Captivating Health Insights

In this episode of Captivating Health Insights, host Maddison Bezdicek sits down with Kevin Hallen, Managing Director, Health Solutions at Captive Resources, to conclude a captive education mini-series focused on captive structure. Kevin explains how health captives function as member-owned insurance vehicles within a self-funded model supported by stop-loss coverage and a shared reinsurance layer. He outlines how risk is structured across layers and explains the differences between pooled and risk-reward models. The conversation also explores how governance through board participation provides transparency and control, how captives help stabilize renewals and reduce exposure to market volatility, and why structure plays a key role in long-term performance. Kevin emphasizes the importance of education and alignment, highlighting how employers can evaluate whether a captive structure fits their goals, risk tolerance, and overall healthcare strategy. Chapters (00:00:00) - Why Employers Should Explore Captives(00:00:42) - Episode Introduction + Guest Background(00:02:02) - From Casualty to Health Captives: The Origin Story(00:03:30) - The Reality of Healthcare Costs(00:03:45) - What Is a Captive? (Simple Explanation)(00:04:49) - “If You’ve Seen One Captive…” (Types of Structures)(00:05:27) - Governance & Member Ownership(00:06:16) - Breaking Down Captive Layers (Pooled vs Risk/Reward)(00:08:31) - Choosing the Right Captive Structure(00:10:12) - Risk Layers, Protection & Renewal Advantage(00:12:06) - Financial Mechanics: Deductibles & Profit Distribution(00:16:57) - What Makes Captive Resources Captives Different(00:20:10) - Who Is (and Isn’t) a Fit + Getting Started(00:23:47) - Inside the Captive: Community & Engagement(00:26:28) - The Mindset Shift + Future of Captives

In this episode of Captivating Health Insights, host Maddison Bezdicek sits down with Joe Parrilli, Chief Business Officer, Health Solutions at Captive Resources, to continue a captive education mini-series focused on traditional versus captive stop loss. Joe explains stop loss as protection against catastrophic claims and outlines how the captive model differs by providing greater transparency into premium allocation, risk sharing, and financial performance. The conversation addresses common misconceptions around pricing, highlights how captives are structured to break even with the potential return of surplus, and emphasizes the importance of managing total healthcare spend. Joe also explores how captives shift the focus from an annual shopping stop loss to a more strategic, long-term approach to controlling costs and improving outcomes. Chapters (00:00:00) - Captives vs Traditional Insurance: Why Transparency Matters(00:00:49) - Introduction & Joe Parilli Background(00:03:06) - Stop Loss 101: What It Is & Why It Matters(00:03:40) - Captive vs Traditional Stop Loss(00:04:33) - Common Captive Misconceptions(00:05:23) - Why Self-Funded Employers Join Captives(00:08:06) - Beyond Stop Loss: Managing Total Healthcare Spend(00:09:11) - The Power of the Captive Community(00:14:02) - Stop Loss Shopping vs Strategic Cost Control(00:15:07) - How to Evaluate a Captive (Financial + Strategic)(00:17:26) - Long-Term Strategy & the Future of Captives

In this episode of Captivating Health Insights, host Maddison Bezdicek sits down with Dave Gillis, Managing Director, Medical Stop Loss at Captive Resources, to kick off a captive education mini-series focused on transitioning from fully insured to self-funded health plans. Dave breaks down the foundational components of self-funding, including third-party administrators (TPAs), provider networks, and pharmacy benefit managers (PBMs), while explaining how captives provide a more structured and supported path into this model. The conversation addresses common misconceptions about risk, outlines how stop-loss and risk-sharing help stabilize costs, and highlights the value of transparency in understanding true healthcare costs. Dave also explores why pharmacy is often a key starting point and how employers can take a phased, strategic approach to managing spend over time. A practical discussion on gaining control, improving outcomes, and building a more sustainable health plan. Chapters (00:00:00) - Mini-Series Introduction & Episode Overview(00:01:42) - Foundations of Self-Funding (TPA, Network, PBM)(00:03:11) - Why Fully Insured Falls Short(00:04:40) - What the Transition to Self-Funding Looks Like(00:06:15) - Market Pressures & Rising Healthcare Costs(00:07:47) - Captives as a More Supportive Model(00:09:14) - Common Misconceptions About Self-Funding(00:11:55) - Transparency: Seeing the True Cost of Care(00:13:44) - Pharmacy Spend as a Key Savings Lever(00:16:17) - How to Compare Costs & Evaluate Financials(00:22:18) - Understanding the Captive & Stop Loss Process(00:29:32) - Future of the Captive Market & Final Thoughts

