Voices of Self Funding

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. At zakipoint Health, we are transforming the healthcare experience by delivering transparency, direction, and personalized support to members of self-insured plans. Our powerful platform unifies all benefit services, data, insights, and tools into one intelligent ecosystem empowering members to make informed decisions and take proactive steps toward better health outcomes. With AI at its core, zakipoint Health functions as the “Intel Inside” of healthcare navigation driving engagement, reducing risk, and delivering measurable cost savings. Employers and partners benefit from robust reporting, actionable insights, and tools that not only identify healthcare risks but also guide members toward high-value care. By bridging the gap between complexity and clarity in the U.S. healthcare system, we help organizations lower costs, improve outcomes, and support healthier, more engaged populations making healthcare less stressful and more effective for millions.  

Matt Ohrt, National Executive Director of the Free Market Medical Association and former HR leader with 25 years’ experience, shares his move from HR to healthcare reform. He discusses employer-led solutions, the rise of direct primary and specialty care, breaking healthcare’s monopoly mindset, and new market-driven plans reshaping access and costs.

Mike Strong, Director of Policy & Operations Strategy at Reliant Health Partners with nearly 20 years in healthcare. He explores evolving IDR processes and why old arbitration playbooks may fail. He breaks down billing complexity, regulatory pressures, and how TPAs can protect margins while navigating payer-provider tensions.

In this preview episode of Voices of Self-Funding, host Tom Testa sits down with ClarityCare AI co-founders Hermine Tranie and Alex Andrei to discuss their groundbreaking Executive Forum 2026 session: “How to Actually Use AI: A Hands-On Mini-Hackathon for Self-Insured Leaders.” Unlike typical conference talks, this immersive 90-minute workshop invites attendees to roll up their sleeves and build with AI in real time. Hermine and Alex preview what to expect from the hackathon format, share how AI is already reshaping prior auth and utilization management, and explain why TPAs and self-funded employers need to stop talking about AI – and start using it. Don’t miss this unique opportunity to get practical with AI at Executive Forum 2026. Register now and secure your seat in the Ballroom.

Mike Abrashoff, former commander of the USS Benfold and bestselling author, transformed a failing ship into a top performer while advising organizations on leadership and culture. He recounts winning over skeptical leaders, replacing fear with respect, empowering people to act like owners, and why trust and human relationships matter in a world of AI. Practical stories and bold leadership moves.

In this special preview episode of Voices of Self Funding, co-host Tom Testa sits down with Ron Peck, Chief Legal Officer at The Phia Group, to discuss his highly anticipated session at Executive Forum 2026: “Fiduciary Gotchas and the Company You Keep.” From revenue-sharing arrangements to PBM contracts and vendor disclosures, Ron shares what TPAs need to know now as courts and regulators sharpen their focus on fiduciary responsibilities. With plaintiff attorneys getting more creative and DOL audits on the rise, this conversation is a must-listen for anyone looking to protect their business and stay compliant. Catch the full session live at Executive Forum 2026 — register today to reserve your seat and join the industry’s most important conversations. 

In this episode of Voices of Self-Funding, host Tom Testa speaks with MIT-trained AI researcher and ClarityCare AI co-founder Hermine Tranie about how artificial intelligence is delivering measurable wins in utilization management (UM) and prior authorization (PA). Hermine explains how AI agents convert unstructured records into structured insights, drive real-time approvals at the point of care, and free up nurses for higher-value tasks – boosting accuracy, efficiency, and compliance. As a preview to her interactive “AI Mini-Hackathon” session at HCAA’s 2026 Executive Forum, Hermine shares a practical roadmap for adoption and what TPAs and self-funded employers can do today to start seeing ROI. Click here to register.

Lee Lewis, Chief Strategy Officer at the Health Transformation Alliance and host of the Broken Benefits podcast, shares valuable insights into reshaping employer healthcare strategies. He introduces the 'ABC' framework—Advanced Primary Care, Behavioral Health, and Centers of Excellence—as a game-changer for self-funded employers. They discuss the rise of direct primary care, innovative mental health therapies like TMS and ketamine, and how tiered networks can drive better outcomes at lower costs. Practical tips for TPAs to enhance their offerings round out this informative conversation.

In this episode of Voices of Self-Funding, host Ramesh Kumar welcomes Arun Santhebennur, Co-founder and CEO of Voicegain, to explore how voice AI is reshaping healthcare operations for TPAs, payers, and health plans. They tackle the tough truth that 95% of AI pilots fail, unpacking why — from hype and skill gaps to the “build vs. buy” dilemma and change management challenges. More importantly, they share where AI is already succeeding: automating claims status calls, streamlining utilization management, and making complex health plan information accessible to members. Listeners will hear a roadmap for launching successful AI pilots — starting with proven use cases, aligning incentives, and using AI to augment (not replace) people. It’s a forward-looking conversation on turning AI from a risky experiment into a real value driver. This episode was sponsored by WLT Software. For more information, visit HCAA.org.

Join Jim Farley, a seasoned TPA owner with over 40 years in the industry, and Jeff Walter, a tech-savvy TPA executive from PBA, as they unveil their strategic merger. They discuss how this collaboration enhances customer experience while ensuring TPA independence against larger firms. Dive into their approach to streamlining operations with EOS practices, in-house IT, and innovative member solutions like Direct Primary Care and nurse navigators. Their insights reveal a dynamic shift in how TPAs can deliver superior services and maintain strong relationships.