Firm & Final

Hosted by BCS Financial

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Latest episode

Sep 2026

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EN-US

About the show

Firm & Final: The Legends of Stop Loss and Reinsurance is an award-winning stop loss industry podcast from BCS Financial Head of Large Claim Solutions Mehb Khoja. With a new focus each season, Mehb brings together members of the stop loss, reinsurance, and self-funded industries to discuss current and future stop loss issues and trends, and share legendary experience and advice for the next generation of stop loss and reinsurance superheroes. BCS Financial: bcsf.com

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42 recent

September 10, 2026Episode 744 min

LIVE from RiskNavigator 2026 | Pat Gleason, Jim Clement, Ramesh Jayasuriya, Ashley Hume

It's our biggest event of the year, and you're invited! After four seasons of Firm & Final, we invited guests from some of our favorite episodes to join us on-stage at this year's RiskNavigator Conference in Chicago. And for the first time, we recorded the show live in front of a real studio audience. In this episode, we welcome back Pat Gleason from Prime Therapeutics, Jim Clement from Synergie, Ramesh Jayasuriya from Evio, and Ashley Hume from Emerging Therapy Solutions. And with this all-star cast, we tackle the rising cost of drugs, especially gene and cell therapies, discussing innovative solutions to make high-cost medications more affordable. We'll explore insights on system limitations, value-based contracts, AI applications, and strategies for managing the future of high-dollar therapies. And we'll even take questions from the audience. 🖥️ Play on BCS website – https://bcsf.com/firmandfinalpodcast/ 🎧 Listen on Spotify – https://spoti.fi/3U7rYuq 🍎 Listen on Apple Podcasts – https://apple.co/3Kvdlhg ☑️ Sign up to subscribe – https://bcsf.com/firmandfinalpodcast/ 🦸 Recommend a Legend – legends@bcsf.com

August 20, 2026Episode 624 min

Top Strategies for Cost Containment | Jennifer Warren, Mike Linquist, Katie Dudley

The stop loss industry is in a tricky position. Rising healthcare costs are driving loss ratios up, which is forcing stop loss carriers to raise their rates. In turn, higher rates make healthcare less affordable and less accessible, which is a lose-lose for everyone involved. So in this episode, we're focusing on key strategies to help keep costs low and rates affordable. Joining us are Jennifer Warren, Mike Linquist and Katie Dudley. They'll help us explore cost-saving measures like subrogation, site-of-care change, and claims auditing—strategies that can be leveraged by employers, brokers, and even other stop loss carriers to increase accessibility and affordability. 🖥️ Play on BCS website – https://bcsf.com/firmandfinalpodcast/ 🎧 Listen on Spotify – https://spoti.fi/3U7rYuq 🍎 Listen on Apple Podcasts – https://apple.co/3Kvdlhg ☑️ Sign up to subscribe – https://bcsf.com/firmandfinalpodcast/ 🦸 Recommend a Legend – legends@bcsf.com

August 6, 2026Episode 529 min

Managing Cancer Treatment Costs | Pete Scruggs from benefitSMART Cancer Solutions

"Buy healthcare better." That's the guiding philosophy at benefitSMART, an innovative cost-containment solution for the healthcare business that is making headway on one of the industry's biggest problems. The consumption of healthcare is primarily a passive experience for most customers. And, from the standpoint of healthcare as a commodity, it is sold more often than it's bought, leading to rising costs. So in this episode, we are joined by Pete Scruggs, the founder and CEO of benefitSMART Cancer Solutions. benefitSMART is a patient-first health solution founded in 2020 that works within self-funded health plans to lower cancer and specialty care costs through site-of-care optimization and patient advocacy. We'll discuss how their cost containment strategies are changing the way healthcare is bought and paid for, the importance of building trust with the patients you serve, and the evolving role of brokers and stop loss carriers in managing healthcare costs. 🖥️ Play on BCS website – https://bcsf.com/firmandfinalpodcast/ 🎧 Listen on Spotify – https://spoti.fi/3U7rYuq 🍎 Listen on Apple Podcasts – https://apple.co/3Kvdlhg ☑️ Sign up to subscribe – https://bcsf.com/firmandfinalpodcast/ 🦸 Recommend a Legend – legends@bcsf.com

July 16, 2026Episode 433 min

High Drug Costs: Innovation, Access, & Affordability | Pat Gleason, Ramesh Jayasuriya, Jim Clement

