Aligned for Impact with Matthew Naylor

Matthew Naylor: Welcome to Align for Impact. I’m your host, Matthew Naylor. I started this podcast because healthcare and leadership both come down to the same thing, alignment. When people, purpose, and performance connect, real impact happens. On this show, we will talk to entrepreneurs, brokers, and changemakers who are challenging what is broken in healthcare and in business, and find new ways to make a difference for companies, communities, and the people we serve. Ben, welcome to the show.

Ben Inabinet: Thank you for having me.

Matthew Naylor: Matt Naylor your host, and I love talking about alignment and impact. And I love starting with your story. It’s always great when you have new people on and you find out kind of where you’re from. How’d you get into the insurance business? Where’d you grow up? Let’s begin by just telling us about yourself.

Ben Inabinet: I’m a young man, not that young anymore, but everything’s relative. From Columbia, South Carolina. Born and raised, can’t get away from it. I tell people all the time, my soul is to the soil there, so it’s gonna be hard to get me out of there, right?

Was raised by my mother with my brother and sister. We had a really interesting upbringing between Bennettville, South Carolina, which Barack Obama showed up once and told us that we lived in the corridor of shame, something along those lines. And then from there, lived in Columbia where my mother’s been a school teacher for now going on year 30, I believe, this year at Irma Middle School, where I went to high school, and then I went to college in Newberry, South Carolina, at a private Christian school called Newberry College. And had a great time there, played football. And my roots and foundation have always been about people.

When I was growing up, and you asked how I got into this industry, I think insurance finds people. Our industry finds people, and it finds the right people too. But it found me probably when I was going into ninth grade, and my mother had a complete and total hysterectomy. And the reason that’s valuable here is because she had a ton of complications. Now my mom, my old life, Matt, told us, “I make less as a school teacher.” And by the way, in South Carolina, they make a lot less. “But I make less, but this ID card, this Blue Cross Blue Shield ID card, we’re gonna be fine if anything ever happens to us.” Well my mom was in the hospital with complications for almost two weeks. And then afterward, raising three children on your own on a school teacher’s salary, with a dying father from cancer, we couldn’t make it. And we lost our house. We found a rental home. We bounced around that eighth grade year, I think we moved six times in two years, but we got back on our feet, right? But it was hard. And so I always wanted to align myself with—one, I blame the hospital. I hold a grudge too, I can’t help it. I wish I had better character, but I hold a grudge. And so I always wanted to take on the hospital, because I felt like we got wronged.

And so fast forward, I started working at a company called Team IA. And I got to see local company at Alexa in South Carolina. And I was building data centers and custom software with a great guy who I’m still close friends with to this day, whose father really mentored me very well. And I’ve been very, very lucky in my life to have great mentors that I probably didn’t deserve. And we were working on a project at a local BPO in the workers comp industry. And I looked around the room, I said to myself, everything’s paper and everybody’s a hundred years old. If I can’t make it in this, I can’t make it anywhere. So I got recruited to a startup called Netclaim. And what we did was the first end of loss, first reporting, first report of injury for third party administrators across the country on the workers comp side. And I saw firsthand working with York Risk, which later becomes more important in my journey, Gallagher Bassett owned by Arthur J, obviously, EASIS owned by Chubb here locally in Philadelphia, and several other independent TPAs across the country, how workers comp claims are adjudicated, what are the technologies and processes they were stacking, and how our software can interact with it.

Now, again, I was very lucky to be around great leaders. So Hayward Marsh was our general manager, and he’s a great CEO at a really good insuretech company in Kansas nowadays. And Hayward challenged me with him to help lead a predictive analytic modeling suite within our software. And so I worked with two vendors on that around our data stack processing over close to a million claims a year. And we were able to create actionable insights around fraud predictions, subrogation, likelihood of litigation, working with workers comp adjusters, and then mapping out those TPA workflows. So after I got kind of, for lack of a better term, famous for that on that side of the house, a great guy named Rob Gelb left York Risk when it got acquired by Sedgwick. And he came and became the CRO of United Claims Solutions, which is now called Valence Health. And Rob knew me from NetClaim, and he said, “I don’t know what I want you to do for me, but I want you to come join me here at what is gonna be Valence. And I want you to do everything from sales to help tie these four or five acquisitions together to bring AI/ML into our workflows to work with our existing and new customers.”

