Meet the Health Insurance CEO Who Loves Functional Medicine Part 1

Announcer: Welcome to the Functional Forum Podcast, the place health professionals come to hear from innovators and agitators leading the charge. We cover the latest clinical breakthroughs in health technology, as well as practical tools to help transform your practice and the health of your community. Now, here’s your host, James Maskell.
James Maskell: Hello, and welcome to the podcast. This week, we feature Doug Short, the CEO of Benicomp Insurance Company, that is an innovative employer insurance provider. On this podcast, we talked about how functional medicine to grow to service another 200 million people by effectively accessing the employer market, and how we could go about doing that. We talked about why Doug is passionate about functional medicine, and the role that it can play, and why the time is right right now to be able to get more employers and more people into functional medicine.
We also talked about some of the details on how you could have your costs, your cash services that you offer in your functional medicine practice right now, you could reduce the cost of executives, and wives of executives, and CEOs of the people in your community who you’re already serving, and make it easier for them to afford your ongoing services. Even packages. It was an incredible half an hour. This is a game-changer. This is part one of a two-part series. Next week, we’re gonna go even bigger, but this is beautiful. Enjoy.
Hello, and welcome to the podcast, Doug Short. Welcome, Doug.
Doug Short: Thank you, James.
James Maskell:  Doug, I’m absolutely thrilled to have you here on the Functional Forum Podcast. I think this gonna be an inflection point for the whole industry, and I’m very excited for you to share. So, as a starting point, why don’t we just talk a little bit about Benicomp? You’re the CEO. Why don’t you share with our audience a little bit about Benicomp, where you started, and where you guys are going?
Doug Short: Exactly. I am the President and CEO of Benicomp Insurance Company. Our domicile is in Salt Lake City. Our operations center is in Northern Indiana. And I’m in Tampa at the executive center talking to you now. We’ve been around for 55 years. I’ve been here for 38. So, I’m really excited about the changes in the marketplace. One of the things that I’d reflect on real quick is, we launch in, is in the last 15 years, there has been a lot of change in the marketplace, and we want to evolve and to create some unique programs inside that evolution.
James Maskell: Absolutely. Yeah, it’s really interesting. We’ll get into that. One of the things I would like you to do a bit later in the podcast is to school my audience on the ACA. That’s something that I’ve definitely got from our relationship, is really seeing you as someone who knows this world inside out, more than I do. But, before we get there, let’s start with how you were connected to this new operating system in medicine. Some call it functional medicine, new medicine, integrated medicine. You had your own personal connection to it, and I’d love for all of the people at home to hear the story.
Doug Short: Yeah, absolutely. We had my own primary care relationship for decades. Actually, the relationship I have with my PCP would have been the doctor that even delivered my children, so we’ve had this relationship for a long, long time. But the relationship had a lot to do with certain things that we are trying to evolve our company through, which is instead of diagnose, prescribe, trying to help and treat the illnesses. And the thing that really collided is in … Where our operations center is, our clinical director is a very smart man, Dave Wilkins, that has worked closely with one of your functional providers, and he introduced me to Jeff Gladd, and I actually went, and he became my PCP.
And I learned a lot about enzymes, and chemicals, and … It was interesting, as he was talking to me about ways that my body would react to certain things, my mind was relating to the diagnose, prescribe past that I would have come from, if you will. And it was just a dichotomy that I was fascinated by. And as Dave Wilkins and I talked through, we wanted to explore that, and I actually moved my own care to Jeff, and we’ve had a great relationship since.
James Maskell: What was it about the operating system of the medicine that appealed to you over what you’d seen before, as someone who’s also trying to keep themselves healthy and also someone who’s in the business of … controlling healthcare costs.
Doug Short: Actually, fixing the problem is a lot better than putting a Band-Aid on the problem. And I, for the most part, for all these decades of being an insurance company, we pay the bills. But, traditionally, insurance companies don’t get too involved in helping people fix their problem. We end up just paying the bills, and I was fascinated by how that would all come together.
James Maskell: Absolutely. So, you had your own experience going through, and I know you had your family involved in it to check it out. Tell us a little bit about who Benicomp services. Who are the clients? Who signs up for Benicomp? What are the kinds of products and other things that you guys make? And who is using Benicomp currently for their health insurance?
