The Business of Benefits Podcast

What if making mental health care completely free for your employees actually lowered your total plan costs?


In this solo episode, host Chelsea Ryckis breaks down one of the most compelling case studies in Ethos Benefits' history, a manufacturing company with 350–380 employees that eliminated every financial barrier to mental health care. Zero copays. Zero deductibles. Unlimited sessions. Open network. No prior authorization.


The result? 12% utilization (vs. a 4% national benchmark), 594 claims, an average of 14 sessions per member — and a total cost of just $7 per employee per month. Meanwhile, traditional plans with restrictions are benchmarking at $14–$17 PEPM for mental health.
Chelsea also covers the Mental Health Parity and Addiction Equity Act (MHPAEA), updated in 2024, and walks plan sponsors through the compliance pitfalls she sees most often — from restrictive prior authorizations to narrow behavioral health networks to inconsistent NQTLs.
This episode is for HR leaders, CFOs, and plan sponsors who are tired of designing benefits around fear of cost — and ready to see what happens when you design around actual employee needs.

What you'll learn:
Why EAPs alone are not enough (only 4% of employees actually use them)
The real cost of untreated mental health: 23% more absenteeism and 3x higher healthcare costs
What a zero-barrier mental health plan design actually looks like
How 594 claims over 2.7 years cost just $129 per claim on average
The MHPAEA compliance pitfalls plan sponsors overlook — including NQTLs and network adequacy
Why the cultural component of mental health support matters as much as the plan design
How to audit your current plan for mental health parity compliance.

Connect with Chelsea Ryckis:
LinkedIn: https://www.linkedin.com/in/chelsearyckis
Website: https://www.ethosbenefits.com

Connect with Ethos Benefits:
LinkedIn: https://www.linkedin.com/company/ethos-benefits
YouTube: https://www.youtube.com/@ethosbenefits
Instagram: https://www.instagram.com/ethosbenefits
Website: https://www.ethosbenefits.com

The Business of Benefits Podcast:
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Ethos Benefits is a fee-only, fiduciary benefits consulting firm. We don't take commissions. We don't represent carriers. We represent you.


Learn about CEBS!
In a field as complex as employee benefits and retirement, experience alone isn’t always enough. Credibility matters.

That’s why professionals turn to CEBS—the Certified Employee Benefit Specialist designation. Developed in partnership with the Wharton School of the University of Pennsylvania and the International Foundation of Employee Benefit Plans, CEBS delivers comprehensive expertise across both group and retirement benefits—equipping you to lead with confidence and authority.

Set yourself apart with a designation that speaks for itself.
Start your CEBS journey at CEBS.org. 

https://bit.ly/48k4aeZ

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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.

In this special episode of The Business of Benefits, host Austin Townend flips the script and interviews our very own President and Co-Founder, Chelsea Ryckis. Together, they break down exactly what employers need to know about healthcare compliance, vendor accountability, and controlling costs heading into 2026.

We cover the massive compliance shifts from the last 12 months—including the CAA of 2026 and FTC scrutiny on PBMs—and why these changes are the ultimate leverage for plan sponsors. Chelsea unpacks why Direct Primary Care (DPC) combined with HSAs is a game-changer, why ICHRAs are just a bandaid for healthcare inflation, and how to spot the red flags in your broker and PBM contracts. Plus, learn how to stop accepting the bare minimum from your vendors and start demanding true fiduciary alignment.

What you’ll learn

• How recent compliance changes (like the CAA of 2026) give employers unprecedented leverage over their health plans
• Why the traditional high-deductible health plan (HDHP) is failing low-wage earners, and how Direct Primary Care (DPC) actually reduces claims
• The hidden dangers of ICHRAs and why they don't solve the root cause of healthcare inflation
• How to identify "red flags" with your PBMs and brokers, including spread pricing and refusing compensation disclosures
• Why vendor accountability requires more than just a "nice account manager"—and how to use KPIs and scorecards to evaluate them
• The truth about big company purchasing power: why 10,000+ employee companies are often paying more than mid-market competitors

Connect with Us

Chelsea Ryckis on LinkedIn: 
https://www.linkedin.com/in/chelsea-ryckis-8508a192


Austin Townend on LinkedIn:
https://www.linkedin.com/in/austin-townend-619520103


Ethos Benefits:
https://ethosbenefits.com/


The Business of Benefits Podcast:
https://businessofbenefitspodcast.com/

____

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.

In this episode of The Business of Benefits, host Chelsea Ryckis sits down with Dr. Cristin Dickerson, founder of Green Imaging, to uncover the power of direct contracting for employer-sponsored health plans. They dive deep into how getting the "middleman" out of the equation can save plan sponsors up to 60% on medical imaging while actually improving the quality of care for employees.


