86. The Plan Sponsor Movement: Rethinking Employer Health Coalitions

In this episode of The Business of Benefits, host Chelsea Ryckis sits down with Karen van Caulil, Ph.D., President and CEO of the Florida Alliance for Healthcare Value, to unpack how employers are building real leverage in healthcare by purchasing together. If you have ever been told "we're not going to do a one-off for you," this one is for you.Karen explains what an employer-led healthcare coalition actually does, how the Florida Alliance moves 80 public and private sector members from passive payers to sophisticated purchasers, and why the Alliance now works in health policy. She and Chelsea dig into the new Pulse of the Purchaser survey, Florida's standing as the most expensive state in the nation for hospital services at roughly 345% of Medicare, and a real case where Central Florida employers pushed back on a double-digit hospital increase with data and a coalition at the table. Chelsea connects it to fiduciary duty, why compliance is leverage, and the auto-renewals and point solution sprawl that keep plan sponsors stuck.WHAT YOU'LL LEARN• How to tell a real coalition from a pay-to-play purchasing group• Why employers with complete claims access implement at least four more cost strategies• What to ask your PBM today: 100% rebate pass-through, claims-level data, full audit rights• Why price, not utilization, is the real cost driver• The 90-day auto-renewal trap and how to get ahead of itTIME STAMPS00:00 Cold Open: You Can't Purchase What You Can't See00:47 Welcome to The Business of Benefits01:10 Why Every Plan Sponsor Should Be Part of a Coalition02:36 Meet Karen van Caulil and the Florida Alliance03:13 From Payer to Purchaser05:37 Moving Into Health Policy06:37 Real Coalitions vs. $180,000 Committee Seats10:03 "We're Not Going to Do a One-Off for You"11:53 Trust But Verify12:57 Does Every State Have a Coalition?16:37 Regional Differences: Pricing, Direct Contracting, Primary Care19:47 There Is No Good Price for Bad Care20:40 Sponsor: Fiduciary in a Box22:43 Case Study: Pushing Back on a Hospital Increase24:43 Pulse of the Purchaser: What Employers Expect26:18 Florida's Hospital Prices by the Numbers30:16 Data Is a Strategic Asset31:56 Don't Wait for the Law: Act on PBM Transparency Now34:57 Point Solution Overload36:35 The Auto-Renewal Trap40:05 Final Thoughts and Where to Find KarenFROM OUR SPONSORYou're doing the work. Don't leave the proof behind.Managing a health or retirement plan takes time, oversight, and judgment. Fiduciary In A Box documents your governance, vendor oversight, and committee decisions in one secure platform, so your fiduciary process speaks for itself. Learn more at www.fiduciaryinabox.comCONNECT WITH KARENFlorida Alliance for Healthcare Value: https://flhealthvalue.orgKaren on LinkedIn: https://www.linkedin.com/in/karenvancaulilphd/Pulse of the Purchaser 2026: https://www.nationalalliancehealth.org/resources/pulse-of-the-purchaser-2026-survey-results/CONNECT WITH CHELSEA AND ETHOS BENEFITSSchedule a Strategic Analysis: https://ethosbenefits.com/contact/Chelsea on LinkedIn: https://www.linkedin.com/in/chelsea-ryckis-8508a192/Ethos Benefits on LinkedIn: https://www.linkedin.com/company/ethosbenefits/LISTENApple Podcasts: https://podcasts.apple.com/us/podcast/the-business-of-benefits-podcast/id1724134305Spotify: https://open.spotify.com/show/0nlniHvhiOKPJmowsdDlTISponsored by Fiduciary in a Box, the fiduciary operating system for health plan sponsors: https://www.fiduciaryinabox.comFinished with the content? Claim your CE credit here:https://ideas.ethosbenefits.com/continuing-educationSHRMEthos Benefits is recognized by SHRM to offer professional development credits (PDCs) for SHRM-CP® or SHRM-SCP® recertification activities.HRCIEthos Benefits is approved to offer HRCI® recertification credits for this program. This program has been approved for 0.5 - 1 HR (General) recertification credit(s) toward aPHR®, PHR®, SPHR®, and GPHR® certification.