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The ShiftShapers Podcast
Ep #472: Enhancing Benefits Experience and Tackling Premium Leakage: Revolutionizing Data Management with AI - with Shannon Goggin
Do you often find yourself wrestling with the myriad of challenges in benefits administration? Tune into our fascinating conversation with Shannon Goggin, co-founder and CEO of Noyo, as we traverse the landscape of benefits experience enhancement for customers. Shannon shares the inception story of Noyo, a visionary company that simplifies data exchange across divergent systems and how their mission is to enable secure data sharing with the goal of delivering the right information to the right people, at the opportune time.
Ever felt exasperated by the industry's stumbling blocks such as the absence of universally accepted standards or the herculean task of processing an ocean of information? We've got you covered! We dive into the heart of these issues and discuss how Noyo provides comprehensive solutions for companies longing to integrate a seamless benefits experience into their software. We also unravel the knotty issue of premium leakage and delve into the transformative potential of technology, particularly AI, in boosting operational efficiency and reducing the burden on employers. Catch the wave and join us in exploring the monumental influence of AI in managing data and the urgent requirement for speedy carrier set-up and how Noyo's pioneering technology simplifies this process.
Especially this new generation of folks, of buyers, want a frictionless, customizable experience. How do we get them that experience and what's needed to deliver it? We'll find out on this episode of Shift Shapers.
Host:This is the Shift Shapers podcast, Connecting benefits advisors with thought leaders and entrepreneurs who are shaping the shifts in the industry. And now here's your host, David Saltzman.
David Saltzman:To help us answer that question, we've invited Shannon Goggin. Shannon, I'm a professional, don't try this at home. Shannon is co-founder and CEO at Noyo. Shannon, welcome to the program.
Shannon Goggin:Thank you for having me, David.
David Saltzman:So talk a little bit about your journey, because nobody's sitting in sixth grade algebra. Going boy, I really want to work in this industry, so how'd you get here?
Shannon Goggin:I love asking people how they got into benefits because it is usually through a series of happy accidents.
Shannon Goggin:My journey to benefits was.
Shannon Goggin:I started my career in a totally different industry and in management consulting.
Shannon Goggin:I was working for all sorts of different companies, but I really wanted to go and start working at a startup.
Shannon Goggin:I wanted to be part of a company that was building something new in consulting often advising companies or doing analysis for executives at companies to help them think about what the future might look like and how their company should respond and I really wanted to be part of bringing something new to life. And so I moved from New York to San Francisco and I started interviewing at different startups early stage 50 to 200 person companies and I just happened to get a job at a company called Zenefits which was doing some really interesting and exciting things in the payroll, hr and benefits software space, and I learned so much there about technology, about building a company, about building a team and about benefits, and I really was taken with the magnitude of the need and the positive impact that great benefits can have on people and, conversely, how challenging a bad benefits experience can make your life and the times when you need it the most, and that's been my journey to benefits and it's really taken me fully in.
David Saltzman:So talk a little bit about Noyo and the problem that you guys are working on.
Shannon Goggin:Noyo is working on the problem of data in benefits and, more specifically, what I mean by that is when you are trying to use your benefits. If you're a person who gets insurance or 401k or anything else in part of your benefits package, you need to use it when something is going on that's relevant to that and it's very confusing. It's very expensive. It's very complicated for people Like you and me and anyone else who's listening to this, even though we're all relative experts in benefits, it's still complicated to understand our benefits, and what Noyo is doing is working on the underlying problem of can we get the right information in the right place at the right time so that people can have a better benefits experience?
Shannon Goggin:And we don't do that by building apps for members or for employers or for brokers. We do it by building the plumbing under the hood that lets all of these different systems that have some record of you or your benefits or your coverage whether that's an insurance company or a payroll company, or an HR, a bed admin company or anything else we make it really easy for them to talk to each other, to share data securely and to have the right information in the right place at the right time.
David Saltzman:I mean, I was running a TPA when HIPAA started and I remember thinking, gee, it would be really great if we could just easily exchange data and have a common platform. And that was I don't know how many years ago, but it hasn't happened yet. Tell me the major stumbling blocks that you guys are trying to smooth out.
