Broken Benefits

Hosted by Lee Lewis

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Oct 2026

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About the show

Whether you are the benefits manager or CEO of your organization, one of the biggest drivers of organizational performance, that most get totally wrong, is the health and benefits strategy. We spend billions on benefits, yet healthcare is unaffordable and complicated. More than half of Americans don't even take their paid vacation, yet people are burning out faster than ever and remote work is scrambling company cultures. It doesn't have to be this way! Great benefits can attract and retain top talent, communicate your values, rejuvenate your productivity, move your stock price, and even save lives. Lee knows this because he advised and learned from many Fortune 100 employers on how to create wildly profitable and popular benefits programs that enhance all areas of the business. Lee created this podcast in the hopes that together we can save lives, save dollars, and save our talent. Join us, each episode, on YouTube or your favorite podcasting platform for some great conversation with some of the world's leading experts in this space.

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41 recent

October 27, 202653 min

The Cost of Not Asking Questions: Rethinking Employer Healthcare (Feat: Lori Guliano)

What if one of the biggest obstacles to better employee benefits isn't the cost of healthcare, but the questions employers aren't asking? For years, Lori Giuliano approached benefits management much like countless other leaders. Healthcare costs increased, medical trend dictated the budget, and the available options seemed limited to shifting more costs onto employees or reducing benefits. But what happens when you begin questioning the assumptions behind that approach? In this episode of Broken Benefits , Lee Lewis sits down with Lori Giuliano, a benefits leader at a major pharmaceutical manufacturer, to explore her transformation from following the traditional healthcare playbook to actively challenging the system and pursuing a different strategy. Lori shares how learning from other employers, examining vendor relationships and understanding the financial incentives embedded in healthcare helped reshape her perspective on what was possible. The conversation explores the importance of questioning consultant compensation, evaluating traditional versus transparent PBM models, understanding fiduciary responsibility and taking a more active role in managing healthcare spending. Lori also discusses several initiatives she's championing, including advanced primary care, improved access to menopause care, and a secondary health plan designed to create value for employees and employers alike. Throughout the conversation, one idea stands out: better benefits and lower healthcare costs don't have to be competing objectives. From building confidence to challenge established partners to gaining leadership support for new approaches, Lori offers a relatable perspective for benefits professionals who suspect there may be a better way but aren't sure where to begin. Because sometimes meaningful change doesn't start with a new vendor, a new benefit or a bigger budget. It starts with asking a better question. Chapters: 00:00 The Cost of Accepting Healthcare Trend 00:36 Welcome to Broken Benefits 01:00 Meet Lori Giuliano: Rethinking Traditional Benefits 03:00 From Passenger to Driver of Healthcare Strategy 05:00 Why Benefits Leadership Is Personal 09:00 Better Benefits and Lower Costs: Why Not Both? 11:00 Discovering the Hidden Side of Healthcare 14:00 Learning From Employers Who Challenge the System 17:00 Building Support for a Different Approach 18:00 Traditional vs. Transparent PBM Models 21:00 Questioning the Role of Benefits Consultants 24:00 Hidden Compensation and Fiduciary Responsibility 28:00 How Lori Accelerated Her Healthcare Education 33:00 The Business Case for Advanced Primary Care 36:00 Making Better Healthcare More Accessible 41:00 Addressing the Gaps in Menopause Care 45:00 Secondary Health Plans: A Win-Win Strategy 50:00 Why Independent TPAs May Be the Future 52:00 Final Advice and Closing Thoughts

October 5, 20261 hr 1 min

The Benefits Innovation Paradox: Change is Risky. Standing Still is Worse. (Feat: Eric Foster)

