In this episode of The Business of Benefits, Donovan Ryckis guest starred on a Be More Than a Fiduciary Podcast episode with Eric Dyson of 90 North Consulting and Brenda Kruse of Axiom Healthcare Services. Together, they break down how employers can finally escape the renewal treadmill, create a 3–5 year benefits strategy, and apply fiduciary principles to healthcare.


Brenda shares Axiom’s transformation... from repeated renewal frustration to achieving a 13% premium decrease, lowering deductibles, expanding benefits, and reducing employee out-of-pocket costs by 27–38%. Eric and Donovan dig into why the healthcare system fails employers, how to identify misaligned incentives, and why transparency and governance are the keys to long-term success.


They also explore PBM dysfunction, compensation conflicts, the four components of a health plan, and why employers must act as true stewards of their healthcare dollars.


What You’ll Learn:
What’s really behind recurring renewal increases
How Axiom achieved a 13% premium decrease while improving benefits
Why data transparency directly drives better outcomes
Why PBM strategy is the fastest path to meaningful savings
The four structural pillars of every health plan
How to build and follow a multi-year health plan strategy
Fiduciary responsibility explained for employer health plans
How to identify and correct misaligned broker/consultant incentives
Practical governance tools: fiduciary committees, 408(b)(2), comp review
What responsible healthcare stewardship looks like for employers


Eric Dyson — 90 North Consulting
LinkedIn: https://www.linkedin.com/in/eric-dyson/
Website: https://90northconsulting.com/
Podcast: Be More Than a Fiduciary


Brenda Kruse — Axiom Healthcare Services
LinkedIn: https://www.linkedin.com/in/brenda-kruse-2078386/
Website: https://www.axiomhealthcareservices.org/


Donovan Ryckis — Ethos Benefits
LinkedIn: https://www.linkedin.com/in/donovanryckis/
Website: https://www.ethosbenefits.com/
Podcast: https://www.youtube.com/@thebusinessofbenefits

Timestamps:
00:00 – Preview
00:38 – Title Intro: The Business of Benefits  
01:00 – Episode Overview: Axiom’s journey & fiduciary crossover  
02:08 – Guest Introductions  
03:53 – Axiom Healthcare Services: Who they are
04:39 – How Axiom Met Ethos Benefits  
05:10 – Early Challenges & The Broken Renewal Cycle  
05:52 – Ethos’ Approach: Strategy over sidestepping  
06:44 – Building a Multi-Year Plan
07:16 – The Renewal Turnaround (13% decrease)  
08:26 – Lowering Costs for Employees
09:19 – Why Data Matters in Healthcare Strategy  
10:50 – Making Data Simple for Decision Makers
12:27 – Pharmacy Benefits: The 60% Cost Problem  
13:25 – PBM Conflicts & Misaligned Incentives  
15:25 – Fixing PBM First: High-Return, Low-Friction Changes
16:27 – Member Experience: What Improves  
17:37 – Understanding the Four Parts of a Health Plan  
18:20 – Increasing Competition & Transparency
19:46 – Compensation Transparency & Fiduciary Responsibility  
20:35 – Forming a Fiduciary Committee  
22:53 – Industry Conflicts & Broker Incentives
25:07 – 408(b)(2) Disclosures & Reasonable Arrangements  
26:22 – Why Compensation Alignment Matters  
27:15 – Advice to New Advisors & Consultants  
27:50 – Advice to New Benefits Managers  
29:18 – Raising the Standard of Care in Healthcare  
31:11 – Internal Alignment: How Employers Improve Outcomes  
32:27 – A Better Approach: Curiosity Over Judgment  
33:10 – What “Good Healthcare Stewardship” Means  
34:28 – Ethos Healthcare Documentaries  
35:20 – Closing Remarks & Episode Wrap


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Finished with the content? Claim your CE credit here: https://ideas.ethosbenefits.com/continuing-education

SHRM: Ethos Benefits is recognized by SHRM to offer professional development credits (PDCs) for SHRM-CP® or SHRM-SCP® recertification activities.

HRCI: Ethos 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.