And we were doing that, we were rolling, got to meet great people along the way, another great mentor in Ronnie Brown who really helped me in my journey, who you’ve met. And from there, this thing called COVID-19 happened. And I became a very expensive line item. So Rob and the board wanted me to go a different direction and I accepted that. And so I ended up joining my best customer who was Continental Benefits. And from there, they immediately got acquired by Marpay Labs. And we became Marpay Health. And so I was the last employee of Continental Benefits and the first new employee of Marpay Health. And from there—

Matthew Naylor: What did Marpay Health do?

Ben Inabinet: Marpay Health was a third party administrator. I think we were cutting edge, I think we were a little ahead of the curve. We were a third party administrator really focused on trying to blend managed care with general TPA work and trying to take that next step forward.

Matthew Naylor: For self-insured medical plans?

Ben Inabinet: Yes sir.

Matthew Naylor: And did you have a focus, school districts, municipalities, universities, health systems? Was there things that you as a TPA focused on?

Ben Inabinet: I wouldn’t say we found ourselves focusing on things. So initially when I got there and started rolling, I was focused on K-12 education because there were changes in legislation that allowed self-funded plans to carve themselves out from the state plan. And that’s actually gone very well in that market. To this day, it’s gone very well. Then from there, I personally saw the opportunity for small and medium sized business self-funding. Most third party administrators, their systems are built to support 500 plus and only 500 plus employers. Their vendors are only built to support that large market segment. All of their workflows, Matt, in my opinion, are tied together to do that. And they don’t trend down. It’s a top down strategy that they’re imposing. Nobody yet, I thought, was built to be bottom up with impact on the member holistically. And we attempted that through strategic partnerships with Crumdale at the time, with also with Hari Sundrum and Radion and other distribution partners that I helped create.

And then from there, our focus really trended for me personally to small and medium sized business across the country, regardless of SIC code. I thought I developed in conjunction with Ronnie, Art Hoth, and a few other people, a really great stack, and Nathan Ogden, a really great stack to help small and medium sized businesses. And we were very lucky to have great partnerships in our industry, which is obviously how we met, that helped us reinforce that.

Matthew Naylor: And when you say create really great solutions for small and medium sized businesses, what did that mean to you then?

Ben Inabinet: What it meant to me then, Matt, was simply about accountability and transparency, and not being a glacier. I associated everybody I was competing with as glaciers. They didn’t move, they were not agile, they were not responsive, saw the data. And so what I was trying to build on a Javelina, which was WLT platform at the time, with our operations teams, was something that was highly responsive, highly customizable (which was a mistake), an accountable product that we could bring to market to employers who only saw a black hole the entire time that they’ve had benefits.

Matthew Naylor: And how’d you end up at Crumdale?

Ben Inabinet: I was lucky enough in January of 2021 to get introduced to a guy named Jake Wilcox. And Jake, from there, we hit it off and he said, “I think we would like to bring Marpay into the fold of the Crumdale family for our distribution of our product at the time,” which at the time was a pure self-funded play. And then from there, Jake and through you, challenged us to help develop and be one of the first TPAs for the level funded product, which we worked really hard on. And I think we did an okay job, especially while I was there, to toot my own horn.

