The Granite List Live

What Claims Data Misses and What It's Costing Self-Funded Plans

When a catastrophic claim hits, most plans are already behind and so are the brokers, TPAs, captives and stop-loss carriers supporting them. This week, Jim Carlson, VP, Head of Business Development, Self-Funded, and Wian Stipp, Lead Machine Learning Research Engineer, of Evidium join The Granite List.Live to discuss what it takes to close the gap between budgeted and actual healthcare spend, as well as why claims, clinical, and pharmacy data so often exist in silos. Oncology, rare disease and chronic condition progression are among the conditions driving the most financial exposure, and earlier visibility into those cases can change outcomes for the plan, the member and every stakeholder responsible for managing that risk. This conversation will dive into what proactive management of complex members looks like, why claims analysis only tells you what already happened, and what stakeholders gain when they can see what is coming before it hits.

The Unboring of Benefits

A great benefits offering not only provides members with the solutions and support they need to lead healthy, fulfilling lives, but it also must be easily accessible to members so that they can easily use them in a time of need. This week, Jill Freeman, benefits leader and author, joins Sally on The Granite List.Live to dive into the crucial role that effective benefits communication plays in member utilization and ultimately member wellness. After years of experience on the employer-side of benefits, Jill witnessed first-hand the disconnect between benefits offerings and utilization. Identifying effective benefits communication as the missing, critical piece to make benefits understandable and accessible, Jill outlines the need for a consumer-like experience in benefits. Order your copy of The Unboring of Benefits: A Blueprint for Real Life Benefits Communication: https://books.manuscripts.com/product/the-unboring-of-benefits-build-a-communication-blueprint/ Interested in taking part in a Benefits Communication boot camp? Connect with Jill on LinkedIn to learn more: https://www.linkedin.com/in/jill-freeman-b96b446/

Financial Wellness That Works

In this episode of The Granite List Live, David Stedman, CEO of BrightDime, joins host Sally Pace to explore the growing importance of financial wellness in today's workforce. As inflation, debt, and financial stress continue to impact employees across industries, employers are searching for solutions that create meaningful outcomes rather than simply checking a benefits box. David shares how BrightDime helps employees navigate financial challenges through personalized coaching, practical financial tools, and technology that enhances, rather than replaces, the human experience. With their high-touch approach, David outlines the measurable impact BrightDime can have on engagement, retention, and overall well-being.

Food is Medicine: GLP-1s + Monj for Lasting Lifestyle Change

GLP-1 therapies can help patients lose weight and improve health outcomes. But without positive and sustainable lifestyle changes, like proper nutrition, healthy cooking habits and movement, patients risk: Plateauing or regaining weight Poor adherence to GLP1's and early discontinuation Unsustainably high healthcare costs for self insured employers and beyond This week Sally is joined by Adam DeVito, Founder of Monj, and Maggie Biscarr as they explore how coupling GLP-1 therapy with Monj’s practical, hands-on approach delivers the missing link. Monj has helped many people take charge and measurably improve their metabolic health along with emotional and psychological wellbeing, through food.

Pets As The New Dependents

This week Aaron Oaks, CEO of United Pet Care, joins Sally on The Granite.List Live to discuss the shifting view and expectations around pets and their care. Pets are quickly becoming the new dependents in the workplace, yet most employee benefits still overlook this key part of modern families. As expectations shift and competition for talent intensifies, benefits leaders face growing pressure to support employees and their pets—all without adding administrative burden or complexity.

PBM Reform: Make Way for Transparency

This week, Steven T. Boyd, Liviniti's EVP Business Development, joins Sally as they dive into one of the most significant shifts in pharmacy benefit management in decades, the Consolidated Appropriations Act of 2026 (CAA 2026). With new requirements around rebate pass-through, PBM compensation, fiduciary accountability and reporting, CAA 2026 is causing opaque, decades-old PBM business practices to shift to the kind of transparency that the forward-thinking PBM, Liviniti, has long offered.

Building a Defensible Appeals Process

With the intensification of fiduciary scrutiny across the employee benefits landscape, self-funded employers are facing a new reality: the appeals process is no longer just an administrative function; it's a critical component of fiduciary responsibility. This week, Sally is joined by Jennifer McCormick, Vice President, Consulting, and Ron Peck, Chief Legal Officer, of The Phia Group as they dive into the evolving legal and compliance challenges facing self-funded health plans. In an increasingly complex regulatory environment, they provide employers, brokers, TPAs, and advisors with the insight needed to confidently prepare and navigate their plans.

The Simple Button for Federal Tax Compliance

Federal tax compliance in employee benefits is not optional; however, it does not have to be complicated. This week, host Sally Pace is joined by Sanju Sriram, CEO of Simple720, and Stuart Gibson, Tax Consultant, as they dive into one of the growing pain points in benefits administration - federal tax and reporting compliance. With PCORI fees (Form 720), ACA reporting, Form 5500 filings, and Department of Labor requirements placing a significant burden on HR teams, Sanju and Stuart outline how the Simple720 solution works to turn hours and days of work into just a few minutes.

The Hidden Barriers Impacting Women's Care

This week, Sally is joined by Kristen Nicholson, Chief Operating Officer of Comfort Imaging, as they dive into the barriers women face when trying to access a crucial aspect of care. Despite rapid advancements across healthcare, traditional mammography has remained stagnant for over 25 years, causing women to delay care due to discomfort and fear. Kristen shares how Comfort Imaging is creating a better mammography experience for women with their innovative Koning Vera Breast CT Technology, designed to deliver faster, more accurate, and more comfortable screening. Combined with an individualized, guided patient experience, Kristen details how Comfort Imaging removes traditional barriers to care, motivating women to engage in crucial preventative care earlier and more consistently.

