Partner Profile: OneDigital

Welcome to our Partner Profile Series. Each month, we feature insights and perspectives from HR professionals and consultants working with various clients to address today's most pressing issues.

This month, our spotlight is on OneDigitalOne Digital’s team of fierce advocates helps businesses and individuals achieve their aspirations of health, success, and financial security. Its insurance, financial services and strategic HR consulting provides personalized, tech-enabled solutions for a contemporary work-life experience.  ODLogo2.0_New-OneDigital-Logo (1)

This month, I sat down with Josh Kampa, a Senior Business Development Executive at OneDigital. Josh is responsible for cultivating relationships and driving new business in Minnesota, South Dakota, North Dakota, and western Wisconsin. While cost control and employee wellness through benefits are key priorities, I also find fulfillment in supporting HR leaders with their strategic initiatives. 

Tell us a little about yourself and your role at OneDigital 

Kampa-ProfileI am a son of a Vietnam-veteran and retired Army Seargent Major. The reason I start with that is I learned very early on, when moving across the country every 3 years—you don’t have to travel internationally to experience a different culture. I appreciated experiencing that as a child because that really built a foundation for who I am today. I’m married (wife is an HR professional) with three kids and have been in sales/business development roles for over 20 years. I began working with HR and finance leaders nine years ago, focusing on HR strategies to attract, retain and engage employees. I have almost four years in the benefit space and while much of my focus is employee health and wellness, I remain active in all facets of HR. 

What are some of the biggest trends you're seeing in the employee benefits industry right now? 

Medical high-cost claimants are leaving many groups and carriers scrambling for solutions following the increased prevalence of neonatal, cancer, and mental health claims after the pandemic and the innovations resulting in new expensive gene therapy and microtargeted specialty pharmaceuticals.    

If you are fully insured, keep an eye out for exclusions or plan design changes being implemented to curb the spend; if your goal is reduced spend, this may not be an issue, but if you are concerned about a reduction in benefits to your employees, this could be relevant. Watch what your carrier is passing along as overhead cost for your high-cost pooling level and if that pooling level is being adjusted to accommodate the higher cost of what is now considered a high-cost claimant.  Changes to your pooling level or the premium allocated to pay for it can have huge implications on how your plan is rated going forward and can go unnoticed without a diligent partner in your corner.    

For those groups that are self-insured, while you may enjoy the transparency and lower cost of controlling your plan through self-insurance, it is hard to avoid that just a handful of members typically make up 30-40% of your total spend. While you can customize and change your plan and administration, a new telemedicine vendor or a change in deductible isn’t going to materially impact that high claim portion of your spend. Watch out for new lasers included in your stop loss renewals; while these used to be relatively unheard of, they are becoming more and more common. If you are equipped with predictive analytics on your claims data, taking the laser in the interest of paying a lower total premium may not be a bad play if you have the intel to know the lasered claimant is in remission or not likely to cause additional claim activity in the future.  

Second, watch out for the trap of being overinsured with your stop loss deductible; when was the last time your stop loss deductible was reviewed? With the growing size of high-cost claimants, reviewing that deductible amount can be essential to keeping your plan modern and not limiting your remedies to an astronomical increase in premium or an increased deductible with no financial incentive for taking on more risk.   

This likely all sounds quite complicated, and you may not know the first place to look for some of these pitfalls, luckily a solid consultant will already be aware of this and bring any pertinent information to the foreground.  

Balancing employees' needs with cost control is a challenge. How can OneDigital help companies manage risk and control costs when it comes to employee benefits? 

One of the most impactful levers available to larger, self-insured clients is the ability to carve out high-cost specialty pharmaceuticals to alternate funding sources. By employing this tactic, we can reduce member spending and plan spending without disrupting which drug is being prescribed. We are not inconveniencing members by asking them to switch scripts or adapt to a new formulary, rather we ask that they take one additional step in filling their prescription by providing some personal and financial information to see if they qualify for funding assistance.  

