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PBM transparency, and the growing strength of captives, Maddison highlights what’s officially “in,” what’s outdated, and how employers are shifting from reactive oversight to proactive protection.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.

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.”

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:

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.

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.

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.

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.

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.

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.

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.