In this episode of Captivating Health Insights, host Maddison Bezdicek sits down with Kris Atkins, President of Cancer CARE for Life & INTERLINK, and Ashley Urzendowski, MSN-L, RN, CCM, of Cancer CARE for Life & INTERLINK, to explore the growing impact of cancer on employer health plans. With decades of oncology and transplant experience, Kris and Ashley share how specialized cancer management supports employees through one of life’s most difficult diagnoses while helping employers manage rising costs. The conversation covers high-cost oncology drugs, site-of-care optimization, evidence-based treatment review, Centers of Excellence coordination, and the critical role of early detection and prevention. Through real patient stories, they illustrate how the right oversight can prevent unnecessary treatment, reduce complications, and improve return-to-work outcomes. A powerful discussion on delivering compassionate, clinically sound cancer care that protects both people and the plan. Chapters (00:00:00) - Episode Introduction(00:00:53) - Guest Overview(00:01:25) - Backgrounds in Oncology & Program Origins(00:04:18) - Intro to Cancer Care for Life(00:09:07) - Real Patient Stories & Advocacy in Action(00:13:07) - Why Cancer Costs Are Rising(00:14:59) - Drug Costs & Site of Care Strategy(00:19:04) - Challenges with Providers & Care Management(00:23:02) - Employer Strategies: Plan Design & Networks(00:25:28) - Centers of Excellence vs. Local Care(00:31:00) - Supporting Employees Beyond Treatment(00:37:19) - Prevention, Early Detection & Final Takeaways

In this Season 2 kickoff episode of Captivating Health Insights, host Maddison Bezdicek welcomes behavioral scientist and workplace health expert Dr. Claire Muselman for a focused conversation on leadership, wellbeing, and workplace culture. As organizations enter 2026 and navigate burnout, hybrid work realities, and rising mental health needs, the discussion reframes well-being not as a program but as a leadership responsibility. From the energy leaders bring into the workplace to boundaries around email, meetings, and PTO, Dr. Claire explains how everyday behaviors shape employee health, engagement, and trust. The episode explores why modeling healthy habits matters more than policies, how movement and visibility reinforce connection, and why benefits only work when leaders actively use and normalize them. A practical, insight-rich conversation for leaders looking to build healthier people, stronger cultures, and more resilient organizations in the year ahead. Chapters (00:00:00) - Leading for Wellbeing: Why Leadership Energy Matters(00:01:02) - Modeling Health at Work: The Power of Example Over Policy(00:02:52) - Boundaries, Burnout, and the Signals Leaders Send(00:05:36) - Visibility, Trust, and Rethinking Productivity(00:10:45) - Everyday Behaviors That Normalize Wellbeing(00:16:04) - Using Benefits, Resources, and Empathy to Support People(00:19:43) - Starting the Conversation: How Leaders Can Lead for Wellbeing Today

In this year-end episode of Captivating Health Insights, host Maddison Bezdicek breaks down the most significant trends shaping self-funded employer strategies in 2025 — and what’s ahead for 2026. From the surge in high-cost claims to the evolution of virtual primary care, fiduciary risk, GLP-1 sustainability, PBM transparency, and the growing strength of captives, Maddison highlights what’s officially “in,” what’s outdated, and how employers are shifting from reactive oversight to proactive protection. She also recaps expert insights from the year’s top episodes and reveals the topics listeners want to hear next, including cost containment, captives, compliance, and employee well-being. A fast, insightful guide for employers seeking clarity, innovation, and smarter health plan strategies heading into 2026.