And from there, I was so impressed by Jake—and I hadn’t had a chance to meet you yet, but I was so impressed by the collaboration I had with Jake and Dr. Emerson and Ivana and Mark Lopez and Joe Sweeney and those guys that I interacted with at the time, that I invited Jake with Art Hoth, our CRO at the time, to be one of the speakers on our panel at our keynote conference in Philadelphia. And then at the end of that, Jake goes, “Hey, Ben, you’re okay. I’d like you to come up to Philly. I want you to meet Matt Naylor, my boss, and the founder of Crumdale.” And I said, “I would love to.” And so from there, I flew back up here and I got to meet you and you drove me around and you said famously to me, “I don’t need you right now, but I’m probably gonna need you tomorrow. I need you to work really hard over the next year and I’ll call you back when I need you.” And I go, “Jake, does that mean that he wants me to keep working here? Am I coming to work for you all now?” And he goes, “Well, maybe one day.”

Matthew Naylor: It’s my way of getting to know people. So, Ben, today, what are you focused on at Crumdale?

Ben Inabinet: I was lucky enough to be given the opportunity to help us launch and lead from a sales perspective our third-party administrator, and I couldn’t be tickled more about that.

Matthew Naylor: And what has you so excited about Crumdale Specialty and this Agentic TPA platform that we’re building?

Ben Inabinet: Well, I’ll tell you, Matt, after doing and leading our small business and medium-sized business sales at Marpay for those few years I was there and interacting with so many TPAs throughout my career, it’s clear to me that if the health plan is the home and our broker and distribution partners are responsible for giving us tenants, the third-party administrator is the plumbing and the electricity of the house. We are the conduit. We have to have the running water running and the lights have to turn on. We’re responsible for all that. And so, when you were explaining to me our vision for the foundations on what we were gonna build with this, I jumped at the chance to leave a role I was very comfortable in and I think I was doing an okay job at to help execute on this. Because one, the market demands it. We’ve seen it through acquisition and a lack of entrepreneurship really, that the market is starving for a bottom-up partner focused on the member, making impact where quite frankly other people are choosing not to—and it is a choice. And so, when you were speaking to what AI/ML is going to do from a workflow perspective, obviously that resonated with me with my experience. And then also, us being insurance people running an insurance company, if you look at our peers, that’s something that a lot of people are gonna be really excited about and it’s already resonating.

Matthew Naylor: And how, from your perspective Ben, how and what are we doing with data and AI to drive to a lower cost and produce a better outcome for a client and their employees?

Ben Inabinet: Well one, being able to provide—let me back up. The biggest problem, or one of several, one of the biggest problems in our industry, unlike workers comp, is everything’s in a silo and there isn’t an alignment of interest. There are five pillars of a health plan: risk, administration, medical management, pharmacy benefit management, and cost containment strategies, right? We are truly a one-of-one that is turning those five fingers who are operating independently and not always in the best interest of the plan into a fist. Now the TPA is the central connectivity of what’s making that happen. So, with what we’re trying to accomplish there, Matt, from a workflow perspective, it’s so important what we’re doing and how we’re doing it, but also who we’re serving along those lines. So our connectivity couldn’t be more important as well as where we’re gonna be taking it because we are at the starting line right now.

Matthew Naylor: And leveraging data and AI to make it actionable, and you talk about those five levers. What are some of the things that you see that we’re doing that others have not tried to do? I really believe we’re trying to set a new standard. We’re trying to reimagine how things are managed, administered, and delivered. When you think about optimization and integration, you’ve been on the front lines. What do you see that is really making us unique and different?

Ben Inabinet: Well, technically—and I think that’s always something, macroeconomic vs. more tactical, right? Tactically, I think our integrated J-code strategies are no better representation than what you’re talking about.

Matthew Naylor: And what’s a J-code?

Ben Inabinet: A J-code is an infusion, injection, or medication done in an acute setting that, quite frankly, in many cases could be done in the member’s home, but also be run through the member’s pharmacy plan. But because the components of an unbundled self-funded plan are done in silos, the left hand isn’t always good at talking to the right hand, and it’s also not necessarily in the left hand’s best interest for the right hand to work.

Matthew Naylor: Why?