Healthcare costs keep rising. Employers know they need to do something different. But doing something different comes with risk. That tension sits at the center of Lee Lewis' conversation with Eric Foster, a benefits leader and consultant who has spent more than two decades in the industry and previously led benefits at Lowe's and Albertsons. In those roles, Eric helped manage health plans covering roughly 150,000 to 200,000 lives and hundreds of millions of dollars in healthcare spending. In this episode of Broken Benefits , Eric explains why healthcare is ultimately an opportunity-cost problem for employers. Every additional dollar consumed by healthcare is a dollar that can't be invested somewhere else in the business. Yet simply repeating the same strategy isn't an option either. Eric and Lee explore what it takes to create a culture where benefits teams can experiment, test new ideas and learn without allowing the fear of failure to become an excuse for standing still. Eric shares lessons from running multiple pilots, testing competing solutions and using real-world experience to make better decisions about what deserves to scale. The conversation also goes beyond healthcare cost. Eric makes the case that benefits teams should borrow capabilities from their own marketing organizations, listen more carefully to employees, turn successful programs into stories people actually understand and even equip recruiters to use benefits as a competitive advantage in the fight for talent. They also discuss the value of building a strong network of other benefits leaders, learning from failed experiments, holding vendors to higher standards and recognizing that communication and engagement may represent far more of a benefits leader's job than most organizations realize. Because innovation carries risk. But when the existing trajectory isn't sustainable, standing still may be the greater risk. Chapters: 00:00 Healthcare Is an Opportunity-Cost Problem 00:58 Welcome to Broken Benefits 02:11 Eric Foster's Benefits Leadership Journey 03:33 Managing Healthcare at Massive Scale 07:57 Where Should Benefits Leaders Focus? 11:20 Benefits as a Workforce Strategy 14:00 Innovating Inside Organizational Constraints 18:00 The Benefits Innovation Paradox 19:35 "More Pilots Than American Airlines" 21:00 Testing, Learning and Scaling What Works 23:00 Why Benefits Teams Need Marketing 27:00 Turning Benefits Into a Recruiting Advantage 33:00 The Rising Expectations and Cost of Healthcare 39:00 What Benefits Leaders Can Learn From Recruiters 45:00 Learning From Other Employers' Experiments 51:00 Holding Vendors Accountable 54:00 Why Communication Is 70% of the Job 60:00 Over-Communicate, Learn and Know When to Move On

September 3, 202653 min

The Hidden Levers of Provider Quality, Fiduciary Risk, and Cost Control (Feat: Adam Stavisky)

Adam Stavisky spent years running benefits for the largest private workforce in the country, overseeing the largest private health plan in the world along with a massive 401(k) and leave of absence program. In this episode, Lee sits down with Adam to unpack how a culture built on innovation and razor thin margins forced his team to find creative ways to cut costs without shifting the burden onto employees. Adam walks through the leadership lessons that shaped his approach: how consulting taught him to distill complex problems into a single page, why he insisted his team push back on his own ideas, and the moment a signature program he championed had to be pulled back in front of Walmart's CEO. He shares the exact language leadership used that turned a failure into one of his most defining career moments. From there, the conversation moves into practical strategy. Adam breaks down why provider quality, not plan design, is the biggest lever employers have for improving outcomes and controlling costs, using a striking statistic about C-section rates to make the case. He also flags the fiduciary risks most employers are sitting on right now, including voluntary benefits litigation, payment integrity gaps, and the importance of simply documenting the work you're already doing. If you manage benefits at any size organization, or if you're trying to understand why healthcare costs keep climbing despite everyone agreeing the system is broken, this episode is packed with tactical guidance you can apply immediately. Chapters: 0:00 Cold Open: "You Had to Take Cost Out of the System" 0:50 Welcome to Broken Benefits 1:05 Meet Adam Stavisky: From Top Consultant to Walmart's Head of Benefits 1:42 From Consulting Decks to "Kitchen English" 2:56 The Real Shock of Moving In-House: Relationship Building 5:06 How Adam Protected His Calendar to Protect His Team 5:54 Sponsor Break: Catalyze Health 6:42 Empowering a Benefits Team to Push Back and Take Bold Action 8:39 The Most Underrated Leadership Skill: Prioritization 10:54 Inside Walmart's Culture of Innovation and Cost Discipline 14:20 When Leadership Says "Find $100 Million," Where Do You Start? 16:22 What Most C-Suites Get Wrong About Managing Healthcare 22:15 The Signature Program That Failed: A Lesson in "Limiting Blast Radius" 24:28 Why Every Executive Recommendation Should Include the Best Counterargument 26:36 "Don't Delegate Up": Building a Team That Owns Decisions 28:48 Ownership Mentality and the Hardest Job of a Leader 31:44 Opportunity #1: Provider Quality Is the Biggest Lever in Healthcare Costs 36:03 Why Provider Directories Are a Hidden Cost-Control Tool 39:33 Risk #1: Fiduciary Due Diligence Employers Can't Ignore 40:26 Voluntary Benefits, Commission Structures, and the Schlichter Bogard Lawsuits 41:57 Payment Integrity: Detection Isn't Enough, You Need Resolution 44:37 Sponsor Break: Catalyze Health 47:12 Engaging a Workforce as Diverse as a Small Country 51:39 What Gives Adam Optimism About the Future of Benefits 52:48 Where to Find Adam Stavisky 53:09 Outro: Subscribe and Share

