- Key insight: Uncover how Fello restructured its healthcare benefits to improve utilization and outcomes.
- Expert quote: "We wanted to reimagine everything." — Jonathon Rondeau, president and CEO, Fello
- Supporting data: 80% of employees used a newly introduced online therapy platform.
Source: Bullets generated by AI with editorial review.
At Maryland-based Fello, expanding opportunities and
"When I got here nine years ago, I saw that … we weren't keeping up with all the things [people] need, including pay, training, talent development and employee benefits. So there has been a real focus on that, [because] we support people, and the vast majority of our employees are working directly with people with disabilities. It's like flight attendants say: "If they can't put the oxygen mask on themselves, [meaning] if they can't take care of themselves and their family, how can they provide services for [other] people?"
Read more:
In addition to more than doubling starting salaries for the organization's direct-support professionals (previously $9.88 per hour and now $21.50) and
"People were just not accessing that," he said. "We went through a couple renewals, and each time our broker, an insurance company, would say, 'If you just put a wellness program in, that's going to improve your outcome.' But when you looked historically at our data, our three highest claimants are people with chronic diseases that wellness [benefits] have nothing to do with, so I asked the pointed question of, How is this going to affect that? In the end, about five years ago, we changed brokers."
And that was just the start. "We wanted to reimagine everything," Rondeau said, "but particularly focusing on health insurance and all the ancillary pieces within that, and to be able to control what we cover, how we cover it, what that costs, and to have some predictability around that. So [about four years ago] we made the decision to move to self-insured, and tenets that we put into that early on were that we were going to freeze the cost of healthcare for our employees in that year, meaning that their costs out of their paycheck would never go up in some areas, and then any savings we get by being self-insured, we're going to reinvest back into our health-related benefits."
Read more:
Improving benefits understanding and utilization
In the year after the switch, Rondeau focused on helping people understand the details of the plan and
"We partnered with ModRN Health to provide an on-site urgent and primary care clinic at one of our offices," Rondeau said. "That's available to all of our employees, whether they take our health insurance or not, and if they do and they have dependents on the plan, their dependents can use that clinic as well. It's essentially concierge-level, one-on-one support that a nurse practitioner provides."
Rondeau noted that the easier, cost-free access has led people to seek preventive care after long gaps and helped people get chronic conditions such as diabetes under control. If there is a nonemergency after normal hours, employees can communicate with the nurse practitioner to receive advice and prescriptions when applicable, then follow up in person if need be. More recently, Fello expanded the urgent care access to residents of a group home it supports.
In the area of mental health, the company rolled out free access to online therapy platform BetterHelp in 2025, which in its first six months 80% of employees used at least once, Rondeau shared. While general medical, vision and dental benefits are available to full-time workers only, both BetterHelp and the free preventive and urgent care services are available to both full- and part-time employees.
Read more:
By prioritizing thoughtful benefits implementation and support, employee trust has been established, which boosts engagement, Rondeau said. The organization's efforts earned it a 2026 Rosie Award from health benefits redesign collective Health Rosetta, which "recognizes organizations that are transforming healthcare through innovative, high-value health plans that improve outcomes while reducing costs," for three consecutive years, and it was just included on the Baltimore Business Journal's list as one of Maryland's Best Places to Work.
To fellow leaders looking to make improvements to their healthcare strategy, Rondeau recommends not shying away from change, which could include exploring a self-funded route.
"People think you need to have a huge employee population to be able to be self-insured," he said. "We started our self-insurance journey when there were only about 110 people on our health insurance plan — not a huge number — but by creating these robust benefits we now have close to 400 people on our health insurance. Have a conversation with an employee benefits broker you trust, or look for a new one, and really take the time to explore that. It may not be right for everyone … but I have yet to talk to another CEO who is self-insured and regrets it."