Pharmaceutical costs are one of the key factors driving increased health care expenditures in the U.S. Which is pretty stunning when you consider that most Americans don’t have any idea how those drugs are priced, or even how they get to market. So in this episode, we’re exploring the complexities of high-cost drugs, including gene therapies and specialty medications, with some of the top experts from the Blue Cross Blue Shield family of companies. Joining us are Pat Gleason from Prime Therapeutics, Ramesh Jayasuriya from Evio, and Jim Clement from Synergie. Together, we’ll have a very frank conversation where we try to define what constitutes a specialty medication, explain how value-based contracting and warranties work, and explore what the future may hold for pricing in the pharmaceutical industry. And, each panelist will offer up what they see as some potential solutions to help improve drug affordability and access in the U.S. healthcare system. 🖥️ Play on BCS website – https://bcsf.com/firmandfinalpodcast/ 🎧 Listen on Spotify – https://spoti.fi/3U7rYuq 🍎 Listen on Apple Podcasts – https://apple.co/3Kvdlhg ☑️ Sign up to subscribe – https://bcsf.com/firmandfinalpodcast/ 🦸 Recommend a Legend – legends@bcsf.com

June 25, 2026Episode 331 min

Hardening Stop Loss Market | Jeremy Freestone, Ryan Siemers, Steve Gransbury

Even veterans of the stop loss industry are scratching their heads these days, wondering if this is the hardest market with which we’ve ever had to contend. With loss ratios peaking at 91% last year and widespread underperformance across all segments, insurers are struggling to keep pace with the accelerating trajectory of high-severity claims. But big premium adjustments risk alienating customers. So in this episode, we’re discussing these trends with three veterans of the stop loss industry, and exploring opportunities to stabilize and sustain the stop loss marketplace moving forward. Joining us are Jeremy Freestone from Symetra, Ryan Siemers from Aegis Risk LLC, and Steve Gransbury from Captive Resources, LLC. With their insights, we’ll explain the current market’s repercussions for the growth of self-insurance, the increasing impact of new technology on the underwriting process, and four potential solutions to button up margins as we head into the next year. 🖥️ Play on BCS website – https://bcsf.com/firmandfinalpodcast/ 🎧 Listen on Spotify – https://spoti.fi/3U7rYuq 🍎 Listen on Apple Podcasts – https://apple.co/3Kvdlhg ☑️ Sign up to subscribe – https://bcsf.com/firmandfinalpodcast/ 🦸 Recommend a Legend – legends@bcsf.com

May 28, 2026Episode 222 min

Stop Loss Sales Under Pressure | Ed Wadhams, Tom Costello, Pete Laio

The dynamics between selling stop loss policies and underwriting stop loss policies have always created a strange dichotomy in the stop loss industry. But the latest NAIC data show loss ratios in stop loss climbing to an astounding 91%. And, in an environment where both of the severity and frequency of claims are on the rise, this added pressure is being felt by everyone. So in this episode, we’re speaking with sales leaders from throughout the industry about the implications of these loss ratios, how sales strategies are evolving to meet the new market realities, and the impact of continued broker consolidation. Joining us are Tom Costello from Symetra, Ed Wadhams from QBE, and Pete Laio from BCS. Together, we’ll discuss trends in self-funding, captive programs, and the move away from fully insured models, as well as new approaches to balancing profitability and growth in a high-loss environment. And all our guests will make sure to share their predictions for how these dynamics will impact us in the year ahead. 🖥️ Play on BCS website – https://bcsf.com/firmandfinalpodcast/ 🎧 Listen on Spotify – https://spoti.fi/3U7rYuq 🍎 Listen on Apple Podcasts – https://apple.co/3Kvdlhg ☑️ Sign up to subscribe – https://bcsf.com/firmandfinalpodcast/ 🦸 Recommend a Legend – legends@bcsf.com

April 23, 2026Episode 129 min

Stop Loss and Supplemental Benefits | Drew Neslin & Liz Midtlien

While the world of stop loss often focuses on mitigating catastrophic employer risk, supplemental health products are designed to protect the working families at the heart of those plans. In this episode of Firm & Final, we explore these "two sides of the same coin," examining how these two distinct product lines manage different layers of risk in an increasingly expensive healthcare landscape. We’re joined by two of our BCS Financial colleagues: Liz Midtlien, Head of Large Claims Solutions; and Drew Neslin, Head of Supplemental Health Solutions. Together, we break down the similarities and differences between these markets and how they can work in tandem to support both employers and employees. Tapping into the depth of their individual experiences, Liz and Drew define some of the features that make supplemental insurance unique, explore the contrasting market challenges that the two industries face, and chart the potential for "claims integration," where medical data is used to automatically trigger supplemental benefit payments. Finally, our guests offer their predictions for the coming year, from industry consolidation and market exits to the "doubling down" on technology and transparency to better serve the needs of the modern workforce. 🖥️ Play on BCS website – https://bcsf.com/firmandfinalpodcast/ 🎧 Listen on Spotify – https://spoti.fi/3U7rYuq 🍎 Listen on Apple Podcasts – https://apple.co/3Kvdlhg ☑️ Sign up to subscribe – https://bcsf.com/firmandfinalpodcast/ 🦸 Recommend a Legend – legends@bcsf.com