Over the course of the last few years, we have found that typically less than 1% of enrolled members are impacted by this program and that savings typically total around $20,000 in plan savings annually per member who participates. No other program results in that level of savings with so few members impacted. This is really the only tool in our toolbox that completely removes some members from the high-cost claimant list. If you are large enough to self-insure and consider a pharmacy carve out, but do not have a program like this implemented, you are leaving money on the table. 

While your options to customize your benefit package are much more limited if you are a smaller, fully insured group, make sure you have a partner that can help you outsmart the system. Before you receive the renewal from your carrier, you should already have a pretty good idea of what a “fair and reasonable” renewal would be based on your claim experience thanks to your consultant. With that information, you are now equipped to evaluate any renewal or proposal and understand whether someone is just buying your business (likely meaning a massive increase in a future year) or is a relatively competitive offer in that it is more beneficial to you the plan sponsor to have them on the hook for any potential claim cost in excess of paid premium as opposed to being liable for it as a self-insured plan.    

Technology plays a growing role in employee benefits. How does OneDigital leverage technology to help their clients?   

Employees value user-friendly technology for benefit access and education. Innovative tools are essential for HR teams, especially given talent shortages and turnover. Streamlining administrative tasks allows more focus on strategic HR efforts. Additionally, data-driven tech tools maximize the impact of employee investments. PTO Exchange exemplifies a seamless benefit that employees desire. 

How do you see employee benefits evolving as the future of work takes shape? 

I think we’ll continue to see the concept of a benefits package becoming less cumbersome with fewer member decisions points and instead accomplish the customization or choice employers strive for by building complimentary benefits around a solid, simple offering. I think we’ll continue to see a reduction in the number of plan designs regardless of benefit type. Medical specifically, I think we’re seeing this come to fruition with the rise of simple and easy to understand HDHP paired with an HSA. The easier the plan is to understand and the fewer choices a member makes to get coverage, the better. Members likely do not understand the difference between four different deductible or copay plans and why they might choose one over the other, so we’re instead seeing employers opting for one simple plan, often choosing an HDHP with an HSA to leverage the financial possibilities an HSA allows.  

Employers are still recognizing the importance of members benefits and healthcare journey being unique to an individual member and instead of allowing that to be expressed through a plan design choice, we’re seeing employers watching claims data to meet the member where they are at with custom programming to answer specific needs in the data like diabetes management programming, virtual mental health support, care navigation resources, transplant policies, etc. The key is that successful plan sponsors are targeting the additional cost and communication effort of these programs with the laser precision of what the data says, as opposed to adopting a plan or program that sounds like it might be helpful without first identifying the need in your population. 

What are some key practices OneDigital uses to build strong and lasting relationships with its clients? 

We really pride ourselves on being trusted consultants rather than the traditional transactional brokers. While some may be familiar with brokers in the sense that they are a fleeting acquaintance that delivers their renewal once a year, we work really hard to integrate ourselves into the day to day of our clients as the first person they think of when they have a question or a member has an issue, a monthly constant keeping plan performance on their radar so that renewals are never a surprise and claim trends can proactively be addressed, and the reliable navigator steering clients through the rough waters of ever evolving compliance requirements and emerging vendors and solutions. It is rewarding to know that our clients are quick to turn to us even if the question or issue isn’t specifically within the realm of employee benefits; they know OneDigital is a full-service shop to help with all aspects of the employee experience.    

While this industry has a less than savory penchant when it comes to compensation and carrier relationships, OneDigital really stands apart in the transparency of our practices and how at the end of the day we’re about finding the right solution with the right carrier with the right price for our client regardless of what that means for bonuses and overrides. While some brokers may not blink twice at a percentage-based commission, it is standard practice for OneDigital to review the merits of that set up to ensure our incentives are aligned and we’re not getting a raise just because your membership had a rough healthcare year. 

Follow OneDigital on LinkedIn or visit its website.  

Are you interested in becoming a partner? Learn more about PTO Exchange's partnership program.   

Published on Jun 18, 2024 by Dave Sherman

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