Part 3 in an ongoing series about making the switch from retirement to healthcare advising. Catch up on
In shifting from the retirement to healthcare side of benefits consulting, several industry leaders who made the change had epiphanies along the way to a new career destination.
"Growing up in the retirement industry, my mother's motto was always that we wanted to provide people with the ability to retire with dignity," says Jamie Greenleaf, co-founder of Fiduciary in a Box. "So, my mission had always been making sure that a plan was running fiduciarily sound in order to deliver better outcomes."
Her exploration of the healthcare space began when an employer asked her to help search for a health savings account (HSA) provider. "I got in the car and Googled, 'what is an HSA?' I didn't even know what that was."
After researching this topic, she wondered why no one seemed to be talking about these accounts and their sheer power: A triple-tax advantaged way to pay for healthcare expenses today, tomorrow and into the future.
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Her next move was to invest considerable time, money and energy into building a tool to help employees make better decisions on the plan they selected at open enrollment. While employers loved it, she noticed that brokers became naysayers who doubted it would work for the populations they served.
"I got really interested in why, and then I quickly realized that these poor employers didn't have proactive plan designs because they were in a heavily conflicted environment," she says. "Then the Consolidated Appropriations Act (CAA) came along, and I was like, 'Oh my gosh, this is exactly what happened in the retirement space.'"
That revelation drove Greenleaf to pursue the most meaningful possible impact by pivoting to the healthcare space where she hoped to duplicate her success with retirement plans that had more than 90% participation and great account balances.
One of her fellow advisers actually boomeranged across the industry twice. When Hugh O'Toole started as a group health underwriter, he was terrified about continuing to dole out 30% to 40% renewals to clients and sought to put his social work background to good use by doing something valuable for society vs. bankrupting people.
His next stop was the retirement industry, which he later learned was swindling clients. That led to what O'Toole describes as "a Don Quixote mission for 25 years with a lot of other good people like Barbara Delaney, Jamie Greenleaf and her mother, Dorann. We cleaned up through transparency, disclosure, regulation and lawsuits to take down asset-management fees."
Avoiding conflicts of interest
Barbara Delaney, founder of StoneStreet Benefit Advisors, also embarked on a winding road. She started out 43 years ago doing oversight on defined benefit plans and later 401(k)s. After a stint at EF Hutton, she joined an employee benefit firm and was amazed by how much money was made on health insurance. "That was foreign to me," she recalls, noting payments ranging from 5% to 10% of premiums, which were going up every year.
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It occurred to her at the time that she might have been doing something wrong because "401(k)s were just being born and it was hard to make money." Delaney later formed her own business, which was then acquired in October 2019 by a large HR and benefits brokerage through whom she sought cross-selling opportunities.
It didn't take long for her to raise concerns about all the commission-based conflicts of interest involving third parties that reminded her of the same negative patterns in retirement plans that eventually were mopped up.
After an amicable departure, she became a donor for the recently formed nonprofit Nautilus Health Institute, which was founded by Health Rosetta co-founders Dave Chase and Sean Schantzen. "We're here to offer plan sponsors open resources and open inventory for how they can put a put in a fiduciary process," she explains, noting how it avoids conflicts of interest.
Now CEO of Innovu, O'Toole remembers giving CFOs impassioned speeches on financial wellness and the danger of being put out of business by healthcare and pharma. He was accompanied by his son, a college sophomore at the time who's now a Deloitte accountant. "That was my aha moment," he says. "You can't sit around and whine about people not funding retirement when they have no money."
He eventually invested in Innovu and joined the company board before occupying the corner office in 2018. As much as he uses data analytics to find fraud, waste and abuse in healthcare and population health opportunities, he still identifies as a financial-wellness advocate. "I'm just trying to find the capital for people to become financially well," he adds.
