BPM’s Top Consultants weigh in on clients, claims and complexity

The life of a benefits consultant is no easy feat as benefits consulting demands range.

After all, a single advisor – or consultant - may design a plan that serves a Gen Z hire in their first week and a baby boomer heading into retirement in the same breath. Between renewals, compliance obligations, claims data and a shifting external landscape, the job requires consultants to read the environment, dig into the numbers and turn both into strategies that work in practice for members at every stage of their working lives.

Clients’ best interests remain at heart for consultants

Candace Dodson was recently recognized as a BPM Top Consultant. The benefits broker and insurance advisor at CDW Benefits was quick to emphasize how fiduciary duty is at the heart of it all.

"I truly believe that you need to always put the client first," she said in a statement. “Our role is to educate, service and manage benefit plans for employers, and a lot of times the employers don’t have time to know everything there is to know about their plan, especially in the smaller market and employers who don’t have HR departments or specialists on staff. As a consultant we need to ensure the employer is aware of the liabilities, how important the benefits plan is, how the renewals work and how premiums should be deducted or paid.”

Yafa Sakkejha, who’s president and CEO at Beneplan, agrees.

“I don't think I'm a top consultant. I always think we have to be doing better and by doing it better, we have to stop over complicating and over intellectualizing things," she said, noting how Beneplan recently launched a service called Benefits Coaching, inspired by US enrollment firms that sit with every employee one-on-one to walk them through their plan.

Sakkejha noted how her team sees thousands of enrollment forms a year, and a large number contain errors because employees don't have the time or knowledge to navigate industry jargon - terms like dependent, beneficiary and coordination of benefits.

“There's no magic to being a top consultant. Our job is to just get people's claims paid as soon as possible and at the lowest cost possible," she added.

Sam Beales, president of Benefluent Advisory Inc., believes his recognition as a Top Consultant is due to how the firm runs a boutique model built around senior-level expertise, rigorous market reviews and what Beales describes as fiduciary-style thinking around group benefits and retirement plans.

Rather than managing plans on a year-over-year renewal cycle, his team pushes employers toward multi-year strategies and is willing to challenge legacy plan designs and vendor relationships that no longer serve the organization.

For Dodson, her approach comes down to education and understanding that no two clients have the same needs. Her time working at Manulife showed her how many brokers default to sending identical specs and plan designs for every group, regardless of size or budget and skipping the work of investigating what the employer wants. She said that habit is especially damaging for small groups of two or three lives, where there’s no HR department to fill the gaps.

"One of the biggest things that I do that other advisors don't do is really customize and find out the needs and the budget for every single client. I don't do cookie cutter plans," she said.

Joseph Chan, founder and Chief Loonie of Looniewell, one of last year’s top consultants, acknowledged his experience as a former plan sponsor has given him a clear view of what plan sponsors need from their advisors. The role demands versatility, he said, and consultants who fall short are the ones who stop advocating for the client. His firm operates on the principle that the client's interests come before the advisor's.

"We manage the benefit plan, retirement plan or whatever the financial implications would be as if it's our own money," he said.

Top consultants’ work demands versatility and long-term approach

When it comes to being versatile, Benefluent treats affordability and competitiveness as a design challenge rather than a trade-off, Beales explained. The goal is to shift spending away from low-value or invisible plan elements and into benefits that employees notice and use, whether that means modernizing mental health and virtual care offerings, strengthening group retirement and savings programs, or right-sizing legacy coverages where utilization has dropped.

"If leadership can't explain their benefits and savings strategy in two or three sentences, our work is not finished," he said in a statement, adding his firm opens every engagement the same way. "What business problem are you actually trying to solve?"

According to Dodson, benefit plans have shifted to a hiring and retention necessity and a comprehensive plan where the employer covers most of the premiums signals something about the organization. But she stressed that the investment is wasted if employees don't understand what they have or how to access it, particularly as how employees value the plan depends on education, not just plan design.

Still, she noted that employees today have a sharper awareness of their coverage needs, particularly those managing health conditions or supporting a family, and that benefits have become part of how people think about their financial planning.

“The cost of offering a benefits plan can be expensive for an employer; however, I am seeing more employers looking to add to their coverage especially in the mental health category, adding a HCSA, or a group RRSP,” said Dodson in a statement. “As much as everyone’s talking about employers having to reduce benefits to control costs, or increasing the employees share of the premiums, I am not experiencing this.”

When do consultants redesign plans?

According to Beales, Benefluent has spent recent months overhauling health and wealth programs for mid-market employers whose needs have outgrown standard off-the-shelf solutions. That often has meant redesigning traditional plan structures to match how members actually use their drug, extended health, mental health and paramedical benefits, then moving fast on implementation to capture savings where plans had been running inefficiently.

John Glynn takes a similar approach, noting how symptoms and root causes in group benefits can vary drastically.

“I focus first on diagnosing what's driving the problem, whether it's cost structure, utilization, plan design, or employee behaviour," said Glynn, president at Ascent Insurance Services Inc. in a statement. “From there, I prioritize practical solutions that balance financial sustainability with employee experience, and I stay closely involved through implementation to make sure the solution actually works in practice.”

Looking ahead, Beales’ team is building out analytics and benchmarking tools aimed at giving mid-sized plan sponsors access to the kind of data insights that have historically been reserved for the largest plans.

"A mid-sized firm with a sharp, modern benefits and savings narrative can compete very effectively with large and enterprise organizations whose programs are less targeted," he said in a statement.

Meanwhile, Glynn’s recent work has centered on helping clients manage long-term benefits costs and improve plan sustainability through more proactive design reviews and deeper analysis of claims trends, particularly as employers deal with inflationary pressure across their programs.

Moving forward, his priority is moving clients away from reactive plan management and toward a more strategic, forward-looking approach to how they design and fund their benefits.

But if there’s anything that Dodson's years in the industry have taught her, it’s that predicted trends don't always materialize, and that’s why she doesn’t advise employers to make any sudden moves.

"Acting or doing any knee jerk reactions is not required at this time," she said in a statement. “If any rules or bill changes happen in regard to benefits, we get on it right away to ensure our clients are still onside with their private benefit plan.”