Ben Inabinet: A misalignment of interest around workflow. A TPA, traditionally, an unbundled self-funded TPA wants to be first and foremost automated completely, right? And integrated J-code strategies disrupt those automations. I’m asking you to pen the claim, I’m asking you to stop payment, I’m asking you to take a second look. Well, automation means margin. Automation—

Matthew Naylor: Margin to who?

Ben Inabinet: The TPA.

Matthew Naylor: Who else?

Ben Inabinet: Well, also potentially to the carrier partner, depending on the structure of the plan.

Matthew Naylor: And why would the margin be going to the carrier, not inuring to the benefit of the customer?

Ben Inabinet: Well, that would be a larger question, right? But I think also in some cases maybe they’re marking it up, maybe they have certain promises. There’s also rebates associated with it, especially in acute settings that the plan isn’t seeing at all.

Matthew Naylor: So in your example, if I’m following you correctly, Ben, you could have a high deductible health plan. You could have an ASO carrier in a United, Cigna, Blue Cross, or you could have a large independent TPA that has misaligned interest with PBMs, where they’re getting rebates, they’re getting discounts, they’re getting spread. It’s inuring to their benefit, but not the benefit of the employer or the member. And in that example, the member has a high deductible health plan. If they’re with one of those other providers, not with a Crumdale, they’re gonna pay max out-of-pocket on deductible. And then the employer is going to pay a higher claim charge for the services that are being provided, because they’re not leveraging data and AI and doing this J-code management to reduce the claim cost. In addition, the incentives are misaligned with the actual plan and member. So you’re telling me that we do it 180 degrees differently.

Ben Inabinet: Absolutely, Matt, yes. And again, the beast is not the carrier or the TPA here. The beast is the integrated medical system who owns a compounding pharmacy or specialty pharmacy, who’s buying it from them under a separate LLC or whatever business agreement you wanna call it, and they’re selling it back to themselves, marking it up, keeping the rebate for themselves.

Matthew Naylor: Wait, wait, hold on a second, this is getting really complicated now. So you’re saying the hospital is—

Ben Inabinet: Purchasing it from themselves and marking it up.

Matthew Naylor: Purchasing it from themselves, marking it up, and then jamming it down the throat of the consumer, and jamming it down the throat of the employer. And the PBM or the carrier getting rebates, or they’re keeping their customer, which is the hospital, happy, because they’re getting, I guess, a discount because of a network or something.

Ben Inabinet: In many cases, Matt, the PBM is not making a dollar off of the J-code, because they’re not fulfilling the script. And neither is the carrier, because it’s purchased from the specialty pharmacy that the hospital owns. So in many cases, the hospital is retaining the rebate on the drugs that they’re providing to the member, not the plan.

Matthew Naylor: So there’s no discount?

Ben Inabinet: None. And they’re marking it up three to five X, at a minimum.

Matthew Naylor: So have we had examples, Ben, with our Agentic TPA platform that we’ve built from the ground up, leveraging data and AI, where we’ve actually reduced a member’s high deductible to zero, taking this injectable pharmaceutical drug that was gonna be dispensed at the hospital out of the hospital setting, putting it at home infusion, and getting the full discount and the full rebate back to the customer? Is that what we do?

Ben Inabinet: Yes, and you gotta remember also, Matt, that we’re doing this—and again, one of the core functions that we’re doing, our existing partnerships have been excellent to us. I couldn’t be prouder to partner with them, great people, right? But because of the misaligned interest, they’re able to take action on about 40 today J-codes that we know about, right? Our team’s identified almost 300 that we believe we have precedent and defensibility action on, but they can’t disrupt their automation.

Matthew Naylor: So when you say J-code management, we must have a platform that’s able to identify the member’s issue, problem, or challenge prior to pre-authorization or dispensment of the service, is that what you’re saying to me?

