Voices of Self Funding

What separates a great stop-loss partner from an average one? According to Joe Dore, President and CEO of USBenefits, it's not just pricing; it's proactive collaboration. In this episode of Voices of Self-Funding, Joe joins host Tom Testa to share how early intervention, strategic partnerships, and a consultative approach can help employers avoid costly surprises, reduce high-dollar claims, and make smarter decisions in an increasingly challenging healthcare environment.

For more information on stop-loss coverage and other self-funding topics, visit www.hcaa.org. 

This episode is sponsored by zakipoint Health. 

Tom sits down with Matthew to tease his upcoming TPA Summit session: Building Health Plans that Consumers Understand and Love. The complexities of Consumer Simplification for TPAs and Administrators.

Tom sits down with Nick to tease his upcoming TPA Summit session: Ending Rx Guesswork -- And Yes This Impacts GLP-1s

Tom sits down with David to tease his upcoming panel participation in a TPA Summit session: Rewiring PBM Contracts for True Alignment

In this episode of Voices of Self-Funding, host Tom Testa sits down with Angel Onuoha, co-founder and CEO of Avelis Health, for a deep dive into how AI agents are reshaping payment integrity, claims auditing, and healthcare cost management.

Inspired by his own experience navigating inflated medical bills after multiple knee surgeries, Angel set out to tackle one of healthcare’s biggest hidden problems: payment errors and billing complexity. The conversation explores how Avelis is using AI agents to transform summary plan documents into auditable claim rules, identify overpayments in real time, and even deploy voice AI to communicate directly with providers about denied or recouped claims.

Angel also unpacks why generic large language models can be dangerous in healthcare workflows, the importance of explainability and auditability in AI systems, and how organizations must rethink PHI security, access controls, and trust when deploying AI at scale. Angel shares his perspective on why today’s payment integrity ecosystem suffers from misaligned incentives — and why AI may finally give TPAs and self-funded employers the tools to proactively reduce waste without adding administrative burden.

If you want to understand where AI in healthcare is moving beyond hype and into real operational impact, this is a conversation you won’t want to miss.

This episode is sponsored by zakipoint Health. 

 

Are you tired of the "lazy way" to cut healthcare costs—just increasing deductibles and co-pays?

In this episode, we’re talking to someone who calls that approach what it is: the definition of insanity.

Host Ramesh Kumar welcomes Adam V. Russo, Esq.—co-founder and visionary of The Phia Group, LLC, an innovative cost containment leader and attorney who represents employers and plan fiduciaries across the U.S.

Adam is here to break down the secrets of delivering a great healthcare experience on a self-funded plan. You'll learn:

• Why Direct Primary Care (DPC) is being called the "best" plan design choice for both employee retention and health, with studies showing a 13% reduction in overall claim spend in the first year.
• How Adam's company, a successful self-funded employer, leveraged DPC to personally circumvent a $6,000 to $10,000 ER bill for just $80 a month.
• The critical need for a complete employee mindset shift and a five-year education plan to truly win at cost management.

Don’t miss this powerful conversation on why increasing cost-sharing measures has failed, and how DPC offers a path to long-term success. Tune in now!

This episode is sponsored by zakipoint Health. 

In this episode of "Voices of Self-Funding," host Ramesh Kumar sits down with Trey Hinson, Founder of Goliath Sales Strategies and a seasoned marketing and sales leader with over 24 years in the healthcare benefits space.

Trey unpacks what authentic, research-driven sales and marketing look like in today’s self-funded ecosystem. You’ll learn:

• Why modern brokers are demanding measurable outcomes, value-aligned proof, and a disciplined ICP strategy—and how carriers and TPAs can better meet those expectations.
• The shift from feature-centric pitching to case-study-backed storytelling.
• The importance of rep enablement for building a sales system that scales sustainably.

This is a must-listen conversation for anyone looking to strengthen broker relationships, improve retention, and build sales systems that last. Tune in now!

This episode is sponsored by zakipoint Health. 

In this episode of "Voices of Self-Funding," host Ramesh Kumar welcomes Jonathan Socko, President of East Coast Underwriters, LLC, a Managing General Underwriter (MGU) specializing in Stop Loss insurance.

Jonathan shares his perspective on stop-loss underwriting for small groups and unveils the blueprint for a remarkable success story: a 30-life employer group that has been successfully self-funded for 10 years with their PMPM costs increasing only 10% over that decade.

You'll learn:
- The crucial role of partner cohesion between the broker, TPA, and stop-loss carrier to manage claims proactively.
- Why data transparency and a specific data flow are non-negotiable for effective claim prediction and management.
- The essential mindset shift—and commitment to aggressively attacking costs—that ensures a small group’s self-funded plan remains successful and sustainable.

Don't miss this conversation for an insider's view on stop-loss and the strategy that delivers long-term savings. 

This podcast is sponosred by zakipoint Health.

In this episode of Voices of Self Funding, host Tom Testa sits down with Matt Ohrt, National Executive Director of the Free Market Medical Association (FMMA), to explore how employers can take back control of healthcare costs and quality through free market principles. Matt shares his personal journey – from a 25-year HR career and near-fatal accident to leading national reform movements like Self Fund Health, Rise Up Health, and Healthcare Best Practice Group. Together, they explore how self-funded employers can drive meaningful change by demanding transparency and value, the rise of direct primary and specialty care as cost-saving, patient-centered alternatives, and why breaking healthcare’s “monopoly mindset” is key to restoring competition, affordability, and trust – all while looking ahead to what’s next for self-funding and free market reform in 2026 and beyond.

This episode is sponsored by zakipoint Health. 

In this preview episode of Voices of Self‑Funding, host Tom Testa sits down with Mike Strong, Director of Policy & Operations Strategy, Health Plan Cost Containment at Reliant Health Partners, to discuss his upcoming Executive Forum 2026 session: “Who Really Wins? Transforming the TPA Playbook for IDR.” Mike offers a candid look at how the Independent Dispute Resolution (IDR) process is evolving, why traditional arbitration strategies may no longer be enough, and what TPAs can do now to protect margins while strengthening payer‑provider relationships.

Hear the full session live at Executive Forum 2026 — register now and be part of the industry’s most important conversations.