August 11, 202655 min

Stop Paying. Start Leading: Taking Control of Healthcare Strategy (Feat: Paul Dumas)

What happens when a benefits leader stops accepting rising healthcare costs as inevitable? For Paul Dumas, the answer was simple: start taking control. A longtime CHRO, Paul had spent decades approaching benefits much like many other employers do. Watch the trend. Build the budget. Work with the broker. Try to come in below the projected increase. That changed when his organization saw a 19.5% healthcare trend and was suddenly $15 million over budget after a single month , driven in large part by the rapid growth of GLP-1 utilization. That moment forced Paul to look much deeper into the healthcare ecosystem and question assumptions that had gone largely unchallenged. In this episode of Broken Benefits , Paul walks Lee Lewis through what he discovered, including misaligned incentives among brokers, PBMs and carriers, the difference between a discount and a genuinely good price, the problem with treating healthcare as a fixed expense, and why employers need greater independence and transparency throughout their benefits ecosystem. The conversation also explores Paul's approach to rebuilding the strategy from the ground up, including transparent broker compensation, a transparent PBM, an independent TPA, reference-based pricing, care navigation and a stronger emphasis on primary care. And the results were significant. Paul shares how his organization identified $8.5 million in hard savings in year one and approximately $24 million in year two , allowing the organization to reinvest those savings into total rewards, mental health and other areas that directly benefit employees. This isn't a conversation about simply cutting benefits. It's about asking a more important question: What if employers could spend less on healthcare while actually making the benefits experience better? That's the conversation. Chapters: 0:00 Introduction: Why Healthcare Can't Stay a Fixed Cost 1:37 Paul's Journey Into Healthcare Strategy 4:09 The $15 Million Healthcare Wake-Up Call 6:18 Misaligned Incentives: Brokers, PBMs & Rebates 10:33 Why Employers Need to Take Back Control 16:25 The Problem With "Discounted" Healthcare 20:55 Rebuilding the Healthcare Ecosystem 25:20 What Happens When You Eliminate Rebates? 26:36 Primary Care, Navigation & Better Outcomes 28:48 $8.5 Million in Year-One Savings 29:09 $24 Million in Year-Two Savings 30:49 Reinvesting Healthcare Savings Into Employees 36:28 How Benefits Leaders Can Drive Change 42:47 The Playbook: Where Employers Should Start 48:11 Reference-Based Pricing & Regaining Control 54:08 Final Thoughts With Paul Dumas

July 14, 202654 min

The Business Case for Better Benefits (Feat: Scott Kirschner)

For years, employee benefits have been viewed as an unavoidable expense. Scott Kirschner believes that's the wrong way to look at them. In this episode of Broken Benefits , Lee Lewis sits down with one of the industry's most respected benefits leaders to explore how thoughtful benefits strategy can become a catalyst for business growth, employee engagement, and long-term organizational success. Rather than focusing solely on controlling healthcare costs, Scott explains why the most successful organizations approach benefits as a strategic investment. From building credibility with executive leadership to aligning benefits with broader business objectives, he shares the lessons learned throughout a career spent proving that better healthcare decisions can deliver measurable business value. The conversation explores why benefits leaders should think like business executives, how data and financial discipline influence decision-making, and why innovation often begins with asking better questions. Whether you're a benefits professional, HR executive, CFO, or business leader, this episode offers practical insights into transforming benefits from a cost center into a competitive advantage. Chapters: 0:00 Introduction 1:41 Why Better Benefits Are a Business Strategy 5:12 The Biggest Mistake Employers Continue to Make 10:03 Benefits Are About More Than Healthcare 15:18 Creating Value Employees Actually Notice 20:44 Why Cost Cutting Alone Doesn't Work 26:07 Building a Benefits Strategy Around People 31:54 The Data Employers Should Be Paying Attention To 37:46 Measuring Success Beyond Claims Costs 43:38 How Leadership Shapes Employee Experience 49:57 The Future of Employer-Sponsored Benefits 55:46 Final Advice for Benefits Leaders