We cover how direct contracting works in practice, why traditional insurance models artificially inflate imaging costs, and how Green Imaging is flipping the script by providing transparent, cash-pay rates. Dr. Dickerson explains the HIPAA Omnibus Law that makes this possible, how to build a zero-out-of-pocket benefit that employees actually use, and the real-world savings employers are seeing. Chelsea and Dr. Dickerson also discuss the future of direct primary care, navigating hospital pushback, and why every employer has a fiduciary duty to explore these solutions.


What you’ll learn
• What direct contracting is and how it eliminates the middlemen driving up healthcare costs
• Why there is an inverse correlation between cost and quality in the U.S. healthcare system
• How the HIPAA Omnibus Law protects employers and employees when carving out imaging benefits
• The exact process for members using Green Imaging, from text-based scheduling to receiving care
• How plan sponsors can structure their benefits to incentivize zero-out-of-pocket imaging
• The challenges of navigating the "down the hall" mentality and how to educate employees
• Why direct contracting for imaging and direct primary care are the easiest first steps for employers


Connect with the Speakers:


Cristin Dickerson: 
LinkedIn: https://www.linkedin.com/in/cristin-dickerson-md-a1a1b013/
Green Imaging: https://greenimaging.net/


Chelsea Ryckis: 
LinkedIn: https://www.linkedin.com/in/chelsea-ryckis-8508a192/
Ethos Benefits: https://ethosbenefits.com/


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.

In this explosive episode of The Business of Benefits, host Chelsea Ryckis and Fiduciary Benefits Consultant Talia Hansen sit down with entrepreneur and billionaire Mark Cuban to discuss the massive disruption happening in the healthcare industry. Mark shares the origin story behind Cost Plus Drugs and Cost Plus Wellness, and why employers hold the ultimate power to fix the broken healthcare system.


We cover how employers can stop overpaying for healthcare, the critical importance of aligned incentives, and why direct-to-employer programs are the future. Mark breaks down the hidden games played by traditional PBMs and carriers, and how taking an "outside-in" approach is the only way to truly advocate for patients. We also explore the value of having an internal "Healthcare CEO" to manage claims, and Mark shares his visionary idea for replacing health insurance premiums with a revolutionary healthcare banking model.


What you’ll learn:
• The "aha moment" that led Mark Cuban to start Cost Plus Drugs and expose the massive markups in the pharmaceutical industry.
• Why the traditional RFP process is designed to protect incumbents and keep employers in the dark.
• How to identify and eliminate misaligned incentives in your health plan to save money and improve care.
• The power of direct contracting and why employers need an internal "Healthcare CEO" to audit claims and manage vendor relationships.
• Mark Cuban’s vision for the future: eliminating traditional health insurance companies in favor of a healthcare banking and loan model.

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.

Your health plan contracts are full of hidden traps and most employers never read them until it's too late.


In this solo episode of The Business of Benefits, Chelsea Ryckis of Ethos Benefits pulls back the curtain on the most alarming contract clauses she's encountered in the last six to eight months. From undisclosed broker bonuses and spread pricing to termination traps and one-sided indemnification clauses, Chelsea breaks down exactly what to look for and what it actually means for your company.


This episode is essential listening for any business owner, HR professional, or benefits committee member who wants to fulfill their fiduciary duty and protect their plan participants.


What You'll Learn:
- The six forensic lenses Ethos Benefits uses to review every vendor contract
- How to identify hidden conflicts of interest and undisclosed compensation
- Why your scope of services must be written down and what happens when it isn't
- How to use KPIs and performance guarantees to hold vendors accountable
- Why implementation guarantees matter more than service guarantees
- How vendors use HIPAA as an excuse to block your access to your own data
- The termination clause that forced a plan sponsor to pay a broker they'd already fired
- Why the future of healthcare reform lives in contract language

Connect with Chelsea Ryckis:
https://www.linkedin.com/in/chelsea-ryckis-8508a192/

Ethos Benefits: https://ethosbenefits.com/

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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.

In this special episode of The Business of Benefits, we pull back the curtain on a real-life, multi-year healthcare strategy transformation. Join our hosts as they sit down with Connie Alvarez, Director of HR at Wynden Stark, to dissect the five-year journey of their self-funded health plan. This is a masterclass for any employer feeling trapped by rising premiums and lack of control.

We explore the highs, the lows, and the unexpected curveballs—from navigating mergers and acquisitions to tackling the complexities of a fluctuating workforce in the healthcare staffing industry. Discover how Wynden Stark, with the guidance of Ethos Benefits, moved from a fully insured model to a custom, unbundled, self-funded plan, achieving over $3.7 million in savings in just two years. This case study reveals the power of a fiduciary approach, the critical role of data in negotiations, and how to build a plan that delivers both financial results and a superior member experience. If you want to learn how to take back control of your healthcare spend and become a true steward of your company’s benefits, this episode is a must-listen.

