Therese McCoy, MS, CEBS®, CSFS®

The Gap Between Benefits and Business

Early in my career, I thought benefits was a coverage business. Thirteen years in, I know it’s a financial one, and that gap is exactly why so many employers overpay for a decade before anyone tells them the truth.

I’ve now seen this problem from every side of the table, and that vantage point is my entire story.

I spent seven years consulting at a large national brokerage firm, where I earned my CEBS and served on the Houston CEBS Board of Directors, learning benefits the way a financial advisor learns a portfolio—as a set of levers, not a set of plans.

From there, I moved inside a major health system, Kelsey-Seybold, where I saw how care is actually delivered and paid for. I watched the incentives change almost overnight after Optum acquired Kelsey-Seybold. Decisions increasingly reflected the priorities of a vertically integrated healthcare giant rather than an independent physician group.

Then I moved to ParetoHealth, on the captive side, where the economics of pooled risk came into focus.

Today, I’m back to consulting at Hotchkiss, helping employers move from fully insured plans into self-funded, captive, and alternative arrangements.

That path matters because most people selling to CFOs have only ever stood in one place. I’ve stood in most of them.

And here’s what standing in all of them taught me.

Lesson One: CFOs Aren’t Skeptical of You. They’re Skeptical of a Category That Has Earned Their Skepticism.

When a CFO pushes back, brokers hear rejection.

I hear pattern recognition.

This is a buyer who has been sold “savings” every renewal season for fifteen years and watched costs climb anyway. The skepticism isn’t an objection to overcome; it’s actually the most rational response in the room.

The moment I stopped treating it as resistance and started treating it as evidence that the buyer was paying attention, my conversations changed.

Lesson Two: You Cannot Sell Financial Risk With Insurance Language.

Fully insured renewals are a black box, and the industry likes it that way.

When I sit with a CFO, I don’t talk about plan design. I talk about retained margin, IBNR, fixed versus variable costs, and where their premium dollar actually goes.

CFOs don’t need to be sold on self-funding. They need to be shown the economics in the language they already think in... and then they sell themselves.

Lesson Three: The Health-System Years Were the Ones That Made Me Credible.

Anyone can quote a spread. Very few people selling funding strategies have watched a claim move through a health system from the delivery side.

When I explain why cost variation exists, why network arrangements are structured the way they are, and where the real waste lives, I’m not reciting a carrier deck. I’m describing something I watched happen.

CFOs can tell the difference between someone who read the material and someone who lived it.

Lesson Four: Trust Is the Product. The Funding Strategy Is Just the Delivery Mechanism.

I move employers into arrangements that can carry more visible risk than what they had before.

No CFO signs up for that based on the strength of a pitch alone. They sign up because they believe the person across the table will still be there when the first bad claims month hits—and that person will have told them the hard truth before it did.

Everything in this business compounds on that one thing.

Here’s what I’d tell any woman building a career selling something complex to skeptical, sophisticated buyers:

Your credibility is not your pitch.

It’s the sum of every seat you’ve sat in and every uncomfortable truth you were willing to say out loud.

I didn’t win CFOs by getting better at closing. I won them by having genuinely stood where they stand and refusing to pretend the easy answer was the right one.

The employers still overpaying aren’t doing it because the better model is hidden. They’re doing it because no one they trusted enough has walked them through it yet.

That’s the job.

That’s the whole job.