Doug Short: Well, we are not a primary insurer like Blue Cross or Cigna. We are a supplemental ancillary insurer. And we pick up things that other insurance companies won’t cover. And for the last decades, most insurance companies not wanted to pick up prevention, or early detection. They have not wanted to pick up things that would help people maintain their health. They would only pick up things once there was a diagnosis. And that’s frustrating to me as a claims payer. Because the cow’s out of the barn at that point. It seemed far more logical to me to be on the front end of prevention and early detection.
So, along that journey, James, we were actually blessed by the launch of the ICD-10s in one of these products called Benicomp Select. The ICD-10s actually opened a lot of the windows … cracked them, if you will, to start with, for prevention and early detection. Basically, there can be a claim, even though there’s not a cause or a diagnosis yet. And we discovered how to insure that so that the primary medical plans are, in some cases, even yet, they’re afraid to cover that. Because, it’s paying for treatment that the disease hasn’t manifested itself, yet. And of course, I wanted to prevent the disease. It’s just a dichotomy, and we saw that, and we are right now the nation’s largest provider of that ancillary program that allows employers or employees to have a program that would pay whatever the base medical plan denies. Prevention is one of the big denial points.
James Maskell: Yeah, it’s super interesting. One of the things that I think you shared with me just, what percentage of Americans are relying on employers for their healthcare? ‘Cause I think that’s … Up until now, functional medicine has sort of survived and thrived in a very different medical environment than the rest of medicine. Like, the majority of functional medicine clinics, integrated medicine clinics, are either cash or hybrid cash/insurance, but like 75%, I think, are mainly cash. And it’s operating outside of the system. Can you explain for the audience, by participating in this kind of thing, how much of a bigger market could functional medicine attain by operating in this kind of world?
Doug Short: It’s a remarkably larger space for functional medicine. And if I put a word picture to the way this product called Benicomp Select. It could be found out on the website under Benicomp Select. The way that product works, it would remind you of a Medicare supplement, which is supplementing the primary plan. I also think of another example word picture, might be an Aflac program that would be purchased in addition to a primary plan.
So, what it turns out is, the primary plan has a controlling factor involved in it trying to control how much is paid. And, there are people like me that they want to have things like preventive care, preventive blood studies, nutrition, maybe even the exercise or movement, glucometers, they want that to be a covered charge to keep them healthy. I want to keep myself healthy as opposed to allowing myself to break, and then I go in for coverage.
So, to answer one of the questions you just asked, the nation is broken really into three or four parts. I’m just using word pictures here, but you got to think about Medicare is probably one of the largest payers in the country, but that’s for the retirees. You also need to keep in mind, before we go into two, three, or four, that the baby boom is approaching. And that’s going to actually tilt Medicare to being even larger. But then, you go into Medicaid and that would be the less-fortunate, the poor, the indigent.
But then, you go over to primary insurance, which is employer-driven. So, for decades, maybe 100 years, the employer has insured that space. The employer has put that coverage in place as an employee perk to the employees. In addition to their compensation, in addition to their pension, they would have benefits, and the majority of all Americans that are working age have been historically insured through the employer.
James Maskell: Absolutely. Do you have an idea of how many million Americans that is?
Doug Short:  Well, if there’s 300 million American’s, I’m guessing … I haven’t looked it up, but I’m gonna guess 200 million of them are insured through their employer. It’s a large number.
James Maskell: Yeah, absolutely. So, typically, what’s been happening is someone … whoever gets sick, they get sick, they try the standard of care modalities, they don’t end up getting better, they go through all the evidence-based structures, and then they still find themselves not better. And then, maybe through a friend, or a relative, or someone in the community, or the marketing of one of the people in our community, they’re sort of desperate and they like, hey, I’ve heard good things about this practitioner. They end up in a functional medicine doctor’s office. So, at this point, typically, they’re paying cash. And one of the things that you really help me to see is that, ultimately, when people are paying cash for medical services, they’re kind of overpaying what they should be paying, because it’s all post-tax money. Can you explain that a little bit?
