not a detriment.
I think a lot of businesses in that space are looking for help, but there just aren’t enough people to help guide them to the better solutions and situations that are available. There aren’t enough people who are willing to explain it and take the time to engage them and show them what their options are as a small employer. Sure, the margins may not always be there, but there’s 10 times the number of small businesses out there.
PW: What trends and innovations are making a difference?
For small employers, I’m a big fan of medical cost-sharing. That’s sort of my recipe for groups of 25 and under. What comes of that is transparency. Once you’re there, it’s like, “Why haven’t we always done this?” Because you see these drugs are often free at a local grocery store or pharmacy, or that a diabetic’s endocrinologist is $170, not the $3,000 that you thought it was when you were under an insurance contract. Transparency is eye-opening. Doctors, pharmacists and practitioners aren’t going to let some marginal cost get in the way of someone coming to see them. I think a lot of it comes back to just being real people and interacting with each other.
I know Dave Chase’s big thing is relocalizing health care, and I wholeheartedly agree with that. We’ve let far-off insurance carriers come between ourselves and practitioners and local pharmacies when we could just knock on the door and say “I have a good or service you might want. What if I just pay your directly for it?” I don’t think that’s out of the realm, and we as brokers need to be facilitators of that exchange as much as we are facilitators of the exchange of buying an insurance product.
PW: How receptive are your clients and prospects to these new ideas and strategies?
Nobody wants to go first. It takes one employer in one market to be willing to go first, and I feel like I have that with one particular client. But it took a year to decide what to do. They were with a BUCAH plan, had a moderate increase of 2.9 percent this year after a 70 percent increase last year and he said to himself, “I’m going to do this for one year. I’ll absorb the full increase, but I’m never doing it again.”
That one year where we were planning involved a lot of creativity and engagement. But once we got it figured out, he became my biggest evangelist when it comes to telling other employers, “This can be done. It’s working great for us. We direct-contracted with a local physician, moved to a non-traditional risk management plan and we’re saving lots of money and actually giving it back to the employees.” Now he’s willing to say, “Don’t ask for permission to give a prospect or client my cell number. Just give it.” When we started, he was the biggest skeptic; now he’s becoming the biggest champion. But it involves getting that buy-in.
Diabetes is huge in my part of the country. How do you manage that? And we’re a very relational state. So many people want to say, “Yeah, yeah, we’ll do that. No problem!” And then they go back later and realize, “Oh wait, we have this relationship with so-and-so. You know, I know we said we can do it but we just can’t pull it off.”
In benefits, that can turn into what happened to me back in 2012. “Yeah, I know you can save us a million dollars in our health spend, but we’ve been with our broker since 1976, and our carrier has always taken care of us. I just can’t make the move.” And I’m looking at them thinking, “That’s real money that could have helped your employees, and you’re going to let a relationship get in the way?”
What breaks my heart is we’re letting things get in our way, not because of something we’re doing in the employees’ best interest, but due to relationships. I’m not saying those relationships aren’t often important, but we need to recalibrate our viewpoint. We need to look at it from the perspective of someone making $10 or $12 an hour. What would they think if they knew you were letting a 30-year relationship get in the way of an improvement?
PW: This industry has long been seen as stodgy and reluctant to adapt. Do you see that changing? If so, how can we keep that momentum going?
We have to up our game. We need to view ourselves on the same level as a trusted attorney, a CPA or a risk manager. We influence virtually every aspect of these businesses. We’re doing our whole industry a disservice if we just sling product. We need to go in with the view that we can have a positive impact on these businesses as a whole and become viewed as a trusted advisor.
I also think we need to rely on community. You don’t get the confidence to do this by yourself; you get it by being part of a community of like-minded professionals. We need to cultivate that community to push the message in each of our own networks. I wouldn’t be anything without my network of industry peers.
PW: How can the industry make itself more appealing and attract new blood?
We need to propagate the fact that it’s a noble profession. I’m big on root words, and to be in sales is to be of service. That’s not a bad thing; insurance is one of the underpinnings of society. Why don’t we spread that message?
I grew up in a very affluent school district; no one aspired to be a salesperson. People wanted to be a doctor, a lawyer, an engineer. It took me a long time to get over that. We can’t remove that stigma until we raise the level of what we do.
We have to be a beacon and emit the idea of what we want our industry to become. In our own ways, we need to preach the value of what we do to our communities and the businesses in them.
PW: What are your favorite things about your job?
I have six nieces and nephews. They’re all in their late 20s and they’re all scared to do adult things like get married and have kids because they think, “How can I afford to have a child? How an I afford health care?” What gets me out of bed every day is the fact that I can impact that. I want to help people have functional, healthy family lives in whatever way they define that.
That happens by perhaps saving an employer money on their health insurance so they can pay people more so they don’t feel that way. Or maybe someone they hire who is 27, married and thinking about having a kid won’t have to spend $14,000 to deliver that child. I think we have these fears and barriers, many of them artificial, that we put before us that can stand in our way. That’s my why. I can help that person who’s in a bunch of debt move on with their lives and be more productive.
PW: Where do you look for inspiration when you need it?
I love my kids. I love watching them play sports. I’m a big team guy, so I thrive on seeing them do well in gymnastics and school. When I need to recharge, I immerse myself in my family. When I get burned out, I love my industry friends. The relationships I’ve developed with people from Q4 and Health Rosetta—I feel like I’m back in high school again, where you get stressed out about finals and you blow off steam joking around with your friends.
PW: Finish this sentence: The key to success in this industry going forward is…
Giving everything. Your time. Your knowledge. Your mentorship. Give as much as you can and it will come back.
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