Ben Inabinet: Absolutely, Matt. We’re sweeping the electronic medical record on the 1st and 15th of every month, and we are flagging members who are engaging healthcare, and then from there, using our data as you described, right? And our precedent, our 15 years, hundreds of thousands of members we’ve worked with, and then we’re providing actionable insights back to the member through our Crumdale advocacy team. To me, again, technology’s really simple. I don’t want 100% technology doing something any more than I want 100% of people doing something. And again, uniquely Crumdale, we’re blending people and technology together to produce a better outcome through our Crumdale advocates powered by our technology partners to directly interact a better solution to the carrier’s pre-certification.

Matthew Naylor: Sounds like in that example, Ben, if I’m listening well, everybody’s winning. The broker’s winning because they have a better solution they brought to the client. The employer’s winning because they have a lower total claim cost. The member’s winning because they are maybe not even paying anything in their high deductible health plan. Is that the way it’s working?

Ben Inabinet: Yeah, but the interests are aligned through the strengths of the contracts and partnerships you created, right? But also the technology has now reached a point where we can back up what we’re talking about without a huge manual lift, which allows our team to scale more on behalf of the customer and the plan. That’s how we can go from 40 J-codes consistently to almost 300, I believe in 2027. It’s how we’re gonna be able to interact proactively with a member before they ever become a claimant. The technology has caught up to the ideas and because we’re built bottom up, foundationally web-based, we’re gonna be able to take advantage of that. And you asked earlier, and I didn’t answer your question fully about data and transparency. And I think in a concise way, Matt, it goes back to that great saying, “water, water everywhere, but none to drink” for the man in the boat. And everybody that you’re gonna talk to, everybody who pitches me, everybody who talks to you, talks about data, data, data. And that’s beating a drum to me. What are you gonna do about it? And we collect data from, again, the five or seven silos that make up the health plan. But we back that up with people who are taking those actions, and creating actionable insights on behalf of the member and the plan sponsor. So it’s not just about—anyone can collect metadata and piles of data that can go for years across millions of people. That’s actually not that hard anymore. What are you gonna do about it? And I think we’re answering that question in a very unique way. And the TPA is the next evolution for us personally, not only from an accountability perspective, but from a workflow perspective, how we’re making our fist into a punch.

Matthew Naylor: Where do you see things going, Ben? Where do you see the biggest opportunity?

Ben Inabinet: In our industry?

Matthew Naylor: In our industry.

Ben Inabinet: In our industry, it is going to be one in entrepreneurship around working with regional and independent health providers that still exist. Post-ACA, before this thing got passed, we had 5,000 independent medical systems. Now nationally, we’re floating around less than 700 now. When I was a kid, Charlotte Baptist, I believe it was called, is now called Atrium Health. They operate in 29 states and have over 60 people who don’t practice medicine who are multimillionaires. So first and foremost, for us to heal and take this industry forward, it’s gonna take wonderful people like you and the other Matt Naylors of our industry to effectively communicate what’s actually going wrong. And what’s going wrong is M&A on the wrong side of the table that’s driving up costs for consumers. We know every time a hospital completes an acquisition, the workforce in that market goes down and the costs go up. That’s healthcare inflation. That’s not margin to you, that’s not money to me. It’s definitely not new money to the people paying for the plan. But that’s margin back to the nonprofit medical center, which is a very loose term in my opinion. So how we attack that, how we attack the M&A activity that’s leading to worse care and higher costs is gonna be very important. I think also what we have to do—you know the man who cured polio, at University of Pittsburgh, I believe, Southern boy here, Southern education, right, 42nd education in South Carolina, so I may not know that. But when he cured polio, he refused to patent it because he believed that the cure for polio was for the world. So when I hear about Keytruda costing in an acute setting $50,000 a month, and I know, by the way, through our integrated J-code strategies, we were able to get that on a standard dose at around 25 to 30—

Matthew Naylor: And what does Keytruda do?