In Part 2 of their conversation, Captivating Health Insights host Maddison Bezdicek welcomes back Adam Russo, Co-Founder and CEO of The Phia Group, to discuss fiduciary responsibility—one of the most overlooked and misunderstood obligations for self-funded employers. Russo explains why employers, not TPAs or brokers, ultimately bear the legal responsibility for final-level claim decisions—and how failing to understand this can lead to lawsuits, reputational damage, and regulatory exposure. He shares real-world stories that reveal just how complex claim decisions have become in an era of AI-driven reviews, million-dollar claims, and mounting audit pressure. Russo also explains how Phia’s fiduciary model (PACE) helps employers ensure compliance, transparency, and fairness—protecting both the plan and its members. His message is clear: awareness, data, and expert support are key to staying compliant, compassionate, and protected. Chapters (00:00:55) - Welcome Back: Part Two with Adam Russo(00:01:19) - What Does It Mean to Be a Fiduciary?(00:01:30) - The Million-Dollar Claim Story(00:03:33) - Who Actually Decides If a Claim Is Payable?(00:05:22) - The Birth of PACE: A Fiduciary Solution(00:06:53) - From “Take It Under Advisement” to “How Do I Fix It?”(00:08:04) - Legal Meets Clinical: Making Smart Claim Decisions(00:09:52) - The Rise of Complex Claims and AI Denials(00:12:00) - The Stop-Loss Dilemma(00:13:10) - The $100 Million Claim Era(00:14:00) - The HR Dilemma: When It Gets Personal(00:15:28) - Ignorance Isn’t a Defense(00:16:11) - Captives, TPAs, and Fiduciary Duty(00:17:59) - Knowing You’re Responsible(00:18:58) - Final Takeaways: Don’t Take It Lightly(00:19:07) - Closing Thoughts

In this first installment of a two-part conversation, Captivating Health Insights host Maddison Bezdicek sits down with Adam Russo, Co-Founder and CEO of The Phia Group, to unpack one of the most misunderstood—and increasingly risky—compliance issues for self-funded employers: mental health parity. Russo explains that while parity laws aim to ensure equal access to care, the reality is far more complex. He likens today’s boom in out-of-network mental health facilities to the 1990s prison expansion—driven by profit rather than patient outcomes—leaving employers exposed to excessive claims, DOL audits, and rising costs. Russo urges employers to take a proactive approach by reviewing plan documents, analyzing data, and enhancing communication, so that parity in practice aligns with parity on paper. He also calls for a shift from “innovation” to affordability, noting that “access doesn’t matter if employees can’t afford to use it.” Chapters (00:00:42) - Welcome & Introduction to Adam Russo(00:01:00) - How The Phia Group Began(00:03:19) - Rewriting the Rules of Cost Containment(00:06:34) - Mental Health Parity: The Title IX Analogy(00:09:07) - From Prisons to Parity: A New Industry Boom(00:13:52) - Employers in the Crosshairs(00:14:09) - Root Causes vs. Band-Aid Solutions(00:15:14) - Data Doesn’t Lie: Start With Your Claims(00:18:55) - Why Plan Language Alone Isn’t Enough(00:21:08) - The Engagement Gap(00:23:44) - Access and Affordability: Two Sides of the Same Coin(00:25:36) - Compliance Reality Check(00:29:39) - Affordability Is the New Innovation(00:32:20) - The Pandemic’s Lingering Impact(00:33:39) - A Personal Story: When Mental Health Hits Home(00:35:56) - Proactive Compliance Over Costly Audits(00:38:35) - Appeals, Lawsuits, and Doing the Right Thing(00:42:16) - Final Thoughts: Empowerment Through Education