Together Health: Rethinking Primary Care

On this week's episode of The Granite List.Live, Sally is joined by Huy Tran, Founder and CEO of Together Health, and together they dive into the challenges of today's healthcare system as well as how to create a better path forward. Together Health explores what primary care should look like today—accessible, affordable, and built around real relationships. As a modern direct primary care model, Together Health delivers care in-person, in-office, and virtually, creating a more seamless experience for patients, clinicians, and employers alike.

The No Surprises Act in Practice: Strategies for Health Plans in a Shifting Landscape

The No Suprises Act (NSA) was designed to protect patients from unexpected and surprise medical bills. However, for health plans, it’s created a complex and evolving landscape of disputes, compliance requirements and rising costs. On this week's episode of The Granite List.Live, Sally is joined by Christine Cooper and Jack Towarnicky as they break down what has changed, what’s still unclear, and how plan sponsors can take a more strategic approach to managing Independent Dispute Resolution (IDR), provider negotiations and overall plan spend. From regulatory updates to real-world insights, Cooper and Towarnicky offer practical guidance for navigating the NSA with confidence.

Smarter Members, Smarter Utilization

Emergency room visits are one of the most misunderstood and expensive drivers of employer healthcare spend. In this week's episode of The Granite List.Live, Sally is joined by Al Lewis, Founder and Quizmeister-in-Chief of Quizzify and longtime health policy veteran, to uncover how smarter member education leads directly to smarter utilization. Al breaks down why ER visits now account for roughly 6% of employer health spend, when in reality they should be closer to 3%, and how employers can close that gap through better literacy, consent awareness, and validation.

Bending Pharmacy Spend

On this week’s episode of The Granite List. Live, Sally is joined by Anthony Hartley, Co-Founder and CEO of Patient Advisor LLC, as they dive into the hidden driver of pharmacy spend. Patients with autoimmune conditions and other chronic conditions take prescriptions that manage/mask symptoms without leading to remission or reversal of disease. This group of individuals may equal as much as 50% of pharmacy spend for an employer. Anthony details how cell therapies can help patients get better health outcomes at a lower cost to plan sponsors, raising the question of why such innovation has not been widespread yet.

Introducing Spectra: Pharmacist-Led Clinical Oversight

In this week's episode of The Granite List. Live, Sally is joined by Ryan Rice and Jake Goll of Prism Health Group as they dive into Prism's new clinical performance engine, Spectra. Designed to enhance pharmacy benefits management, Spectra leverages pharmacist-led analysis and retrospective oversight to improve patient outcomes and cost savings.

Leading Innovation in Musculoskeletal Care

This week, Jessica Landin, CEO of Vori Health, joins The Granite List.Live to share Vori Health's innovative approach to musculoskeletal (MSK) care. With a physician-led, hybrid-care model, Vori Health provides patients with effective, conservative care pathways for MSK conditions.

Dollars and Sense: How Paid Leave Boosts Your Bottom Line

Paid leave isn't just a benefit—it's a strategic investment in your most valuable asset: your people. On this week's episode of The Granite List.Live, Sally is joined by Grace Erickson, VP of Revenue for Cocoon. Together, they dive into why comprehensive leave policies are the secret weapon of forward-thinking companies and how supporting employees through life's pivotal moments is your competitive advantage. Spoiler alert: When you show up for your team, they show up for your business.

GLP-1s for Employers: Navigating What’s Next

This week on The Granite List.Live, Sally is joined by Jessica Lea, PharmD and CEO of Tria Health, as they dive into the fast-changing landscape of GLP-1 medications for obesity and diabetes. Jessica shares her insight on why pharmacist-led oversight is important, especially with complex and costly drugs like Ozempic and Wegovy. Additionally, together, Sally and Jessica explore: Challenges employers face when deciding whether to cover these medications The impact of direct-to-consumer options The importance of combining medication with lifestyle changes for lasting results Future developments in GLP-1 treatments and their potential uses. Learn more about Tria Health on The Granite List!

The Price Isn't Right?

This week, Ron Peck, Chief Legal Officer for The Phia Group joins Leigh on The Granite List.Live. The Phia Group is a health care and benefits cost containment expert, servicing employers and insurance carriers - as well as those that service them. Listen as Ron dissects societal trends resulting in mass confusion, dependence upon networks, and systemic issues that all combine to result in skyrocketing costs - as well as inadequate (and potentially damaging) legislative remedies.

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Shifting Healthcare: Work Right NW's Total Worker Approach

This week, Justin Zimmerman, Sales and Business Development, Work Right NW, joins the Granite List.Live to share his insight on Work Right NW's total worker health approach. As a leader in industrial sports medicine, Work Right NW provides the industrial athlete with proactive care to reduce injuries, improve employee health, and foster a culture of safety. Beyond sharing what differentiates the Work Right NW approach, Justin also equips employers with the five things they should have top of mind when evaluating and vetting different injury prevention solutions!

On-Demand Benefits Access

As 2025 comes to a close, Alycia Riedl, Immediate Past President of NABIP, joins Sally to discuss the biggest trends in employee engagement, the importance of access for employer-sponsored health plans, and solutions to the fragmentation in healthcare.