Ben Inabinet: Keytruda is almost a cure-all—cure-all, loose term. It is a very effective treatment for over a dozen different types of cancers. And this list goes on of drugs in a similar class that are super expensive, and it’s taken every month and a half, and in an acute setting, it’s gonna cost between $40,000 to $60,000. Well, to develop that drug was a public-private partnership. We funded it with grants and tax dollars. They funded it in the private sector. I don’t think it’s being discounted based off of our public investment in it. And there are dozens of drugs that way that I believe that we need. And you’re seeing some of that now through the Trump-Rx program, not to go down that rabbit hole, but you’re seeing it now where it’s amazing that quote-unquote margin pressure. Stocks are trading higher, their revenues are still constant.

Matthew Naylor: Is Keytruda like the type of infusion that would happen at the hospital where the hospital’s making a lot of margin? And is that like the J-code strategy that you’re talking about that Crumdale has because of data and AI? Were we able to identify that individual, take them out of the hospital setting and do that same infusion at home and lower the cost significantly?

Ben Inabinet: Absolutely, cut it in half, Matt.

Matthew Naylor: Cut it in half?

Ben Inabinet: We have members who we have cut it in half for. And it is simply one, getting it done in an independent infusion center or at the home, right? But also just simply moving the bill from the member’s medical plan to the member’s pharmacy plan provides immediate savings whether they’re getting it done in the acute facility or not. Now you have some facilities that are saying, “Well, if I’m not filling the drug and you’re not benefiting from that, then I don’t wanna treat the member.” That’s fine, if you can rest your pillow on that, that’s okay. But for us, we can take immediate impact overnight on what I think is gonna be the number one, top two drug in the world in 2027.

Matthew Naylor: You know, when you talk about hospital consolidation a moment ago and all the M&A that’s happened, I think one of the things that I’d love to get your perspective on is how do you drive through our TPA and Agentic platform lower cost and better value when you have all these hospital consolidations? Like what are we doing that’s able to identify real issues, knees, backs, hips, other issues where we’re getting people into the right setting where they’re getting great value, but they’re getting it at a better cost. What’s going on there?

Ben Inabinet: Not to oversimplify it, Matt, but it really goes back to the strengths and simultaneous weaknesses of some of the carriers in market. If everyone is in network and then nothing’s out of network, then everything’s out of network from a cost perspective. And there’s no transparency. Who does 20 hips a month and who does one? Well, they’re both in network. Why don’t you tell me who does it the best? And they can’t do that from a contracting perspective. So through our Crumdale data and AI suite, we’re able to measure outcomes data and then refer members to high quality, low cost providers to then steer them in that background. And hopefully they’ll take a recommendation with it, right? But that’s a heck of a lot better than the current system which is based on a referral out from a physician who may not have an aligned interest. And by the way, 60% of members choose their doctor on Facebook or Instagram or referral. That may be great from a comfort perspective, but the data doesn’t align with your outcome.

Matthew Naylor: So if you have a TPA that’s not agentic, that’s not driven by AI, that doesn’t leverage data and optimization integration, could you have a situation, Ben, in your experience, that you might have a great network regardless of the name of the network, you may have an average discount with a so-called great network, is there any incentive—I guess, how do claims get adjudicated? How do people process stuff? And like how do people actually steer people to better value at lower costs, or are those incentives misaligned too?

Ben Inabinet: I think a lot of it, Matt, one, yeah, it can be misaligned. It can absolutely be misaligned, but two, traditionally there’ve been so many restrictions on the TPA and also what is their ability to actually deliver that service, right? Many TPAs are locally based regionally for a specific state. Healthcare is local, I get that, but they don’t have the investment from a workflow perspective. Their mobility referral is based off of sweat equity with single case agreements, which again may not provide the best outcome to the member. And so our ability to again, blend single case agreements with the technology and data on the backend to optimize that, huge. But then also many TPAs, Matt, are only—they wanna stay good at what they think theyre good at, which is adjudicating claims in a timely manner as it pertains to their ASA agreements or agreements with providers, right? That’s what they think their role is. And again, I believe, we believe our role is not only to do those things, but also get the member in a position to get the best possible care for the least amount of money and do it proactively ahead of schedule so that they can access care quickly the way that they should.