In this episode of Captivating Health Insights, host Maddison Bezdicek leads a live roundtable with four industry leaders on the future of Medical Stop Loss (MSL) captives: Steve Gransbury, President, Health Solutions at Captive Resources Tara Krauss, President of A&H at QBE North America Brad Nieland, President and CEO at Berkley Accident and Health Jay Ritchie, President and CEO at Tokio Marine HCC – A&H Group   Together, they explore how captives are helping employers navigate rising healthcare costs, manage high-severity claims, and build healthier workforces through collaboration, data sharing, and innovation. The discussion covers key findings from recent market reports, trends in specialty pharmacy and pediatric catastrophic claims, as well as the growing role of AI, analytics, and direct contracting in risk management. Listeners will learn why captives are becoming a mainstream solution for employers seeking long-term stability, proactive engagement, and sustainable performance of their health plans. Chapters (00:00:00) - Captivating Health Insights Podcast Intro(00:01:03) - Meet the Panel(00:01:35) - Intro to Stop Loss and Captives(00:03:57) - Top Underwriters on Cancer and the Future(00:05:35) - Reasons We Need a Catastrophic Medical Reinsurance(00:07:30) - President and CEO of Berkeley Accident and Health Discusses Healthcare and(00:09:01) - Exploring Stop Loss in the Healthcare Market(00:11:14) - Employer groups and their health care coverage(00:13:50) - How Do Captives Help Employers Manage Their Health Plans?(00:15:54) - Exploding specialty pharmacy High Cost Claims(00:22:18) - Broker Perspectives on Group Captives(00:27:32) - Captive Member Performance(00:31:05) - Expert Advice for Moving from Fully-Insured to Self-Funded(00:35:24) - The Need for More Visibility Into Data(00:36:47) - AI and the Future of Health Care(00:44:23) - The Human In the Loop(00:45:53) - The Role of Stop Loss in Business(00:46:37) - Employers and the Health of their Employees(00:50:35) - Employers and Direct Contracting(00:52:43) - The Tightening Market(00:55:27) - Exploring the Health Insurance Captivity Market(01:02:05) - Captive Stop Loss

Learn how connecting benefits, claims data, and culture can build a healthier, more resilient workforce. In this episode of Captivating Health Insights, host Maddison Bezdicek sits down with Jennifer Lee—Vice President, Business Development Leader at QBE North America—to discuss organ transplant coverage and why it’s an essential protection strategy for self-funded employers. Jennifer explains how QBE’s fully insured, first-dollar organ transplant carve-out policy works—transferring risk away from the plan, smoothing volatility, and protecting both the captive and excess layers. The conversation highlights the rising costs of transplants, from kidneys to complex heart and bone marrow procedures, and how coverage can shield employers from high-cost claims while enhancing employee benefits. Jennifer also shares how the policy supports participants with case management, travel and lodging benefits, and direct provider payments. Listeners will understand why this proactive solution is growing alongside the shift to self-funding and how it can strengthen long-term benefit strategies. Chapters (00:00:00) - Captivating Health Insights Podcast Intro(00:00:47) - Meet Jennifer Lee: From High School Intern to QBE Leader(00:02:03) - What Is Organ Transplant Coverage, Really?(00:03:19) - Risk Transfer 101: Why Underwriters See You Differently(00:04:00) - What Happens If You Don’t Carve It Out?(00:05:52) - The Odds of Needing a Transplant(00:08:01) - Protecting the Plan: How the Coverage Works(00:10:37) - What’s Not Covered (and Why That’s Rare)(00:11:07) - Premiums, Discounts & Stop-Loss Savings(00:12:05) - Networks vs. Carve-Outs: What’s the Difference?(00:14:18) - A-to-Z: The Transplant Process in Action(00:17:21) - What “Pre-Cert” Means and Why It Matters(00:19:01) - Market Momentum: More Employers Are Carving Out(00:21:51) - Proactive vs. Reactive: Protecting for the Long Game(00:22:14) - Wrap-Up & Key Takeaways