What You’ll Learn

• The 5-year roadmap from a fully insured plan to a high-performing, self-funded model.
• How to navigate a 42% renewal increase and turn it into a -1.3% decrease.
• The power of carving out your Pharmacy Benefit Manager (PBM) and the massive savings potential in Rx.
• Strategies for implementing an unbundled plan with an independent TPA and fiduciary PBM.
• How to use data and analytics to negotiate with carriers and stop-loss providers.
• The importance of member communication and advocacy in a self-funded environment.
• Innovative solutions like international pharmacy sourcing and spousal HRAs that drive down costs.
• How to maintain an excellent member experience even with major plan design changes.

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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.

In this session, Chelsea Ryckis and Julia Watt, Director of HR at Medical Technology Transfer (MTT), delve into a case study on "Future-Proofing Your Health Benefits." They discuss how MTT, a 125-employee company, achieved a 67% reduction in claims cost over three years through a multi-year strategic plan. This conversation offers a roadmap for employers of all sizes to move away from the traditional, reactive renewal cycle and adopt a proactive, data-driven approach to managing healthcare costs and fiduciary responsibilities.

What you'll learn:

• How a small employer (125 employees) can implement innovative healthcare strategies often considered only for large corporations.
• The limitations of fully insured plans and the benefits of transitioning to level-funded and self-funded models.
• The importance of data transparency in understanding and controlling healthcare cost drivers.
• How to strategically unbundle your health plan and select vendors aligned with your company's best interests.
• The critical role of a fiduciary PBM in managing pharmacy costs, which are often a significant expense.
• Actionable steps to take control of your health plan, negotiate better terms, and reduce costs without compromising employee benefits.

--------------------------------

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.

In this episode of The Business of Benefits, host Donovan Ryckis sits down with Patrick Haig, co-founder and CEO of Goodbill, to reveal the secrets of hospital billing that every employer needs to know. They dive deep into the world of 501(r), a little-known IRS regulation that requires nonprofit hospitals to offer financial assistance, and how it can dramatically reduce healthcare costs for both employees and plan sponsors.
Patrick explains how Goodbill leverages this and other strategies to audit hospital bills, find errors (which appear in about half of all bills), and secure significant savings. This is a must-listen for any CFO, CHRO, or business owner looking to fulfill their fiduciary duty, contain rising healthcare costs, and provide real, tangible support to their employees—especially those on high-deductible health plans.

What you’ll learn:
- What 501R is and how it mandates financial assistance from 80% of hospital beds in the US.
- The surprisingly high income thresholds that allow many employees to qualify for bill reductions or full waivers.
- How to get refunds for hospital bills that have already been paid.
- Why half of all hospital bills contain errors and how to find and correct them for savings of 20% or more.
- How proactive bill review can be a powerful tool for employee advocacy and trust-building, not a punitive measure.
- Practical steps for implementing a bill review and financial assistance program, whether you have a fully insured or self-funded plan.

Time Stamps:
00:00 – Preview
01:16 - The Business of Benefits Intro
01:43 – Meet Patrick Haig
03:11 – What is 501R?
05:15 – For-Profit Hospitals and Financial Assistance
08:23 – Income Limits for 501R
12:00 – How Goodbill Reviews Bills for Errors
13:35 – Why Don't More People Know About 501R?
16:05 – The Bill Review Process
18:51 – Shocking Bill Review Results
22:09 – Fiduciary Duty and Overpaying for Healthcare
25:28 – Bill Review Thresholds and Inaccuracy Percentages
29:26 – Common Hospital Billing Errors
34:28 – Implementation and Integration of Goodbill
37:15 – Timing and Refunds for 501R
41:47 – Where to Find Patrick Haig

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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.

In this episode of The Business of Benefits, host Chelsea Ryckis sits down with two trailblazing benefits leaders, Stephanie Porrino, Director of HR at Hendry Marine Industries, and Kristina Ewing, Director of Health and Wellbeing at Shoestring Valley Holdings at the Best of the Best Florida Healthcare Alliance event. Together, they share their journeys of transforming employer health plans through innovative strategies, data-driven decision making, and bold vendor partnerships, offering actionable insights for employers ready to take control of their benefits and deliver real value to their people.


From self-funding and reference-based pricing to no-cost care alternatives and fiduciary governance, Stephanie and Kristina reveal how they navigated complex challenges, disrupted traditional models, and built multi-year benefits strategies that prioritize both financial sustainability and employee wellbeing.