Matthew Naylor: So like before someone even gets an MRI, before someone even goes to a facility, like how does that actually happen? How does that actually take place?

Ben Inabinet: So we again, we’re sweeping the electronic medical record to see who is engaged in care. And so you just don’t show up and get an MRI, you know that, I know that. You know, you’re going to seek care, then from there the doctor or physician or nurse advocate or whoever is inputting data into a software suite. And we are communicating with that software suite capturing that data. Well, again, that’s great data. What are you going to do with it? So then through our technology stack, we’re looking for where there are gaps in care as an example, you know, you’re going to get an MRI. Okay, well, who are the possible specialists, right? And our nurses and our farm techs and our physicians and our teams, they’re looking at that data for possible insights to help a member on their care journey. So it isn’t about denying care. It isn’t about trying to get people not to be sick, it’s going to happen. But when they’re engaging care, when they’re facing the toughest battle they’ve ever been in, it’s about getting them to where the best outcome for them is.

And I’ve got horror stories on that earlier in my career. I’ll never forget when I worked at my previous employer, we had a 900-life group in rural South Carolina where a man needed a kidney transplant, and he was on the list. And he went to the doctor, he went pre-cert, and we attempted to do an intervention. I physically called the member with the broker, and I said, “Hey, we will get you to Mayo. I’m going to pay for a car to drive you to Jacksonville. I’m going to put your family up at the Marriott.” The whole thing. And he goes, “Well, I met my surgeon in church, and I think I’m going to do it with him.” And that guy didn’t make it. I’m not trying to be negative, but that surgeon, when we did the data on him, we told him, “This guy’s in the bottom 10% of quality nationally.” We know that. He’s been at four different hospitals. He’s been sued before, and the guy still talked him into doing it with him. And so that’s something that members are facing every day, and they don’t have the data, they don’t have the workflow, they don’t have the back end that we do that can help them.

Matthew Naylor: What do you think, Ben? We’ve been talking about employers, and clients, and members a lot. You know, 100% of our business is through trading partners, brokers, consultants, and agents that are out in the marketplace, on the front line, constantly looking at different solutions for their self-insured, level-funded, captive clients. How do you think we’re setting a new standard for brokers? What do you think we’re doing that’s truly unique and different, and helping them be better at what they do every day?

Ben Inabinet: I think for one, you know, a lot of people, Matt, talk about how we’re going to take work off your plate. Again, our unique experience being in their shoes—many of the people who work here worked at agencies. You owned an agency for a long time. And so us being in their shoes and understanding what the expectations that they have with the people that they’re choosing to work with, we again have aligned our workflow from a human level and from an automation level to accommodate them, to give them the look and feel of not only their biggest competitors, but allow them to streamline the things that they do best, which is quite frankly finding new people to partner with and being accountable to the people they’re already working with. So we not only are an accountability tool for them in a meaningful way, we’re also a prospecting tool for them in a meaningful way.

And so I think that’s probably where we align best with our trading partners. They can rest easy. One of our partners in Phoenix, when we did our presentation to them, he paused me talking and he goes, “You all hear that? That’s sleep insurance.” And it just stuck with me. You can rest your head partnering with us, knowing that you have teams of dedicated people who don’t work for you, work with you, who are accountable to the plan and trying to make it run as best as possible. And I think quite frankly, again, when you look at the rest of the supply chain, that’s not always true. And so again, I think that’s a very unique approach to market that I’m very proud of.

Matthew Naylor: What’s your favorite story here at Crumdale? What’s the one story that you love that you would like to share?