Shannon Goggin:There are a few categories. One is there's a lot of different systems and there's meaningful work required for any two different systems to talk to each other. And I don't mean that to sound too techno-speak, but if you've got one insurance company and one payroll company and they're trying to send data to each other unless they already have established a shared format, a shared way to do that, it's going to take development work. It's going to take operational work. It's going to take a lot of brain power and effort to figure out how to do that in a way that doesn't require a bunch of people calling and emailing each other all day long. That's where technology can provide a ton of value and leverage, but it's hard to design and hard to build and you've got to get people adopting it.
Shannon Goggin:So one big challenge is just the sheer number of different systems. There are the sheer amount of information that's out there and to do that in a way that's hands-free, that's compliant, that's secure, because this information is sensitive and important there's a lot of that that's going on, I think. The other big category I would point to is there's been a lot of effort around developing standards. But standards take. You need everybody in the industry to agree to those standards, and so if you do it by one giant committee, that's a very slow way to get something done, and if you don't, then you risk having people not adopt the standard because it doesn't capture some sort of information that they need or something that works with their system, and so it's a very, very challenging thing to get everybody to do the same thing at the same time.
David Saltzman:You said that what you all are working on is kind of connecting the pipes, talk about, maybe, what the inflow pipes are and then where the outflow pipes go to. If we can continue using a plumbing metaphor, Sure, yeah.
Shannon Goggin:So we at our core, noyo, is building a product, a suite of solutions that any company that's trying to put a benefits experience into their software. They can come to Noyo and get what they need from us, and so I'll give you a couple of examples of what that might mean. That could mean a payroll company or a benefit administration company who sells or serves employers, helping their team understand what their benefits are and make their decisions to actually enroll. It could be a software company that's serving brokers, that's building tools specifically for a broker to understand who are your clients and what did they have and what do they need. It could be a personal finance app that you might use with your family to look at how much should I put in my savings this month versus my 401k, versus my whatever other financial mechanisms. You might want to understand what your deductible is on your medical plan or how much is in your HSA, and so all of those are examples of applications that need to know something about your benefits. That's to be able to give you the experience of trying to give you. What Noyo does for them is we build a really easy way for them to come to us and query split yuan information about your benefits to connect to your data and put that into their application. And then we also give them really easy tools where they can make changes to that and we will connect to a lot of different insurance companies to be able to actually process those changes.
Shannon Goggin:So to get even more granular, if an employer is using Ben Admin to manage their open enrollment this year and their broker or their benefits consultant is working with them to pick which plans they're going to offer and then they set that up in the Ben Admin system, when the employer goes into the Ben Admin and says you know, okay, everybody's ready for open enrollment and then all of the staff come in and they make their decisions for the upcoming year, usually what happens is the HR team at the company or the broker is going to go in at the end of that open enrollment window see what everybody decided for their benefits elections, and then they'll have to go process that with the insurance company.
Shannon Goggin:They'll email, they'll make calls, they'll check on. It takes a long time and a lot of man hours to do it and it's very inefficient and it's very easy to make mistakes in that process. With Noyo, that Ben Admin can just send that through our software. They just tell us who wanted to enroll and we go take that out across a bunch of different insurance companies and we actually get those people enrolled in insurance and then we're tracking their coverage throughout the year to make sure there's never any unexpected laps in their coverage or any changes that you know that didn't get picked up on and carried back through all those systems.
David Saltzman:Is that something that would typically, in your modeling, be a broker expense, or would it be an employer or a plan expense?
Shannon Goggin:This is such an interesting question. It really varies based on how all of these different companies have their arrangements. Sometimes employers are paying for people on their HR benefits administration team to be doing this. Sometimes the brokers are taking it on. Sometimes the general agency is taking it on. Sometimes the insurance company is reimbursing any or multiple of those groups for doing the work.
Shannon Goggin:It's a really big discussion topic right now, which is the value of having people properly enrolled in. Insurance serves everyone right. The insurance company needs to know who's enrolled so they can be charging billing correctly and getting their premiums paid, so that they can be responding to claims inquiries correctly and making sure that they're actually paying for coverage. The broker needs to have that correct so they can get paid their commission properly. And, of course, the most important thing, the member needs to know that's what's going on so they can actually use the doctor, and the employer is going to maybe be deducting money from their paycheck, and so if any one of those things goes wrong and falls out of sync, it's a huge headache that has a ton of ripple effects. As a result, everybody gets some of the value, and I think it's a big discussion topic right now of you know who should pay to solve the problem.