Doug Short: Exactly. When the functional practices accept cash from a consumer, what they’re doing is, they’re struggling to get it paid by the insurance policy. So, they want cash to be able to take care of that purchase, but … Well, the moment they take cash from the participant, the participant is paying a grossed-up, or we’ll call it a after-tax dollar. That dollar bill that they’re giving to the functional provider is after tax. And there are ways to get that dollar that is paid to the functional provider to be pre-tax. And if it was cast as a pre-tax claim … If the employer is making … Or, the executive, the participant … It’s their tax rate, and that’s 30, 40 percent.
So, there’s a way that you … There are programs out there, and I am the largest in the country of this program, that would allow someone to have a policy … a policy, mind you, on something that is not insured by the base medical plan. It would pick up whatever is not insured by the base medical plan, and allow it to function through a policy which would be deductible as premium, and non-taxable as wage, and not imputed income to the employee. As opposed to paying cash, which is … The participant’s probably paying 40% greater than they could if they would have this policy structure in place. The Department of Insurance approvals like we have.
James Maskell: So, what is it about Benicomp that gives you the ability to be able to make the regular payment, like cash payments that would be made from a patient to a practitioner, that would allow that to be a pre-tax payment?
Doug Short: Well, the thing that is … To me, it’s fascinating, but the words I’m gonna use are very simple words, but they are very meaningful words. When money moves from an employer to an employee, that’s called imputed income. That’s the word that’s used. It’s imputed income, and that income is taxable as wage. If the money were to move, instead of to the employee directly, it would move to an insurance company, that dollar is called premium. That’s a significant word. That’s a legal word. A premium is deductible to the employer, it’s taken off of the employers, it’s an expense to the employer. But then, when you become in a policy, like Benicomp is a Department of Insurance approved policy, that means the payments that I would make to the functional provider on behalf of the participant, those payments are not withdrawals, they’re not a payment, it’s called a claim.
The word claim is, again, a legal, significant word. You have to have a license to be called a claim. And when it pays as a claim, it is a non-taxable value. So, what had happened in 2010 is, when the ACA came out, the ACA moved towards the ICD-10s, and what that did is, it changed the Internal Revenue Code of section 213, basically allowing as a claim, as an eligible claim, something that does not have a primary diagnosis. Well, that’s prevention. It made prevention an eligible claim.
Now, there’s many, many plans in America that still won’t pay for it, because they’re waiting on there to be a claim coded in order to have the cause, and then they’ll solve the issue by paying the bill. So, to have the ability to code something as a ICD-10 eligible code that would be for prevention, prevention would not have a diagnosis, there’s no primary diagnosis to prevention. That is an eligible claim inside of the IRC 213 as it stands right now.
James Maskell: So, let’s just unpack that a little bit. So, what I’m hearing you say is that, currently, if let’s say you’re a … if you’re the owner of a business, if you’re a CEO, or if you’re an executive, instead of paying yourself a wage and then, out of that wage, paying anyone in our community for a preventative service, or a non-covered service, essentially, that instead of paying them … Let’s say it’s a 500-dollar payment that you pay to a practitioner. The equivalent of that is actually somewhere in the range of, let’s say, 700 to 800 dollars, because that’s how much pre-tax income you’d need to make 500 dollars to give to a practitioner.
But, ultimately, what you could do is, you could put that 800 dollars into, essentially, like a premium type of product, like Benicomp Select, and then that whole 800 dollars could then be used to pay for these non-covered services because of these rules. Is that right?
Doug Short: That’s exactly the case. But, let me put one more caveat that makes this even more special. Is, when we filed decades ago for the filing approval with the Department of Insurance in all of our states that we have … When we filed for that, what the providers need to understand is, there are three different premium models. And I’m actually filed and approved for all three. We’re using the third, but this evolution will make a lot of sense. What most insurers want to do is, most insurers want to charge a full premium. So, they would charge maybe 1,000 dollars in premium in order to finally give to the participant 400, 500, 600 dollars in claims. That’s called full premium.
There was a second premium model that the government allowed that’s called premium refunding, which would be like a settle up. An insurance company settle up. And that would be where the insurance company might charge 1,000 dollars in premium, and if the claims only came in at 500 dollars that year, there would be a give back or a settle up of some of that difference.