Ben Inabinet: I think it was 2023. One of our sales reps sold his first big opportunity here. And I was a big part of that, I like to think, or a small part of it depending on who you ask. And everything that we pitched on immediately happened, immediately. And you gotta remember, when you’re looking across a CFO, you’re looking at someone who’s of high success. So many people we partner with. I hear people in our industry talk about 50-man group, 100-man group, that’s an employer who’s had the success as an entrepreneur to get 55 people who are depending on him for how they’re gonna take care of their family. That guy must be brilliant, right? And so when we pitched that nursing home in Florida and we got the opportunity to work with his, I think it was 880 employees across seven states, and we told him, “Hey man, you’ve got nine people driving half of your spend and here’s how I’m gonna take action day one.” We were done with all nine of them by month two. And we took them back to pre-COVID spend that year.

And so it was such a fulfilling moment to see, but it was also a reassuring moment as at the time, again, I worked with you for two years prior to coming here, but as a full-time employee, being in the trenches and seeing firsthand what we created, it was just so fulfilling. And keep in mind that’s nine people who no longer had a deductible and copay to worry about. That was four grand a year that we put back in nine people’s pockets, who were nurses, who were assistants, who were janitors. This is a lot of money for them, a lot of money. So we made differences in their lives.

And I’ll tell you one more. That same year, our broker gave my cell phone number to one of the people that we helped through our patient assistance program. And I had a mother call me and tell me that at the time, Humira didn’t have the biosimilars, and we were able to take her through alternative sourcing because of her income. And she was with her daughter—she was a single mom, which brought me back to my family’s experience. And she was choosing whether to eat dinner or not and rationing medication. Her daughter had severe Crohn’s disease. And so she was only filling it twice a month because that’s all she could afford. And her daughter was scared to death of needles, so she was gonna get it done at the hospital. Well, I tell the story all the time, because Humira in a normal setting is $81,600 on a standard dosage. And the plan was getting charged about $235,000 because it was a J-code, Matt. So in our underwriting process, everyone else is DTQing or slapping a 50 on this case. And we looked at it and said, “Nah, this is like a trend increase, and we’re gonna help this lady day one.” And we put our money where our mouth was at the time, Matt, and that broker who’s retired now gave that lady my cell phone number. She was crying on the phone: “Mr. Inabinet, thank you so much for helping.” Boy, did it bring it together for me, you know what I mean? And it motivated our rep, he’s gone on to be our best performer here.

Matthew Naylor: Yeah, well, Ben, I love what you’re saying, because it’s about alignment and impact. It’s about building a great business, doing the right thing, working hard, having a great team. And at the end of the day, you’re doing the right thing for a customer, and you’re making a difference in their lives. It’s really cool to get to do here every day. Ben, what’s the one question I didn’t ask you that you wanted me to ask you?

Ben Inabinet: I think it’s about where we’re going and why it’s so important. And for me, Matt, I’m so motivated by what we’ve been able—use “we” loosely, it was a lot of you, but what we’ve been able to accomplish the last four years, how many people we’ve helped, the tens of millions, approaching $100 million we’ve saved on this stuff. And when I was sitting down with Eric, or Dr. Emerson, and evaluating the gap between what we can do versus what’s happening, it woke me up. And then when I’m in market with our great trading partners, talking about what they need, and it’s completely aligned with what we’re building, I just can’t wait to get it out there to them. So when I know how we work, and been around it now for six years, I know we’re at a starting line, not a finishing line, where all of our competitors, quite frankly, are already at their finish line. They only have so much capacity, and they don’t have the ability to innovate. And so us being at the top of this, not at the bottom of it, not at the mountain top, our mountain’s a little higher. I’m motivated and fired up in a way I haven’t been in a long time, and I work pretty hard.

Matthew Naylor: Yeah, well, we’re setting new standards, and we’re reimagining how healthcare should be delivered in this country, and you are one of many, many people on the Crumdale team that are doing great work, and I really have enjoyed the conversation today.