June 17, 202650 min

Beyond Borders: What Global Healthcare Can Teach Employers (Feat: Dr. Lowell Fernander)

What happens when a practicing physician steps into the world of employee benefits? In this episode of Broken Benefits , Lee Lewis sits down with Dr. Lowell Fernander, a physician-turned-benefits executive whose career has taken him from healthcare systems in the United Kingdom and Europe to helping lead healthcare strategy for one of America's largest employers. Drawing on his unique experience in clinical medicine, health informatics, provider strategy, and benefits leadership, Dr. Fernander offers a rare perspective on the challenges facing healthcare today. From the philosophical differences between healthcare systems around the world to the realities of employer-sponsored healthcare in the United States, this conversation explores what employers can learn from global approaches to care delivery. Along the way, Dr. Fernander shares why benefits leaders have an enormous responsibility in shaping healthcare outcomes, how data can uncover opportunities for better care, and why collaboration across the healthcare ecosystem is essential if we hope to improve outcomes while controlling costs. If you're an employer, benefits professional, healthcare leader, or simply interested in the future of healthcare, this is a conversation you won't want to miss. Chapters: 0:00 Every Healthcare System Has Problems 0:28 Welcome to Broken Benefits 1:25 How a Physician Ended Up Leading Benefits Strategy 4:28 What America Can Learn from European Healthcare 8:02 Is Healthcare a Right or a Privilege? 10:42 Why the U.S. Healthcare Debate Misses the Point 13:00 The Real Problem: Access to Care 17:03 Healthcare Deserts and the Hidden Cost of Poor Access 21:03 Employers Shape Healthcare More Than They Realize 25:03 Why Data Is the Foundation of Better Benefits 29:00 Looking Beyond Cost Savings 33:00 The Employee Engagement Problem 37:00 Building Better Healthcare Experiences 40:00 The Impact of Social Determinants of Health 44:00 Why Healthcare Is an Ecosystem Challenge 48:02 Where Employer Healthcare Goes Next 50:06 Closing Thoughts

June 2, 202657 min

From Accounting to Innovation: A Different Mindset for Better Benefits (Feat: Brian Duclos)

What happens when you put an auditor in charge of employee benefits? You stop accepting assumptions. In this episode of Broken Benefits , Brian Duclos shares how a non-traditional background in accounting and internal audit shaped his approach to benefits strategy—and ultimately led him to challenge many of the industry's long-standing norms. Rather than accepting annual cost increases as inevitable, Brian applies financial discipline, operational rigor, and data-driven decision-making to one of the largest expense categories organizations face. The result has been a series of innovative plan design strategies, stronger vendor accountability, and a fundamentally different way of thinking about benefits management. This conversation explores the importance of data ownership, performance guarantees, vendor oversight, and why benefits leaders should start thinking more like business operators. If you're responsible for managing healthcare costs, improving employee outcomes, or driving value from your benefits program, this episode offers a practical blueprint for doing things differently. Chapters: 00:00 The Audit That Changed Everything 00:26 Introduction to Brian Duclos 01:16 From Accounting to Benefits Leadership 04:16 Why Brian Left Internal Audit to Fix Benefits 08:09 The Advantage of a Non-Traditional Background 11:05 Challenging Industry Assumptions 14:09 A Case Study in Benefits Innovation 18:13 Why Operational Excellence Matters 20:34 Building Innovative Benefits Strategies 21:53 Start with the Data 24:01 Turning Insights into Action 25:36 Getting Team Buy-In for Change 29:13 Psychological Safety and Innovation 30:12 How to Sell New Ideas to Leadership 33:00 Building the Executive Business Case 34:56 Vendor Accountability and Performance Guarantees 38:00 Finding Hidden Costs in Your Health Plan 39:53 Following the Data to Better Outcomes 43:10 Eliminating Misaligned Incentives in Healthcare 45:12 Contracting, Transparency, and Employer Leverage 47:42 Choosing the Right Advisors and Partners 49:36 What Industry Conferences Actually Teach You 51:33 The Traits of Successful Benefits Leaders 53:15 Brian's Framework for Driving Change 55:10 Final Advice for Benefits Professionals 56:49 Closing Thoughts