But, there’s a third premium model. It’s an eligible model. But, there’s a lot of insurance companies don’t like to use this model because it doesn’t have as much proper margins to the insurance company. And this is our primary model. And the third model is called variably funded. And what variably funded premium is … And it’s an approved premium method by the government and the Departments of Insurance. What variably funding is, we only charge what the value of the claim is that’s being incurred, plus the administration charge.
So, in the example that you gave, if the claim to the functional provider is 500 dollars, they would have to have a taxable compensation of 800 dollars or more being paid to them in order to net the 500 dollars to give to the functional provider the cash payment. In our case, the employer is allowed to pay us the 500 dollars. Just the 500 dollars, plus 11% is the cost of the administration charge. They would pay us the 500 dollars plus the 11% and deduct that as premium. That’s an expense to the corporation. And we would then remit back to the functional provider on behalf of that participant the 500 dollars. That’s a claim. When it remits to the provider, of course, we are sending tax statements to the provider that that’s their revenue. But, it’s not a function of revenue to that participating employer.
The other thing, James, that is very unique about the way that our product is filed, is … And I saw this for myself, as it related to my functional experience with Jeff Gladd. The other thing that’s interesting is, there are some employers that they choose not to … they want to have this as an executive perk. Not necessarily as a value that would filter it’s way through all the employees, which is fully possible. I’m just trying to make the point that we are filed and approved to be an executive perk, so it could be placed on the two or three executives inside of a corporation, where those executives would have this value added to their wage package. But, it’s not imputed income. It’s not taxable income. It’s paid against claims. In many cases, in my case, it’s paid against preventive claims. Claims that will keep me well, as opposed to fixing me after I get sick.
James Maskell: Beautiful. Absolutely. Well look, this is really exciting. I guess what I want to do for the last remaining few minutes here, Doug, is just talk a little bit about our plan to be able to get functional medicine to the masses. If functional medicine could reach a segment of these 200 million people that we’re talking about, the pie, the ecosystem of functional medicine, is gonna grow significantly. It’s gonna be good for the doctors, it’s gonna be good for the supplement people, the lab people, the technology people, it’s gonna be good for everyone. That’s what we’ve been looking to do all the way through what we’ve been doing, is to grow the ecosystem.
And we feel that the number one thing that we can do in order to speed this along is to put patients who are in your clinics … I’m talking now to you, the listener, who runs a functional medicine, integrated medicine clinic, and are seeing people in your practice who are local employers. And, if you are one of those people, and you have patients who are local employers, I think there’s a really big opportunity here. Because, ultimately … Just before I … When I first met Doug, I’d recently been to a clinic in North Carolina, and I’d spoken to a guy who said that, he said that eight out of the 10 biggest employers in Charlotte, where he was from, all came into their functional medicine clinic. The CEOs of these companies, and in some cases other executives, were seeking out functional medicine for Bredesen-style, cognitive improvements for health restoration, for health prevention, for … They just got it. They got the operating system of care. They wanted to operate at the highest level.
Now, next week on the podcast, we’re gonna be talking about … We’re gonna have Doug back for a second segment, and we’re gonna be talking about how we can get functional medicine to all the employees. Because, there is something … As Doug said at the beginning, Benicomp is known for being an innovative insurer. Doug obviously understands what’s happening with functional medicine and getting people well. But, the first step that we have to take here is, we have to connect Benicomp to employers, and particularly to decision-makers in employers.
So, I guess I just want to take everyone who’s listening to take a moment, and just think through all those patient files that are somewhere in your practice. Hopefully, they’re on a computer. In some cases, I know that they’re on pieces of paper somewhere in the office. But, just to take a moment to think, who do I treat, or who have I treated who has appreciated my care, how has come in and paid cash for it, and if they come in again, would probably like to pay a third to a half less, depending on what state you live in and the tax base, and also might be interested in providing functional medicine care to their executive team?
And I guess one thing I just wanted to confirm with you, Doug, is … I guess, part of the reason why people might buy supplemental insurance is because, my understanding is that, it’s illegal for the CEO and the factory worker to have different kind of healthcare, but this supplemental insurance fills that gap. Is that right?
Doug Short: That’s exactly right. A number of years ago, when HIPAA came out, it required uniformity even at the highest level. So, everybody’s got the same primary base medical plan. The other thing that has been a real peril for the executives that many of the functional providers would see … The executives, or the executive team, or the executives’ spouses, it’s the high-level employees or participants. The other thing that was a taxation peril is the FSAs, the HSAs really don’t apply to a participant if they own greater than two percent of their S, or LLC, or partnership.