David Saltzman:Well, I mean, if I'm an advisor, time is my coin of the realm. It's the only thing that I really have to sell. If it's saving me time on the back end, I guess you could try to add that either to fixed expenses or have the employer pay for it, or you could just say this is a fraction of what an employee to do this would cost me, and so I'm going to shoulder the burden. Is your model currently a PMPM type model, or is it a flat fee? Or is it a database? How does that costing end up happening?
Shannon Goggin:So we have a pretty simple SAS model which means our clients license our software. So it could be the Ben Admin, the payroll company, the HR software company. They're licensing Noyo and they get access to our whole platform and suite of tools and solutions and that's a kind of a basic license and then they'll pay based on how much volume they're actually running through our pipes. They'll kind of the usage based. Part of it will come in based on volume. So it's really well aligned with the value that they're actually getting and operational efficiencies, but it and also additional features that they're able to offer to their customers.
Shannon Goggin:So, that's our, that's our typical model. It's a SAS license and it scales with how much you're actually using.
David Saltzman:So let's talk about savings. Do you have any stats or any studies that you've done to show financial efficacy on using this rather than not using it? I know, obviously, if somebody falls outside and inevitably you've been at this long enough the person who doesn't get their ID card is the spouse of the CEO of the company, who is sitting at a pharmacy trying to get a prescription the day after the plan goes live. Those things are nightmares. But in terms of overall cost savings and efficiency, do you have any data that you can share?
Shannon Goggin:Oh yeah, we've done a bunch of work on this and there's also some interesting studies from other companies and other industry groups that will be interesting here. So a couple things I'll point to. One is the concept of premium leakage. This is how much the insurance companies should be collecting for the insurance that they've sold, and how much are they actually collecting? And there's a certain assumed we'll be off by plus or minus X percent and that is okay. Most industries. You can get it to the penny right what I sold and what I billed, those should match, and it should be pretty easy to figure it out In insurance. Very, very regularly people will say plus or minus 10% is what we expect. But that's a humongous variance. And so there's a one element here is just making sure that that stuff is neat and tidy means you might actually have you might be missing out today on a lot of revenue that you should be collecting that you're not. Another example would be on the number of mistakes that we catch.
Shannon Goggin:So one thing our software does that nobody else does is we're checking that the changes that are meant to be taking place on someone's coverage are actually taking place. So give you an example is if you move and you change your address, no one's gonna get that request, say, hey, please change the address for David, push it across these four systems, make sure it's updated. Very simple example we're actually gonna go and look into those carrier systems and we can see exactly when that address changes or doesn't change, which is what we call our ground confirmation. So any change that someone asks us to make whether it's enroll my new kid in coverage, I'm a new hire, please sign me up for the gold plan or anything else Noyo is putting a little tracer on it and every single day until the day that coverage actually takes effect, we are looking to see what's going on. We've done studies on this in a bunch of different ways and a bunch of different cuts.
Shannon Goggin:7% of the time when we do what we call a ground confirmation check, we'll notice that something is different from what we had asked for. That could be your name is misspelled. It could be that you got the silver plan instead of the gold plan. It could be that you asked for coverage for four dependents and you only got three. There's different levels of severity. Not all of them are coverage impacting. Could be that the start date that you asked for or the effective date that you asked for is different. But 7% of the time there's something going different than expected. And when no one is checking, these things compound and you only find out what went wrong or what was different.
Shannon Goggin:When the person typically goes to the doctor, goes to the point of care, gets a bill in the mail, call hey, this doesn't look right.
Shannon Goggin:It makes a call and has you've got a whole problem and a whole bunch of you are trying to trace it down. So that's a massive, massive area of kind of keeping things up to date and up to clean up top. That saves a ton of costs downstream. And then, more specifically, to answer your kind of operational efficiency, we do case studies with all of our customers and we publish some of those. We've had customers tell us 50% less operational touch on any business that's running through Noyo, and so it becomes a no brainer for them to move more volume through Noyo because not only are we putting the information in their systems hands-free as much as possible, we're also stopping bad data from even getting to them. And then, when there is something that needs a person's attention, we're making it a lot easier for them to understand what's going on because we provide a lot of auditability and traceability on. Well, where did this person's coverage go? It's sort of like the you know the Domino's Pizza Tracker of where's my coverage, and those things make a huge impact on our customers.