In this episode of Captivating Health Insights, host Maddison Bezdicek dives into the science of employee health with Dr. Claire Muselman, a behavioral scientist and professor at Drake University, and the founder and president of DCM. Dr. Claire shares research-backed insights on how workplace wellness is no longer a “nice to have,” but a business-critical strategy. From the impact of hydration on cognitive performance to the role of movement, nutrition, and sleep in productivity and claims mitigation, Dr. Claire breaks down the “Life Force Pyramid” and how simple behavioral cues can drive large-scale change. The conversation covers practical ways employers can align well-being with safety, boost engagement across generations, and unlock strategies like gym access, Employee Assistant Program (EAP) awareness, vision care, and peer-driven habit formation. Learn how connecting benefits, claims data, and culture can build a healthier, more resilient workforce. Chapters (00:00:00) - Wellness as a Business Strategy(00:00:35) - Employee Wellbeing(00:04:51) - Wellbeing 101: Movement, Nutrition and Sleep(00:11:12) - Employee hydration and safety(00:17:30) - Getting people to Buy In on Health Initiatives(00:19:45) - Wellbeing Metrics(00:25:53) - Wellbeing and the Tribal Mentality(00:31:07) - Wellbeing and Safety as a Business Strategy(00:37:09) - Healthy Living: The Personal Lift

In this episode of Captivating Health Insights, host Maddison Bezdicek sits down with Dave Gillis, Head of Business Development for Health Solutions at Captive Resources, for a crash course in self-funding and group captives. They unpack how shifting from fully insured to stop-loss arrangements can allow employers to reclaim transparency and control over their second-largest P&L cost. Dave debunks worries about catastrophic risk and administrative complexity, shows how analytics platforms turn raw claims data into action, and shares proven cost-containment plays—from pharmacy-rebate recapture and international drug sourcing to reference-based pricing, direct provider contracts, and expanded virtual care. He explains how captives pool risk, foster community learning, and create a long runway for strategic improvements, enabling employers to own their reinsurance vehicle, benchmark progress with peers, and reinvest the savings in richer benefits. Chapters (00:00:00) - Employers are becoming owners of their health insurance(00:00:52) - Captive Resources CEO on the Challenges of the Industry(00:02:08) - What is the Difference Between Being Self-Funded and Fully-(00:04:28) - Self-Funding vs. Stop Loss(00:07:20) - Anticipating Self-Funded Pharmacy Risk?(00:09:27) - PBM and TPA: How important is it?(00:10:25) - Are We Seeing More Innovation in the Healthcare Market?(00:12:25) - International sourcing and cost-effective PBM(00:14:07) - Group Captive vs. Network Access(00:16:54) - Group Captive and Self-Funded Insurance(00:22:09) - What are the cost containment strategies that employers are using?(00:25:24) - Group Captivity

In this episode of Captivating Health Insights, host Maddison Bezdicek talks with Dr. Jason Chirichigno, an internal medicine physician and clinical leader at Galileo, to explore the transformation of telemedicine into comprehensive digital medical care. Together, they unpack how virtual primary care is redefining access, quality, and cost in today’s healthcare ecosystem, especially for self-funded employers. Chirichigno explains how digital care platforms can replicate and enhance traditional primary care through longitudinal relationships, specialist collaboration, and behavioral health integration. He also discusses data-driven employer engagement, culturally competent care models, and the role of digital medicine in addressing social determinants of health. With real-world examples and forward-looking insights, this episode reveals how virtual care supplements and reshapes modern healthcare delivery. Chapters (00:00:40) - Introduction to Dr. Jason Chirichigno(00:02:35) - The difference between traditional telemedicine and virtual medical care(00:06:28) - What's the future of virtual primary & specialty care?(00:08:26) - Quality of virtual medical care(00:13:21) - Costs savings with virtual medical care(00:16:41) - Virtual medical care: data and user experience(00:21:03) - How has telehealth impacted maternal health?(00:22:37) - How do you get engagement from employers?(00:24:14) - How virtual medical care is impacting the healthcare system?(00:28:05) - Considerations for employees(00:32:23) - Mental health in virtual primary care(00:37:57) - Clinical and employer perspectives on Galileo(00:39:35) - Conclusion & what's ahead

