How and why I became a benefits advisor
My commitment to clients is fueled by empathy for the challenging circumstances that some health plan participants find themselves in, because it’s a road I once traveled
I derive a deep satisfaction from helping close coverage gaps for financially strapped families in the groups my firm serves, knowing all too well how those efforts can mean the difference between life and death.
My commitment to clients is fueled by empathy for the challenging circumstances that some health plan participants find themselves in, because it’s a road I once traveled. But it also drives my desire to disrupt a marketplace that does a terrible disservice to employers and employees alike. And because of this strong belief, I’m always searching for innovative solutions that provide meaningful results.
Dream turned nightmare
When our family moved from Puerto Rico to Florida, I was three years old. Like so many others, my parents chased the American Dream and worked themselves to the bone. My mother was a nurse for the Veteran’s Administration and my father a computer operator for a major bank. They also had part-time jobs just to make ends meet.
But this auspicious start turned into a nightmare when my father was diagnosed with multiple myeloma and mother with pancreatic cancer. Both my parents had health insurance, but our family ended up filing for bankruptcy after struggling to pay out-of-pocket medical bills, which has become a leading cause of financial ruin for working Americans. Even though my mother was a nurse, navigating the health care system was a confusing and harrowing journey.
Those early experiences shaped me and my brother, and we both eventually became involved in the health care field after losing our parents to cancer. Of course, the irony of pursuing an undergraduate degree in risk management and insurance isn’t lost on me. In following this path, I was able to channel my heartbreak to help benefit my clients on the road to a purpose-driven career. It has been a meandering journey fraught with frustration and disappointment, as well as startling revelations and hope.
BenefitsPRO Broker Expo speaker: Be sure to attend Lester Morales’ closing keynote BEN Talk, “Making A Difference,” Thursday, August 20, 2020, 1:00 PM – 2:15 PM
After a stint at one of the world’s largest health care consulting firms, where I led more than 200 advisors, I decided to return to Puerto Rico and start my own business.
The time had finally come for me to pursue a long-held dream of doing my part to disrupt a perverse and broken U.S. health care system that merely treats symptoms without addressing the root cause of rising expenses that bankrupt so many families like my own. I was convinced more than ever that employers could avoid double-digit annual increases to their biggest P&L expense after payroll. It became a matter of rejecting the status quo, kicking middlemen to the curb and self-insuring health benefits.
Better for business and employees
My current advisory practice is built around offering innovative solutions that not only help clients bend the cost curve, but also offer better benefits. The hub of that approach is health care transparency, along with alternative reimbursement strategies anchored by cash prices, bundled payments, direct contracting, a 3.0 version of reference-based pricing, bold Rx strategies that engage the services of a fiduciary PBM and independent local pharmacists, and medical stop-loss solutions that reward employers with lower premiums when these strategies are implemented. Our lofty goal is always to vastly reduce, if not entirely eliminate, employee out-of-pocket expenses.
Group health plan participants make far better decisions when shopping for coverage is a completely transparent process like buying products or services online or in stores. More informed consumers force greater competition across the health care supply chain by rewarding the highest quality care, which in turn drives down the cost of medical services.
Offering affordable health care with transparent pricing that rewards the highest quality of care makes perfect business sense, but there’s also a moral imperative that must be addressed. Designing the right health plans for employee populations that we serve as employee benefit brokers and advisers is critically important, not only because it saves money, but also is the decent and right thing to do.
Employees are a company’s most valuable asset, while top talent offers the best hope for a competitive leg up. It behooves employers to do all they can to protect them at all costs, and making health care services more accessible is a winning formula for doing so.
Lester C. Morales is founder and CEO of Next Impact, LLC.