So, even medical groups, the provider, legal groups, the lawyer themselves, they’re not in FSAs or HSAs because they’re not allowed to participate. That was a rule that was cast a number of years ago. And the other piece about that is, if the employer is not allowed to participate in the normal tools that employees might have, the FSA and the HSA, and the executive isn’t allowed to participate, they weren’t allowed the tax-favored status of those claims. They therefore were paying them all through imputed income.
I’m thinking about two or three things that are just running through my mind. The other one is, just in recent years, the government even made it harder for the executive, because they moved the itemized exemption. It was 7.65 of adjusted gross income, so if your adjusted gross income was 100,000, you had to have 7,600 dollars of deducted medical claims, or claims that would be after-tax dollar, before you were even allowed to itemize them. And today, it’s 10%. They even raised that number. So, the peril behind that is that they’ve made it harder for the executive to participate in a pre-tax method. And what we have is the filing that the executive would need to make it pre-tax, make it a claim. The executive is key to being a good role model for their employees. So, if the executive has a great experience, the executive is a leader. And the executive is a person who says, hey, I’ve had a great experience with this, and I can lower my claim costs by getting in front of claims. That is probably one of the biggest guides or benefits to the employees that there is.
And then, the last thing I’ll mention to you, James, I said at the beginning of this discussion that the baby boomers are approaching retirement. I was at a conference some time ago, and one of the big pension funds said the number one diluter of executives’ 401K is their health that they take into retirement. So, when they have just been taking drugs or … They haven’t fixed their diabetic condition, they’ve just taken drugs to suppress it at the moment. They take that condition into retirement. That is the biggest thing that erodes their pension benefits. It takes money out of their pension to cover their copays, or their deductibles, or things like that.
In their non-working days, they are eroding their own retirement benefits. So, having functional, preventive medicine given to people before they get to retirement so that they can fix the things that keep their pension intact, I think is a virtue. And that’s what we’re here to accomplish.
James Maskell: Absolutely. Yeah, that’s bang on, and I think that, in practices around the country right now, we’re seeing those boomers flexing their financial muscles in practices. We had a podcast just a couple weeks ago where a doctor in Alabama was doing the mild cognitive impairment reversal with the Bredesen Protocol for people of a certain age who were ready to spend money in either losing a diagnosis or getting themselves in tip top shape. But, it makes a lot of sense because, ultimately, it’s the copays and the other things that go into those payments that are gonna bleed their savings dry as they go into retirement. And also, people are gonna live longer, and so there’s not gonna be as much money to go around.
So, we’re gonna have a link here. We’ll put it in the show notes. It’s gonna be goevomed.com/benicomp. And if you go there, what we’d love to see … Later this year, we’re gonna do a tour around America, the New Visions Tour. We’ve spoken about it before. And on that tour, our intention is to sign up employers for a couple of programs. Benicomp Select, and then another product that we’re gonna talk about in the podcast next week, which is super, super exciting, where essentially everyone in the company, every employee, could have access to the wellness services. To finding out their risk through blood markers, and through having access to functional medicine health coaches, and ultimately having access to the functional medicine practitioner doctor community.
So, that is what’s coming up next week, and I don’t want to spoil the surprise, ’cause it’s very, very exciting. But, one thing that would facilitate this to be really, really successful is, if you have people how you’re thinking of now, who you’ve treated, who you know are either executives or are CEOs of companies in their space that have problems with paying for healthcare, or have moaned to you about the problems of their healthcare for their employees or themselves, or are paying cash for your services and would love to have their company essentially pay for their wife’s healthcare, their healthcare, and the executives team’s healthcare, we have a solution. It’s called Benicomp Select. This company gets it. I’ve been down to their headquarters. I turned up on a day where … It’s a healthy group down there. They understand the future of healthcare is actually creating health. And next week, we’re gonna go into how that’s gonna scale out to 150, 200 million people, and what we can do about it. But ultimately, this is gonna be really good for your practice.