Time Stamps:
00:00 – Welcome to The Business of Benefits  
01:02 – Introduction to Guests and Episode Overview  
02:19 – Stephanie and Kristina’s Backgrounds and Company Profiles  
04:10 – Stephanie’s “Aha” Moment: Discovering Healthcare Pricing Discrepancies  
07:19 – Kristina’s Journey: Unbundling and Finding the Right Partners  
09:31 – The Importance of Ownership and Advisor Switching  
10:08 – Kristina’s Multi-Year Benefits Strategy Overview  
13:26 – Overcoming Challenges: Member Education and Engagement  
15:41 – Vendor Summit and Setting KPIs for Accountability  
18:07 – Hendry Marine’s Roadmap to Reference-Based Pricing and Pharmacy Savings  
20:54 – Increasing Preventive Care Utilization with Onsite Clinics  
25:29 – Financial Performance and Savings Highlights from Shoestring Valley  
27:15 – New Program Innovations and Plan Design Shifts at Hendry Marine  
30:25 – Managing High-Cost Claimants and Spousal Coverage Strategies  
32:53 – Incentivizing In-Network Utilization and Mental Health Support  
33:21 – Compliance and Fiduciary Responsibilities: Leveraging CAA and ERISA  
37:03 – Procurement Best Practices: Questions to Ask Vendors  
41:32 – Fiduciary Governance: Committees and Due Diligence  
43:55 – Addressing Disruption and Administrative Burden in Benefits Changes  
46:13 – Q&A: International Pharmacy Programs Explained  
47:33 – Q&A: Direct Primary Care and C-Suite Perspectives on ROI vs. Disruption  
50:44 – Closing Thoughts on Employee Experience and Leadership Alignment  


Guest Links:
Stephanie Porrino 
LinkedIn: https://www.linkedin.com/in/stephanieporrino/
Hendry Marine Industries: https://hendrymarineindustries.com/


Kristina Ewing
LinkedIn: https://www.linkedin.com/in/kristina-ewing-98aa9867/
Shoestring Valley Holdings: https://www.shoestringvalley.com/
Andersen Construction: https://www.andersen-const.com/


Connect with Chelsea and Donovan:
Website: www.businessofbenefitspodcast.com
Instagram: https://www.instagram.com/businessofbenefitspodcast
Chelsea: https://www.linkedin.com/in/chelsea-ryckis-8508a192/
Donovan: https://www.linkedin.com/in/donovanryckis/


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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.

In this episode of The Business of Benefits, host Donovan Ryckis sits down with Trace Voshell, Chief Revenue Officer at GoGoMeds, to expose one of the most overlooked cost drains in employer healthcare: generic drug inflation. While most employers focus on high-cost specialty medications, Trace reveals that generic drugs, covering 80-90% of employees on medication, are systematically overpriced by 30-60% through PBM spread pricing and hidden conflicts of interest.

Trace pulls back the curtain on how PBMs profit twice (on adjudication and through ownership of mail order pharmacies), why brokers often block cost-saving solutions (hint: per-script kickbacks), and how employers can bypass these roadblocks even when they feel "handcuffed" to large carrier PBMs. With real case studies showing $45,000 to $140,000+ in annual savings, this episode proves that transparent cost-plus pharmacy pricing can deliver six-figure savings while offering employees zero-copay medications.

What You'll Learn: 
- Why generic drugs represent the biggest overlooked savings opportunity in pharmacy benefits 
- How PBM "spread pricing" allows them to pocket the difference between what they charge you and what they pay pharmacies 
- The shocking conflict of interest: PBMs owning their own mail order pharmacies and profiting twice 
- Why brokers often block pharmacy savings solutions (per-script fees and backend compensation) 
- Real case studies: How a 70-employee shop saves $45K annually and larger groups save $130K-$140K+ 
- The difference between GoGoMeds and Mark Cuban Cost Plus Drug Company 
- How to bypass PBM roadblocks with direct-to-employer pharmacy arrangements 
- The vague PBM contract language that enables systematic overcharging (and how to spot it) 
- A 60-second ChatGPT hack to identify unfavorable terms in your PBM contract 
- Why zero-copay generics are a powerful recruitment, retention, and employee trust-building tool 
- How to implement mail order generic pharmacy mid-year without waiting for renewal


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Get more on our guest Trace at:
GoGoMeds
https://gogomeds.com/GoGoClient/

LinkedIn: Trace Voshell
https://www.linkedin.com/in/trace-voshell-34040b7a/

Whether you're an HR professional, CFO, CEO, or just tired of rising healthcare costs, this is your call to rethink benefits strategy and finally take control.

Connect with Chelsea and Donovan:
The Business of Benefits Podcast Website:
https://www.businessofbenefitspodcast.com


Instagram
https://www.instagram.com/businessofbenefitspodcast/


Chelsea
https://www.linkedin.com/in/chelsea-ryckis-8508a192/


Donovan
https://www.linkedin.com/in/donovanryckis/

--------------------------------

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.