May 5, 202649 min

No More Excuses: A Hard Look at Healthcare Reform (Feat: Chris Deacon)

In this episode of Broken Benefits , we’re joined by Chris Deacon , a leading voice in healthcare reform known for her direct, no-nonsense approach to fixing a system that too often fails the very people it’s meant to serve. With experience spanning both the public and private sectors—including leading one of the largest public health plans in the country—Chris brings a level of insight that few can match. Her work has consistently centered on one thing: demanding transparency, accountability, and real outcomes in healthcare. This conversation takes a hard look at the current state of the system, the structural issues that continue to drive inefficiency, and the opportunity employers have to take a more active role in shaping better solutions. If you’re tired of excuses and ready to think differently about healthcare and benefits, this is a conversation you won’t want to miss. Chapters: 0:00 - Introduction 1:45 - Change is accelerating 5:58 - Tactical approaches in 2026 14:06 - How do we push back? 20:18 - Examining high-cost claims 26:02 - Fiduciary obligation to shareholders 37:53 - Cleaning up messes vs. new things 44:13 - What can I do right now? 48:10 - Connect with Chris online

April 8, 202654 min

Beyond the Status Quo: Unlocking Opportunity in Benefits & Healthcare (Feat: Milt Ezzard)

In this episode of Broken Benefits , we sit down with Milt Ezzard , a Global Benefits and Mobility Leader, to explore the untapped opportunity that exists within today’s benefits and healthcare landscape. Too often, organizations operate within the confines of legacy systems and outdated thinking. But as Milt shares, those willing to challenge the status quo have a real chance to unlock better outcomes—for their people and their business. From global strategy to forward-thinking program design, this conversation dives into what it takes to move beyond maintenance mode and start building benefits strategies that truly create value. If you’re a leader looking to rethink your approach and capitalize on the opportunity in front of you, this is a conversation you won’t want to miss. Chapters: 0:00 - Introduction 1:47 - Being hesitant to try something new 8:25 - Best practices for Milt 16:20 - Getting back your control 30:13 - Holding vendors accountable 40:30 - Approaching AI products 46:32 - Building benefits that are loved 51:21 - Leveraging Glassdoor 53:26 - Closing remarks

March 18, 202655 min

Breaking the Trend: How Innovation Kept Healthcare Costs Flat for Decades (Feat: Todd Bisping)

In this episode of Broken Benefits , Lee Lewis sits down with Todd Bisping, Benefits Industry Innovator , to explore one of the most remarkable stories in employer healthcare strategy. For nearly two decades, Todd helped lead a benefits approach that achieved something most employers consider impossible: keeping healthcare cost trend flat while continuing to deliver meaningful value to employees. Rather than accepting the steady rise of healthcare costs as inevitable, Todd and his team took a different path — experimenting with new ideas, challenging industry assumptions, and focusing relentlessly on strategies that produced measurable results. In this conversation, Todd reflects on the lessons learned from years of leading benefits innovation, what it takes to implement change inside large organizations, and why employers have far more influence over healthcare outcomes than they often realize. If you’re a CHRO, benefits leader, or HR executive looking for real-world examples of what disciplined, long-term benefits strategy can accomplish, this episode offers both inspiration and practical insight. Chapters: 0:00 - Introduction 1:27 - The best part about running benefits plans 8:59 - The misconception of innovating 19:14 - Leveraging case studies 32:32 - Irrelevant strategies employers need to stop 43:40 - Guiding your priorities 50:50 - The value of pilot programs 54:30 - Closing remarks

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