August 28, 2025Episode 635 min

Capital Markets Vs. Insurance Markets | Theresa Galizia, Tara Krauss, Alexis Neu

It feels like there's a growing disconnect between established players in the stop loss industry and the new entrants who crop up annually. Long-term industry experts point to warning signs that the market may be hardening. Yet every year, new players enter the market, attracted by the undeniable year-over-year growth. So what are they seeing on both sides of this equation that creates this disconnect between the insurance markets and the capital markets? And where are we all going to end up? In this episode, we bring in three pros to sort it all out: Theresa Galizia from Berkley Accident and Health, Tara Krauss from QBE North America, and Alexis Neu from Guy Carpenter. Additionally, they'll discuss why it's so rare to see an all-female panel in our industry, and what can be done about that. And then, why one panelist predicts the stop loss industry will eclipse $50 billion next year! 🖥️ Play on BCS website – https://bcsf.com/firmandfinalpodcast/ 🎧 Listen on Spotify – https://spoti.fi/3U7rYuq 🍎 Listen on Apple Podcasts – https://apple.co/3Kvdlhg ☑️ Sign up to subscribe – https://bcsf.com/firmandfinalpodcast/ 🦸 Recommend a Legend – legends@bcsf.com

July 24, 2025Episode 527 min

How Big Consulting Firms Influence Stop Loss & Reinsurance | Laurie Horan LeBlanc, Andrew Peel, Carol Adams

You can't fully understand the stop loss and reinsurance industry without considering the impact that its myriad consultants have on both insurers and underwriters. These consultants bring decades of experience to bear on behalf of their clients, and offer up a unique perspective on what's happening behind the scenes in our business. So in this episode of Firm & Final, we'll introduce you to three of the industry's foremost experts from the consulting side—Laurie Horan LeBlanc from Marsh McLennan, Andrew Peel from Mercer, and Carol Adams from Guy Carpenter. We'll discuss the current market dynamics, the challenges faced by stop loss carriers, and the appeal of the market to new entrants. As consultants in the industry, Laurie, Andrew and Carol will also share how they evaluate new providers and make recommendations to their clients, claims management issues, and the growing role of captives in the market. Finally, each participant in the conversation will offer advice for clients as they prepare for the 2026 renewals season. 🖥️ Play on BCS website – https://bcsf.com/firmandfinalpodcast/ 🎧 Listen on Spotify – https://spoti.fi/3U7rYuq 🍎 Listen on Apple Podcasts – https://apple.co/3Kvdlhg ☑️ Sign up to subscribe – https://bcsf.com/firmandfinalpodcast/ 🦸 Recommend a Legend – legends@bcsf.com

June 26, 2025Episode 433 min

Meeting the Needs of the Reinsurance Market | Bob Black, Raj Gulati, Tanya Arrowsmith

It’s summer time—normally the calm before the storm for the stop loss and reinsurance industries. But many experts will tell you the industry feels more “unsettled” than usual. It’s a time of churn, as some carriers exit but other new players enter. Some stop loss carriers are struggling to find margin, while some brokers feel like they’re in a strong position. So in this episode, we want to chart a path for meeting the needs of the stop loss and reinsurance industries amid this market uncertainty. We’re talking to three experts from the front lines: Tanya Arrowsmith from Crum & Forster, Bob Black from Aon Benfield, and Raj Gulati from Risk Strategies Company. They’ll explore the dynamics of capacity and profitability, the impact of market cycles, the influx of new entrants, and the ongoing trends of consolidation within the industry. 🖥️ Play on BCS website – https://bcsf.com/firmandfinalpodcast/ 🎧 Listen on Spotify – https://spoti.fi/3U7rYuq 🍎 Listen on Apple Podcasts – https://apple.co/3Kvdlhg ☑️ Sign up to subscribe – https://bcsf.com/firmandfinalpodcast/ 🦸 Recommend a Legend – legends@bcsf.com