Just one thing, Doug. I know we spoke about this before. There are people who are listening to this who sort of bundle their care into packages, where they may bundle like a six-month program for 2,000 dollars or something, that has a number of visits and also other things included. Is it possible to have the same kind of savings in a bundled package?
Doug Short: Well, the thing that I would say is, we would want to help counsel some of these providers through some of these bundles, if you will. Because, when HIPAA came in, and then GINA and FMLA, and COBRA, and all these rules, then the ACA launched, the market is rife with rules that we have to meet. So, one of the rules that got cast was, a membership fee is not a deductible expense by the Internal Revenue Code. A membership fee. And then, if you think about one other. And I use the example of an orthodontist that wants to charge for all 20 of the visits. You know, they want 4,000 dollars upfront. That’s not an eligible claim. The claim would be eligible if it was divided into each of the services.
So, my point is, the package that you want to promote, if it is coded properly, it can run through the Benicomp Select program. If it’s coded as a membership fee, there are … In recent years, there’s been a lot of rules that have been cast against membership fees by the Internal Revenue Code. So, we would help talk that through. And, to the point that James just made, the executives, they … It’s not just that we are trying to feature to the executive. We would feature to every employee. But, really, what the executive is, is the leader, the stalworth of that corporation. The executive is the one who … or the executive spouse is the one who will lead that corporation.
So, the executive, if you’ve got an executive that is using functional medicine, you have a number of things that are virtuous. Not only do you have the leader, but now you have the tax ID and the ACH coding of the employer, but you also have a person who is not allowed, who is restricted from being in FSAs and HSAs, or they’re paying cash. But, you probably have the one that will … If you’ve got an executive coming to you, you’ve got somebody that is in leadership that gets it. And that is the best way to get inside of the employer group. But, next week, what we’ll talk about is, how can we sell preventive, functional medicine to the entire employer population? That’s a fun conversation as well, and we have that solution, too.
James Maskell:  Yeah, that’s gonna be a great conversation. That’s coming up next week on the podcast. So, Doug, you said it perfectly, there. We are looking for leaders. We are looking for leaders in industry that get it. And those leaders are in your practices, I’m absolutely sure of it. So, the best thing that you could probably do, maybe the easiest thing to do, is just to forward this podcast to all the people that you know that are in that space, because they’re gonna get it too. And I guess I just want to end this with one other thing, is that I know that certain groups in our community have been badly done by by insurance, where you sign up for an insurance product, the chiropractors and the nature paths particularly, where they had been signed up with Blue Cross Blue Shield or Aetna, and then had seen their payments go down over time and been screwed by the system. And that’s not what we’re talking about here at all. And I just want to make that clear too, as well, is that when the claim is 500 dollars, it’s paid at 500 dollars because it is part of this supplemental health insurance that’s been bought ahead of time by the company to pay for exactly these kind of services, things that are not covered by the main medical insurance.
And so, I just want everyone who’s listening to this to just see the opportunity that’s here. If you go to goevomed.com/benicomp, there’ll be a place there where you can submit your interest. Ideally, we want to have easy ways which, when you have someone who comes into your practice who is an employer in your local area, to be able to connect them. But, the biggest thing that we want to do right now is to connect to employers that get it. And that could be companies in the space.
I’ve had a couple of conversations with supplement and lab CEOs, and other companies that are in the space. They love what we’re talking about here today, and also what we’re gonna be talking about next week. They love the idea of giving functional medicine to their employees, because if any company’s gonna get behind, it’s gonna be someone in the ecosystem. But, just a challenge to everyone, just to take a few minutes after this podcast, and to make a list of all the people that you’ve treated in the last 10 years that you know are executives at companies who employee certain numbers of people. And I think if we can facilitate this now, by the time we come on tour June to November, we’re gonna open up functional medicine to thousands and thousands, if not millions and millions, of more people. And that is gonna be a transformative moment for our industry, and we’re just very, very excited to be in the middle of all of this.
So, Doug, thanks so much for being part of it. This has been Doug Short, the CEO of Benicomp. Next week, we will be talking about a really, really super-innovative product that Benicomp has created, where every employee can have access to functional medicine, to early diagnosis, to predictive, preventive, participatory medicine. But, until next week, I’m your host, James Maskell. This is the Functional Forum Podcast. Thanks so much for listening, and we’ll see you next time.
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