In this episode of Captivating Health Insights, host Maddison Bezdicek continues her conversation with Kevin Kobielski, President and Founder of Navion, diving deeper into the contract mechanics and procurement strategies that shape pharmacy benefit management (PBM) outcomes for self-funded employers. Kobielski explains how audit rights, market checks, and contract language affect plan savings and accountability. The episode also explores alternative drug sourcing strategies—including Cost Plus Drugs, 340B programs, and manufacturer assistance plans—and what employers need to know about their adoption challenges. This is Part 2 of a two-part discussion. Chapters (00:00:00) - Audit rights in PBM contracts(00:00:21) - Mark Cuban's "Cost-Plus Drugs" program(00:04:11) - 340b pharmacies(00:10:21) - PBM contracts & looking at the optics(00:14:40) - Audit rights in PBM contracts(00:17:08) - Market checks for PBM contracts(00:19:15) - PBM comparisons(00:20:47) - Kevin's take on what's head for PBMs(00:23:18) - Navion's PBM analysis approach(00:26:55) - Wrap up

In this episode of Captivating Health Insights, host Maddison Bezdicek speaks with Kevin Kobielski, President and Founder of Navion, to explore the complexities of pharmacy benefit management (PBM) for self-funded employers. The conversation unpacks how pharmacy spend has evolved to represent more than half of total healthcare costs and why choosing the right PBM partner is critical. Kobielski explains the differences between transparent and traditional PBM models, how specialty drugs and rebates influence costs, and why employers must consider clinical oversight, contract flexibility, and utilization trends when selecting a PBM. This is Part 1 of a two-part discussion. Chapters (00:00:00) - Introduction & navigating the pharmacy benefits landscape(00:01:03) - How Kevin got into the world of pharmacy(00:03:23) - What is a pharmacy consultant?(00:05:15) - Choosing the right PBM for your organization(00:10:33) - The difference between a transparent vs traditional PBM(00:13:36) - What is a specialty pharmacy?(00:17:40) - Transparent PBM vs Traditional PBM: Best Fit(00:20:13) - Reasons Why the utilization of a PBM matters(00:21:47) - Biosimilars(00:23:51) - Components of a PBBM evaluation?(00:26:56) - Clinical management strategies(00:30:13) - MAP and PAP Programs(00:36:14) - International specialty programs & wrap up

In this episode of Captivating Health Insights, host Madison Bezdicek discusses the growing role of GLP-1 medications in treating obesity with experts Brenda Navin of Launch My Health and Kelly Rawlings of Vida Health. The conversation explores how GLP-1s work, their potential benefits for weight loss and metabolic health, and the challenges surrounding their cost and accessibility. Emphasizing the importance of lifestyle interventions, the experts share how integrating proper nutrition, exercise, and behavioral support is crucial for achieving sustainable health outcomes. They also discuss the role of employers in providing access to these treatments and the future of obesity management. Chapters (00:00:00) - GLP-1s and their role in health care(00:00:47) - Brenda Navin on the "Food as Medicine" movement(00:02:45) - The fight against obesity and diabetes with digital technology(00:06:40) - GLP-1s and weight loss(00:12:13) - Weight-loss for obese people(00:16:06) - GLP-1 off-ramping(00:22:12) - GLP1-s and employers(00:40:24) - GLP1-s for weight loss(00:45:05) - What's ahead for the future

Welcome to Captivating Health Insights, where we talk about strategies for a healthier workforce and bottom line. Chapters (00:00:00) - Captivating Health Insights