How HR Can Lead the Next Evolution in Health Insurance

Traditional health insurance is broken — but what’s the alternative?In this episode of Talk HR, hosts Harrison Newman and Sam DiMercurio sit down with Peter Doran, SVP at Pareto Health, to explore how group captives and self-funding models are reshaping the future of employer healthcare. Peter breaks down why the standard fully insured model no longer works, how data transparency empowers smarter decision-making, and why more companies are shifting to self-funding to save costs and improve employee experience.Plus, the team chats with Claudia O’Leary from Beyond Med, who shares how employers can expand their benefits offerings — including access to services like fertility treatments, mental health counseling, and even massages — without increasing costs.Key Moments00:41: Introducing Beyond Med: Claudia explains how supplemental health benefits can make a big impact for both employees and employers.04:21: Welcoming Peter Duran, SVP at Pareto Health.05:32: Why the traditional insurance model no longer works — and how volatility, rising costs, and lack of data transparency have forced change.07:07: Why employers are turning to group captives as a smarter, more sustainable alternative.09:20: Breaking down group captives and self-funding: what they are, how they work, and who’s a good fit.13:50: Which employers benefit most from captives — and why diversity in industries makes the model stronger.17:42: Simplifying the self-insurance model: what it means for HR teams and the key differences from fully insured plans.20:04: The growing cost of pharmacy benefits and how captives give employers back control.22:58: How data-driven plans help companies manage claims and improve the employee healthcare experience.26:23: Real-world success stories: how Pareto members are lowering costs and even giving employees a “premium holiday.”29:02: Peter’s advice for young professionals: find your strengths, align your work to them, and do what you love.31:07: Closing thoughts: Rethinking the “sick care” system and building a healthier, more sustainable future for employees.