David Saltzman:One of the things that's traditionally been a problem for all constituencies is that, bless their hearts, employers don't make decisions on what plan they want for renewal until a few days before open enrollment, and then, if it's a new carrier, it's wonderful to do the enrollment. Most Benadmin systems can accommodate something even in that short turnaround time, but getting the data connections back and forth to the carrier can sometimes take 30 or 45 or 60 days, especially if it's a new carrier. After that, are you working on resolving that issue as well?
Shannon Goggin:Yes, that is a huge pain point and we've actually been able to with some of the carriers in our network. We can get that. You know the functionally like oh, I want to connect an employer onto the connection and EDI parlance that would be, I want to set up a feed right. And that can take, to your point, six weeks, eight weeks during busy season or, if something is extra complicated, it can take longer. Now you're the quarter of the way through your plan year and everyone's still doing it on paper. It's just, it's not great.
Shannon Goggin:And so you know what NOYO does. When we add a carrier to our network, we do a massive battery of testing with them at the very beginning to look at every scenario that's coming through, and we'll do testing with them to make sure that everything is coming through as correct, as expected. And what that means is when we're turning on groups, we actually don't have to go through as much of that group level testing. First of all, it's automated software and second, we've done it all up front and so we can actually turn on groups for many carriers in one day, less than a day, two days, and it's really mostly about hey, let's get this group authorized and then we're connecting them and then we're ready to go and start using it.
David Saltzman:Yeah, it's a huge, huge problem. We've got a couple of minutes left. One of the things that we're asking more these days, for obvious reasons, is how is AI affecting your business today and how do you think it might affect it going forward?
Shannon Goggin:There's so much potential. It's a really exciting time to see these big shifts in technology. I think one of the places that AI can make a big difference across industries and talk about how it applies to benefits is making things more human, understandable, connecting the dots across lots of different things so that you don't have to go and read 15 different you know research papers or documents and figure out what the answer is. But you can actually run that stuff through some of these models and it will summarize for you and synthesize for you. You can make huge improvements to the consumer experience with benefits. Think about you've got a medical plan with an 80 page summary of what it covers and you just wanna know hey, can I get any fertility treatment on this plan? You know what kind of mental health support do I get? And you can power a lot of really, really great simple human interactions to help people understand and engage their own benefits, which is something that I'm particularly focused on in solving it. So that's one that I think is really exciting.
David Saltzman:I think that's it's gonna be a game changer, especially with the rate of healthcare literacy. In Kaiser does these studies, I don't remember. It's every year or every other year and the numbers haven't changed in 15 years. Only 15% of folks can tell you what a deductible is, and some of it is that we have the perception that it's more confusing than it is, and some of it is just that it's confusing. How cool would it be to have an interface like an Amazon or a Siri or whatever you would call it the new thing and say, hey, I got a question about my benefits, blah, blah, blah, and you get the actual, right answer back and you do that in 10, 12 seconds rather than having, as you say, to call your broker or to call the carrier, to sit on hold and to get a customer service rep who started the day before yesterday, who doesn't know their butt, from a hole in the ground, et cetera. So I think it's gonna be huge and I can certainly see applications in what you're doing.
Shannon Goggin:Absolutely, and one of the things that technology is so good for is and we do this in increasingly sophisticated ways. Ai is a great example of a very sophisticated way of doing it. It's to let people use their brain to make decisions with the right information, rather than using their brain to try to figure out what the information actually is, and that is something that I get really excited and passionate about, whether it's talking about the situation you just described, which is, hey, I'm just trying to make a decision about my healthcare for my family. Help me make the decision by showing me what's going on. Showing me the picture Broker might be doing the same thing.
Shannon Goggin:I'm trying to advise my clients on what is the best path for them, and I know what they've told me, and I need to make some decisions. I need to get a bunch of information to synthesize and then make those recommendations for them, whether it's people inside a company, similar to trying to make decisions about, hey, where should we focus our effort? To. You know, make the get the biggest impact out of our time. It's just really. It's really exciting to be able to supercharge people and really put their brains on the stuff that matters the most.
David Saltzman:Absolutely, and we hope you'll come back as things evolve. Shannon Goggan, co-founder and CEO at Noy O'Shanan. Thanks for sharing your thoughts with us today.
Shannon Goggin:Thank you so much, david, it's a pleasure.
Host:The Shift Shapers podcast is a production of Shift Shapers LLC. The content and images of this podcast may not be used without our express written permission. Copyright 2023, All rights reserved.